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Fluoxetine and prolonged QT

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Hello, I have a question regarding a medication that I have been taking for two years. So, I recently got a refill of the only medication that I take, fluoxetine 40 mg. I saw that there was a warning that I hadn't noticed before on the usual papers they give you regarding side effects etc. It was that prozac can interfere with the heart's electrical system, leading to a prolonged QT. Now, I take prozac for anxiety/panic disorder and a huge worry of mine is anything heart related. So this obviously freaked me out and I did a ton of internet research, which I probably shouldn't have because it only worried me more. So I guess my question is, how worried should I be about this prolonged QT occurring? I have not noticed any symptoms of it in the past. I do sometimes get palpitations, sometimes in succession, but I had always assumed that they were due to my anxiety. Some additional information about me: I am a 29 year old female, I took fluoxetine 20mg from the age of 9 to 15 as a child, with no adverse reactions. Additionally, I took venlafaxine for 3 years with no serious side effects.

Category: Internal Medicine Specialist

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Category: HIV- AIDS Specialist
 18 Doctors Online

Hello,

Thank you for choosing DoctorSpring.

I understand your concern and I shall try my best to help you out here.

Your concern of Fluoxetine side effect - Prolonged QT is not without merit.

Fluoxetine (and as a matter of fact most of the drugs ) has a number of side effects. In the bigger picture these adverse reactions occur in a small percent of patients, and the medication is prescribed by assessing a risk benefit ration.

There are more than 100s drugs suspected to prolong QT and Fluoxetine is one among them. The important thing is that Fluoxetine causes prolonged QT in much less proportion when compared to other medications.

Now the question - whether you should be worried ? - NO I don't think so. First of this side effect is rare. Second you have taken the medication for long without any trouble. (The palpitation seems untreated - mostly anxiety related )

You should be really concerned only if you have an already existing heart condition, a history of sudden cardiac arrest in family, history of arrhythmia or an already prolonged ECG as baseline. This your Doctor would have already ruled out. If not it can be easily done in few minutes by taking an ECG.

Please discuss this option with your Doctor. As of now I do not think you need to be concerned with this particular side effect.

So bottom-line is Get an ECG done. If it is alright you can safely continue the medication.

Hope this helps
Feel free to ask followups / clarifications.
Thank you


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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