Does Pristiq increase heart rate? (+3 findings)

In this article, we will discuss whether or not Pristiq increases heart rate, clinical studies and research on Pristiq and heart rate, factors that can contribute to increased heart rate while taking Pristiq, and what you should do if Pristiq increases your heart rate.

Does Pristiq increase heart rate?

Yes, Pristiq can increase heart rate in certain individuals. Tachycardia (increased heart rate) is a possible side effect of using Pristiq. (1)

Pristiq is the brand name of the antidepressant medication desvenlafaxine which belongs to the class of drugs known as SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors). Pristiq functions by inhibiting the reuptake of serotonin and norepinephrine neurotransmitters in the brain, thereby, increasing their concentrations in the body. (2)

Elevated norepinephrine levels stimulate the sympathetic nervous system which is in charge of the “fight or flight” response, this can result in tachycardia or increased heart rate. (3)

This increase in heart rate is usually mild and fades away as the body adjusts to Pristiq. However, if you experience tachycardia while taking Pristiq, consult your healthcare provider about reducing your medication dose or switching to an alternative with fewer heart-related side effects.

What does research suggest?

Studies have shown that SNRIs like desvenlafaxine (Pristiq) can increase heart rate. Elevations in serotonin and norepinephrine levels can quicken cardiac sympathetic activity, which might raise blood pressure and heart rate.

It was shown that hazardous tachyarrhythmias and/or hypertensive crises can result from overstimulation of the sympathetic nervous system. Thus, when using Pristiq, it is imperative to monitor your blood pressure and heart rate. (4)

However, a clinical study was carried out to assess Pristiq’s effects on the heart. In a trial, 23 patients with chronic depressive illness were given desvenlafaxine for a period of eight weeks. HRV (Heart Rate Variability) was evaluated at baseline and after treatment.

During the course of treatment, there was a significant drop in patients’ HRV values. Additionally, there were significant increases in frequency-domain measurements (HF) power.

The study came to the conclusion that desvenlafaxine can normalize HRV in certain individuals. However, the small sample size and lack of a control group limit the findings of these investigations. (5)

What factors may contribute to Pristiq-induced increased heart rate?

There are several factors that can contribute to tachycardia while using Pristiq such as: (6), (7)

• Medication dose: High Pristiq doses can induce tachycardia and cause arrhythmia.
• Underlying medical conditions: Certain medical conditions such as cardiovascular diseases (CVD) like myocarditis and heart failure, hypertension, and diabetes can all induce tachycardia while taking Pristiq.
• Concurrent medications: Certain medications such as thyroid medications, asthma medications, allergy medications, and certain antibiotics like azithromycin can increase your heart rate while taking Pristiq.
• Age: The elderly population is more prone to experience tachycardia while taking Pristiq than the younger population.
• Genetics: Patients with a family history of heart disease are more prone to experience tachycardia while taking Pristiq.
• Lifestyle factors: Tobacco, alcohol, stress, and lack of physical activity can all induce tachycardia while taking Pristiq.

What should you do if Pristiq causes tachycardia?

If Pristiq causes tachycardia, consult your healthcare provider about reducing your medication dose. Your healthcare provider might gradually reduce your Pristiq dose over a period of weeks or months.

According to your condition, your healthcare provider might reduce your dose by 10-20% per week. You should take the reduced dose for at least one week before reducing the dose again.

Additionally, your healthcare provider will properly assess your situation and determine whether the tachycardia is caused by Pristiq or by other underlying cardiovascular diseases or concurrent medications. They will then take the best course of action accordingly.

If tachycardia is caused by Pristiq and is persistent despite reducing your dose, your healthcare provider might switch you to an alternative with fewer adverse effects.

What are Pristiq alternatives if it causes persistent tachycardia?

There are certain antidepressant alternatives that can cause fewer heart-related side effects than Pristiq such as:

• SSRI (Selective Serotonin Reuptake Inhibitors) antidepressants: Examples include citalopram, sertraline, paroxetine, escitalopram (Lexapro), and fluvoxamine. These antidepressants are generally well-tolerated and were shown to have minimal effects on the CVS (Cardio-Vascular System). (8)
• Mirtazapine: It is an atypical antidepressant that is sold under the brand name Remeron. Mirtazapine was proven to be effective and safe in patients with a history of cardiovascular diseases. (9)

Antidepressants, in general, are not considered cardiotoxic. However, SSRIs and atypical antidepressants including citalopram, sertraline, paroxetine, escitalopram (Lexapro), fluvoxamine, and mirtazapine can cause increased heart rate, heart palpitations, or arrhythmia in some individuals. Some may rarely cause QT prolongation in individuals susceptible to it.

Based on my knowledge and research, Pristiq can increase heart rate in some individuals. However, every person differs in their response to medications.

If you experience tachycardia while taking Pristiq, consult your healthcare provider about reducing your medication dose or switching to an alternative with fewer heart-related adverse effects.

References