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Fluoxetine 40 and QT interval high
I have been prescribed Fluoxetine 40 in the morning and Mirtaz 15 at night for my Anxiety disorder and Hupocondriasis. Does fluoxeting increases QT intervals in ECH and is ut safe to take it. And with Mirtazapine it will not cause Serotonin Syndrome??
I have been taking Escitaloporam 10, for 10 years Vilazodone 40 for 3 yrs, Desvenlafaxine, Vortioxetine, Sertraline for 1 month each but it causes a lot of constipation so my doctor discontinued it. And told me to take fluoxetine 40 and Mirtaz 15 at night, as I hv sleep issues at night as well. Please advise.
Answers (5)
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Do not worry, fluoxetine and Mirtazapine will not cause these side effects, cardiac & serotonin syndrome
Continue follow up visits with your doctor,
Baseline assessment for weight, ht, RBS, lipid profile, BP monitoring
If there is history of cardiac issues in a patient, medications are prescribed as per symptoms profile & all other parameters that we discussed investigations
Do not worry, trust your doctor, continue the medications and maintain follow up visits
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Hi.. risk is low with the above doses. Consult online for further doubts
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Dr. K L Tejaswini
Neuropsychiatrist
7 yrs exp
Guntur
Hii..
Side effects like serotonin syndrome are very rare with the above mentioned dosage..
Cardiac side-effects also are mostly dose dependent and may occur after chronic use..
Consult online for further queries and treatment
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Dr. Pavitra Shankar
Psychiatrist
5 yrs exp
New Delhi
Advice
Fluoxetine (40 mg) and Mirtazapine (15 mg) is a commonly used combination for anxiety disorders with sleep disturbance. Fluoxetine can, in rare cases, cause QT interval prolongation on ECG, but at usual doses and in patients without heart disease or electrolyte imbalance, the risk is low. Routine ECG monitoring is only needed if you have pre-existing heart conditions, family history of arrhythmia, or are on other QT-prolonging drugs.
Next Steps
Next steps
• Fluoxetine + Mirtazapine is considered safe and does not usually cause serotonin syndrome, because Mirtazapine works differently (noradrenergic and specific serotonergic action, not strong serotonin reuptake inhibition).
• Since you have tried several SSRIs/SNRIs before, your psychiatrist’s choice here is reasonable, as this combination often improves both anxiety and sleep.
• Do discuss with your doctor if you have any cardiac history, unexplained fainting, or palpitations — an ECG check may be useful for reassurance.
Health Tips
Caution / Helpful tips
• Take medicines only as prescribed, and do not stop suddenly.
• Avoid alcohol and unnecessary over-the-counter medicines, as some may interact.
• Report promptly if you develop persistent palpitations, dizziness, severe restlessness, or tremors.
• Along with medicines, therapy and relaxation practices (CBT, mindfulness, yoga, exercise) are equally important in anxiety and health anxiety (hypochondriasis).
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.