Antiarrhythmics and Neuro-Psychiatric Symptoms

Wow. I started long-acting Propafenone and am having some serious issues. When I took Flecainide, I had to stop taking it because I had some serious anxiety and agitation that accompanied it. They stopped when I stopped the Flecainide. I am on dose 3 of the Propafenone and am seriously in a bad state. I feel anxious, tearful, depressed, and kind of unstable, and it is a sudden onset, as of today. I will not be taking another dose tonight. Anyone else experience Neuro psychiatric symptoms with the cardiac meds? Yuk..... I'll take the arrhythmia over this...

I think you need a full workup to find out how your body processes drugs. That should give you some clues as to what drugs to avoid, how to dose the ones you can take, and so forth. It seems clear you're body doesn't process drugs like most people do.

Anyone else experience Neuro psychiatric symptoms with the cardiac meds?

Yes. For me it was the beta blockers. Both Metoprolol (and especially Propranalol) affected me as you describe and I would take afib over being on either of them! Fortunately, when I switched to the calcium channel blocker, Diltiazem, the side effects went away, although I had the least side effects with the fast acting Diltiazem tabs, versus the extended release capsules.

As to the anti-arrythmic's, never had any neuro psychiatric issues with Flecainide, as long as I took them with the fast acting Diltiazem tabs. We all react differently to these drugs and sometimes you just have to keep experimenting to find out what works best for you and what you can tolerate. That said, some of these drugs take a week or so to get used to, but if Propafenone affected you anything like Propranalol affected me, I don't blame you for stopping it right off!

Jim



Edited 1 time(s). Last edit at 06/07/2024 02:22PM by mjamesone.

Quote
MeganMN
Wow. I started long-acting Propafenone and am having some serious issues. When I took Flecainide, I had to stop taking it because I had some serious anxiety and agitation that accompanied it. They stopped when I stopped the Flecainide. I am on dose 3 of the Propafenone and am seriously in a bad state. I feel anxious, tearful, depressed, and kind of unstable, and it is a sudden onset, as of today. I will not be taking another dose tonight. Anyone else experience Neuro psychiatric symptoms with the cardiac meds? Yuk..... I'll take the arrhythmia over this...

I had really serious side effects from flecainide – Neuro symptoms resolved into complete heart block. But I was taking a higher dose, 150 mg b.i.d. Check your genetics as mine was related to being a poor metabolizer of CYP 2D6. It may be building up in your plasma. Luckily I had a pacemaker, but you don’t!

My CYP 2D6 was fine. What other testing is available, Carey? I got the genetics testing, but it was primarily geared towards other meds,.not cardiac.

I'm not really up on what testing is available, but it's certainly more than just CYP 2D6. The word you want to look for is pharmacogenomics. Quest Labs has a webinar and links to a couple of papers that might be helpful.

I had symptoms when starting Flecainide, but they went away after about 4-5 days. I noticed this after starting the Flec on 2-3 different occasions. It was kind of like a transient "roid rage", like when a guy has too much Testosterone. In other words, it made me temporarily much more intense and agitated than normal. I didn't have this issue though when just taking a single bolus "PIP" dose for conversion attempts.

thanks for the replies!! I kept taking it and the side effects lessened a bit to be more tolerable. The unfortunate news is that my heart rate is still cranking away in the 'too high' range and I am still experiencing the high e topic burden. So will have to try something else come Monday....wondering how long until/if I'm going to get tachy cardiomyopathy...four weeks now of this....