For Wine Lovers

I saw a post recently by someone who mentioned that the drug Ativan
prevented episodes of Afib even with moderate alcohol. Being a wine
lover who experiences wine as a frequent trigger, I thought I would
give it a try. On three separate occasions, one and one half mg. of Ativan one hour before dinner and I was able, for the first time months,
to enjoy a great meal with moderate amounts of wine (about two glasses)
Over the weekend, I put it to the test. I am a vagal afibber who oftentimes can sense the onset of an episode after vigourous exercise.
This past Saturday, I went for a long run and sure enough, after about
an hour rest, that pre-Afib feeling hit me hard. This does not happen
all the time but when it does, an episode is almost guaranteed. I can
say, without equivocation that the smallest amount of wine under this condition will trigger an episode immediately. Upon feeling that
pre-Afib activity, I took three small tablets. It completely eliminated
that pre-fib feeling within an hour and I had a half bottle of wine without any problems at dinner. As a bonus, I had a great night sleep and I haven't felt this good in months. In fact, on each occasion after taking the Ativan, I felt great the next day. I usually experience what I would call aberrant electrical activity (though not PAC's) even when in NSR.
The day after I take Ativan, this activity doesn't occur.

It certainly is not wise to routinely take such a drug, but it's nice to know that once in a while I can enjoy something that I loved before coming down with this condition. It is also something I can use to prevent episodes even if alcohol is not involved.

<Upon feeling that
pre-Afib activity, I took three small tablets. It completely eliminated
that pre-fib feeling within an hour and I had a half bottle of wine ....>


Susan... this IS interesting. I, too, have AFib or AFlutter following exercise, but not always. Odd, eh. And, I don't think that wine triggers my episodes... I have a couple glasses of white or red nightly.

But, exercise does ....sometimes..., often.... triggers an AF attack.

I'm interested in the AMOUNT of Ativan you took. When you stated that you took "three small tablets", what mg was that total or per each tab?

Thanx in advance, keep runnin' and only drink fine wines. Steve

Steve,

I have one half mg. tablets. I tried one half at a time until I found
the dosage that prevents the Afib. The problem with the dosage
is that it is too much to take with any frequency. Ativan is a tranquilizer
which if taken daily over a period of many months can be addictive.
I figure that once a week can't be too bad.

Susan

I was about to post the question "Results from Ativan". In session 12 of the conference room the subject was raised as to the effect of Ativan (Lorezepam ) to lessen the effects of moderate alcohol consumption, is there a result from this. Does it work for other people?? I am more than prepared to give it a try.
Little old real ale drinker me.

Chris H

I was the one who originally posted the message. It works
beautifully for me. It can't hurt as long as you don't abuse it.

This is an interesting discussion, but the advice here should be taken with a great deal of caution.

A web search on "alcohol and ativan" will bring up some articles on these drugs and their effects on neurotransmitters.

Combining two CNS depressant drugs (alcohol and a benzodiazepam, which ativan is) is a classical problem in drug literature.

Those taking these drugs in combination should at least check out the PDR or the NIAAD site at the National Institutes of Health (www.niaad.nih). If you tell your doctor about this kind of drug use, or your therapist (psychiatrist, psychologist or social worker), they will want to have a very serious chat with you. Self-medicating with alcohol for emotional problems like anxiety or depression can lead to making the problems worse in the long-term.

Defining "moderate" alcohol intake is problematic, because people vary in size, health and genetic characteristics. Women especially need to be careful because of lower body mass and a substantially-reduced metabolic capacity, in normal women as compared to men, to break alcohol down in the body.

The NIAAD site suggests moderate drinking is one glass (5 oz) of wine for a woman and two glasses of wine for a man, per day.

The reason that ativan works is that it works on the GABA receptor. GABA is the inhibitory neurotransmitter of glutamate - of which so much has been written about on this forum. Free glutamate is a known trigger for AF. Free glutamate is found in all commercial food and even in supplements. When one takes a benzodiazapam drug it mimics GABA - and you have the answer to why it works.

Fran

PS long term use of these drugs - not even to addiciton - will deplete natural GABA and arrhythmia problems will increase....

Only once in a while....


Fran

I ditto what Michael and Fran said. But one added comment, is that in order for glutamate to break down to GABA, one must be supplying enough B vitamins, esp. B6, and magnesium and avoiding the various forms of MSG in its hidden guises, resulting in more glutamate to GABA ratio.

Richard

Fran and Richard--

Thanks for clearing this up.

What you suggest is that those afibbers who insist on drinking alcohol except in the most moderate amount might take GABA supplements rather than using ativan.

I just talked to a therapist friend about this issue and she assured me that ativan plus alcohol use, in any quantity with any repeated use, is a recipe for disaster.

As an aside, I have been reading Fran's posts regarding glutamate for many months, but only in recent days realized that three of my four major episodes of afib occurred after eating in restaurants.

