6 replies to this topic

[AliYogini]

Last 2 days my heart rate has shot up numerous times throughout the day to 90 to 115bpm for no reason. Although I have mitral valve prolapse I have never had this happen in 30 yrs. 4 days ago I dropped my cymbalta level 1 bead, after a month hold, to just under the 10mg level. The last 4 days I've had a constant headache and palpitations and the last 2 days this elevated heart rate. Although I did reduce my beta blocker in Jan, I didn't have any real problems. The timing of my elevated heart rate episodes seems to correlate to the cymbalta drop. Anyone experience this or hear of this happening?

[fishinghat]

Oh yea! Cymbalta controls norepinephrine (a precursor to epinephrine (adrenaline)). Once the Cymbalta is dropped the body must adapt and learn to control the effect of the norepinephrine. Periods of tachycardia during withdrawal is very common as well as PVCs (which feel like skip beats). Heart pounding also frequently appears as well. Most people do not realize that the adrenal gland does NOT have a parasympathetic nerve going to it. To explain. A sympathetic nerve tells an organ to increase performance and a parasympathetic nerve tells and organ to reduce activity. They act together to produce a balancing of the organs performance. The adrenal gland only has a sympathetic nerve going to it. It is very easily activated by this nerve in times of emergencies (flight or fight scenario). The feed back mechanism is different though. There is a nerve center in the front of the brain (frontal cortex) that contains a group of nerves that detect epinephrine and norepinephrine in the blood. If epinephrine or norepinephrine  levels get to elevated these nerves will reduce the signal to the adrenal gland and slow production of these two neurotransmitters.

 

This is what makes Clonidine so effective on anxiety as it has a structure similar to epinephrine. When it is detected by the nerves in the front of the brain it is detected as epinephrine and the signal to the adrenal gland is reduced.

[fishinghat]

I found 15 references to tachycardia on the forum. About half referred to it developing while on the Cymbalta and about half had events during withdrawal. I did a search for 'rapid heart rate' and fast heart rate and found more but didnot actually count hem.

[AliYogini]

Thank you so much!! Wow. You really have a thorough understanding of all this! I did not know all that. Thank you so much for the explanation it does make me feel better to know the cause of the tachycardia. Now I can see that my original plan to wean off my beta blocker at the same time was not a good idea. I recently found out I was prediabetic and I really think my yrs of taking atenolol contributed to that..so I wanted off the beta blocker as well as the cymbalta. I thought the tachycardia might be from the reduction in the bb, but that was wks ago. The tachycardia started 2 days after my last cymbalta bead drop. Now I know why. So the question now is, what do I do? Stay at this 1 bead drop till it stops? (Or won't it stop?). Or up my bb a little bit to compensate? I wish I could take the drug you mentioned instead of my bb, that would probably lessen my problem. I doubt my dr would switch me right now. Do you think this tachycardia will settled own if I stay at each drop for little while? Yikes, this last 10mg of cymbalta is going to be a battle! I better gear up.

[fishinghat]

My tachycardia did slow up as I would hold at a certain level. Once stable I would again start dropping.

 

Also, from the FDA website. 1.45% of people taking atenolol reported becoming diabetic. I would guess that is probably lower then the standard population.

[AliYogini]

Comforting to hear that.. from someone who actually experienced it. I will hope this will settle down then. Maybe 10mg is one of those threshold dose levels that once you cross it withdrawal symptoms kick in??

My dr didn't think my prediabetes came from my atenolol either. I'm trying to blame something. It doesn't run in my family and I'm not overweight, I ate very healthy, and until recently, was fairly active. I guess it's just another health related mystery that we all encounter.

[fishinghat]

That threshold tends to be 5 to 10 mg. But boy what a threshold.

 

There are so many possible causes for prediabetes. Who can say.