Does Lexapro cause heart palpitations? (+3 research studies discussed)
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In this article, we will discuss whether Lexapro (escitalopram) can cause heart palpitations. We will also discuss related research studies and what factors can influence your heart rate while taking Lexapro. We will also discuss what one should do if this side effect occurs.
Does Lexapro cause heart palpitations?
Lexapro can cause heart palpitations in some individuals. It is one of the known side effects of this antidepressant. Lexapro, also known as escitalopram, is a selective serotonin reuptake inhibitor (SSRI), which is one of the most commonly prescribed antidepressants (1).
It primarily treats depression, anxiety, and various other mental health-related symptoms (1). Lexapro is not generally considered cardiotoxic, but SSRIs, in general, are known for causing palpitations. Some drugs, including Lexapro, can also cause QT prolongation, arrhythmia, and chest pain in some cases (2).
However, these meds are typically considered safe to be prescribed to a cardiac patient battling anxiety or depression. It is important to note that people are different and can respond to meds like Lexapro differently.
Some may have various factors affecting their health which might make Lexapro not a good choice of antidepressant. If you are taking Lexapro and are experiencing heart palpitations, please reach out to your doctor and discuss this side effect.
What does research suggest?
Research studies have established a link between heart palpitations and SSRIs, including Lexapro. One research study indicated that escitalopram, the active drug in Lexapro, is not typically considered cardiotoxic, but the drug can cause statistically significant cardiac side effects in some people (3).
Another research study compared the effects of escitalopram and citalopram and concluded that escitalopram is generally associated with a lower risk of changes in heart rate compared to citalopram, which can cause more pronounced cardiac side effects when high doses are administered (4).
One research study focused on the effects of SSRIs on heart rate in general and showed that escitalopram may reduce heart rate in people who have depression comorbid with hypertension. However, the effects were varied among individuals (5).
SSRIs, in general, can be cardiotoxic in certain individuals, with some containing more risks than others. Escitalopram or Lexapro is generally considered a safer option, but again, it can vary depending on an individual’s physiology (6).
What factors can influence heart rate while taking Lexapro?
Several factors can influence heart rate while taking Lexapro, including:
- Age: Age plays a role in determining the baseline heart rate. Older individuals may experience more pronounced changes in heart rate or palpitation while taking Lexapro as compared to young individuals.
- Dosage: The dosage of Lexapro can also affect its impact on heart rate. Higher doses usually cause more prominent effects.
- Underlying health conditions: Pre-existing health conditions can contribute to heart palpitations while taking Lexapro – for example, individuals with hypertension, angina or other cardiac conditions.
- Concomitant use of other meds: The interaction between Lexapro and other medications can affect heart rate and cause palpitations. It’s important to make sure that you are not taking any such drug with Lexapro that is not compatible with it.
- Worsening stress or anxiety: Lexapro is often prescribed for anxiety disorders. Changes in stress levels or increased anxiety can also trigger palpitations, as these conditions are well known for this symptom. It is important to ensure that Lexapro is managing your anxiety effectively.
- Genetics: Genetic factors can affect how individuals metabolise and respond to medications. Some people may naturally be more susceptible to Lexapro-induced heart palpitations, as compared to others.
What to do if Lexapro is causing heart palpitations?
If Lexapro is causing palpitations or affecting your heart rate, please reach out to your healthcare provider. It is important to check whether Lexapro is affecting your cardiac functions, as this antidepressant may trigger such symptoms in rare cases.
Your doctor may also rule out other factors to make sure if this is directly linked to your antidepressant or if there is any other causative factor.
If Lexapro is not the primary cause of your palpitations, your doctor will adjust your treatment plan and may add more medications to manage your heart rate or eliminate the root cause of your palpitations.
If Lexapro is the cause of your palpitations, your doctor will determine whether the future use of Lexapro is safe for you. Some people may experience palpitations either after dose escalation or if they’re new to Lexapro or antidepressants in general.
In such cases, dose reduction is of great importance and can help your body adjust to the antidepressant more safely, whether you’re new to it or your dose has recently increased. Such cases of heart palpitations tend to get better with time.
If this doesn’t help your body adjust, your doctor may consider alternative treatment options and may change your antidepressant. However, it is important to note that Lexapro should never be stopped abruptly.
If your doctor believes that Lexapro is not the right choice of antidepressant for you, they will safely taper it off and switch you to another appropriate medication. Make sure you do not make any changes to your treatment plan on your own.
What are the alternatives to Lexapro if it causes heart palpitations?
If Lexapro causes heart palpitations, your doctor may switch you to another SSRI, such as sertraline, which is most commonly prescribed to people with cardiac diseases (6).
If you have a healthy heart but still experience unbearable palpitations on Lexapro, another SSRI like sertraline or fluoxetine might be a good option. However, other SSRIs may also cause palpitations.
It is not that common for all SSRIs to affect an individual’s heart rate, but people are different and can respond to antidepressants differently. If SSRIs are not suitable, atypical antidepressants like Mirtazapine can be used.
It is important to note that almost every antidepressant is associated with some side effects, but they do begin to subside as your body adjusts to the medication.
As a pharmacist, I have come across people who experienced heart palpitations as an early side effect of Lexapro but they did get better with time. So, your doctor may reduce your dose and keep you on Lexapro if it works well for you.
Remember, antidepressant discontinuation is not something you should ever decide on your own. Just trust your doctor’s expertise and keep consulting them in case you have any concerns. Do not try to make changes to your prescription on your own.
References
- Landy K, Rosani A, Estevez R. Escitalopram. [Updated 2023 Nov 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557734/
- Highlights of Prescribing Information. Lexapro® (escitalopram oxalate) Tablets. Lexapro® (escitalopram oxalate) Oral Solution. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021323s047lbl.pdf
- Thase ME, Larsen KG, Reines E, Kennedy SH. The cardiovascular safety profile of escitalopram. Eur Neuropsychopharmacol. 2013 Nov;23(11):1391-400. doi: 10.1016/j.euroneuro.2013.05.011. Epub 2013 Aug 6. PMID: 23928296. https://pubmed.ncbi.nlm.nih.gov/23928296/
- Qirjazi E, McArthur E, Nash DM, Dixon SN, Weir MA, Vasudev A, Jandoc R, Gula LJ, Oliver MJ, Wald R, Garg AX. Risk of Ventricular Arrhythmia with Citalopram and Escitalopram: A Population-Based Study. PLoS One. 2016 Aug 11;11(8):e0160768. doi: 10.1371/journal.pone.0160768. PMID: 27513855; PMCID: PMC4981428. https://pubmed.ncbi.nlm.nih.gov/27513855/
- Peixoto MF, Cesaretti M, Hood SD, Tavares A. Effects of SSRI medication on heart rate and blood pressure in individuals with hypertension and depression. Clin Exp Hypertens. 2019;41(5):428-433. doi: 10.1080/10641963.2018.1501058. Epub 2018 Jul 26. PMID: 30047786. https://pubmed.ncbi.nlm.nih.gov/30047786/
- Yekehtaz H, Farokhnia M, Akhondzadeh S. Cardiovascular considerations in antidepressant therapy: an evidence-based review. J Tehran Heart Cent. 2013 Oct 28;8(4):169-76. PMID: 26005484; PMCID: PMC4434967. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4434967/