Michael,

Ativan is somehow boosting the GABA receptors, by way of the benzodiazepam. Common sense tells me that if there is an overexcitation by too much glutamate and there isn't enough GABA produced to counteract this imbalance, especially if there aren't enough nutrients, then either extra GABA or the vitamin cofactors for this process would possibly help. PC did try upping his dose of P5P (conenzymated B6) and magnesium and he didn't show positive end results, but perhaps more B6 was needed. I have been prescribed 270mg per day, of a combo of both.

If you read my thoughts in the conf. room on glutamate, glycine, and cysteine (sulfur containing amino), along with a link, the addition of N-acetyl-cysteine, could definitely help, as well.

You know, Michael, this is all pretty much a guessing game, but sometimes the studies will reveal themselves, or we just have to rely on our own ingenuity. I find it interesting that 3 of your 4 episodes occurred after dining out. Can you think of anything that was unusual about the lone episode?

Thanks Michael,

Richard

Richard--

The glutamate connection is fascinating, now that I have made the link regarding my own dietary habits.

I have been rethinking my last episode, which was the only one which was not preceded by a restaurant meal. It happened last New Year's day very early after I had given a dinner party for several friends. I drank some wine during the meal, perhaps two glasses. I know there is some glutamate in wine and that a glutamate compound is used as a spray on grapes. I think there was salami served for antipasto--that would contain glutamate. I cooked a pasta dish for the main course. The ravioli were made locally but probably contained some "flavor enhancer." The sauce I made was my grandmother's recipe containing anchovies, full of glutamate. On the pasta I grated Parmigiana Reggiano, which is very high in glutamate.

Holmes, I think the evidence is very strong (yes, Watson, you reply).

I also recall that two years ago I was in Italy visiting my cousins for a couple of weeks and drinking more alcohol (which is a trigger) than usual. It is hard to resist one's cousins' constant filling of one's glass. I was surprised to find that I had no intimations of afib, which I ordinarily would expect with frequent alcohol intake. It may well have been that the Piemontese food which I was eating, in both restaurants and in my cousins' homes, which is not very highly processed, and which is largely fresh and locally-produced, was, unlike American food, relatively low in glutamate.

Another association, which just occurred to me. There must be a strong connection between alcohol and glutamate excitability. I know that many times when I have even one glass of wine with dinner at a restaurant, I cannot sleep well all night afterward because I am overstimulated and I cannot quiet my mind down.

A final association: for several years I took an SSRI at a very low dose for anxiety. SSRIs increase serotonin in the synapses. During the SSRI period, I had no problems with afib. Alcohol reduces serotonin in the synapses, so I think there is very likely a connection between low serotonin, high dopamine and susceptibility to afib.

I am wondering whether anyone else here who might be taking an SSRI has notice a connection with afib.

It has been a good day's work. Goodnight, Holmes.

"What you suggest is that those afibbers who insist on drinking alcohol except in the most moderate amount might take GABA supplements rather than using ativan. "

Absolutely not. I only meant to say why it worked, not to recommend it as an antidote.

I personally avoid free glutamate and alcohol at all costs. Even though I have wondered if I could get away with wine or beer made with no additives. I know that sulphites are added to most wines and that sulphite has the same or similar side effects to free glutamate. Someone once recommended Becks beer (I used to drink this a while back) as it has no additives - but I just don't want to rock the boat.

I think it is really exciting that so many people are now making the connection between AF and free glutamate. As it worked so well for me I am convinced that it will do the same for others.

Fran

Fran--

I have you to thank for being persistent in your presentation of the problems of glutamate. Thank you very much indeed.

One of the main reasons for my relative disinterest in topics beyond magnesium supplementation and the like is that I have been afib-free by simply supplementing my diet with vitamins, minerals and the occasional amino acid. I have been very careful regarding alcohol consumption. This has paid off very well.

But I have had questions remaining regarding peri-afib experiences such as days when I noticed PACs or the occasional night when I could not sleep because unusually stimulated or experiencing a spell of tachycardia.

The glutamate theory covers the epi- or peri-afib experiences. I will pursue this topic further by carefully monitoring my diet, whether at home or in a restaurant. Already I am reading the labels of any packaged or processed foods which catch my eye to look for those little phrases such as "vegetable broth added," "natural flavoring" or just plain "MSG." Yep, it's everywhere.

I don't know whether I read it here or elsewhere, but glutamate sensitivity seems also to link to fragrance sensitivity. For many years I have avoided products such as laundry detergents which contain very potent and irritating "fragrance" chemicals. Now I have an explanation for this, also.

My hat is off to you, Fran. And to Richard.

but glutamate sensitivity seems also to link to fragrance sensitivity.

I have this too. Free glutamate is present in many soaps, shampoos, antipersperants and would you believe it toothpaste too!! I can't wear perfume either, but for special occasions I have found that a wee dab of ylang ylang essential oil is lovely - and no-one else wears it!!

I now only use baking soda to wash my teeth and buy hand made soaps and bars of shampoo made with organic essential oils and herbs and spices. They also do lovley bars of antipersperants too made with baking sodas and oils. They really work - but not as long as the 24 hour intensives. My husband always used to have sneezing fits after having a bath or shower. Now we all use these products he no longer sneezes.

There is something really decadent about washing with 'food'. I think it must be nourishing too through the pores...

Fran