Medication of heart palpitations vary from the cause.
- If you suffer from depression or anxiety your doctor will prescribe anti-anxiety drugs which are called anxiolytics. These medications are taken only when you are feeling anxious. It can be something like alprazolam(xanax) or lorazepam(ativan).
- Beta-blockers are widely used and first choice for heart palpitations. They are also used by stage performers to low heart rate, voice cracking and fine tremor of hands because of stress and anxiety. Caucasians respond better than others to this drug. Atenolol (Tenormin), metoprolol (Lopressor), nadolol (Corgard), pindolol (Visken), propranolol (Inderal) are the main beta-blockers used. These drugs are first line in treating angina and hypertension in combination with diuretics and/or nitrates.
- Calcium channel blockers are used to treat angina, hypertension and irregular heartbeats (palpitations). Examples: verapamil, diltiazem.
- Diuretics: furosemide and hydrochlorthiazid and other diuretics combined with other drugs to maintain your heart function.
- ACE-inhibitors treat hypertension, congestive heart failure and they can be used in patients with renal problems and diabetes. Enalapril, lisinolipril and captopril are examples of this medications.
- Digoxin(lanoxil) or digitalis corrects arrhythmia so can be used as a medication of heart palpitations. Other anti-arrhythmic drugs are: amiodarone(Cordarone), flecainide (Tambocor), propafenone (Rhythmol) etc.
- Supplements like vitamins (B12, B3, C, D) to maintain heart health can be used. Antioxidants are good for your cardiac health. This last option is usually completed by diet.
The best medication of heart palpitations is the one prescribed according to the cause. If the disease or condition that causes them is treated palpitations will disappear. Some of the causes are hyperthyroidism, anxiety, alcohol, caffeine, dehydration, hypoglycemia, fever and most important cause arrhythmias.
Your doctor will prescribe the most suitable medications for you.
Each class of drug has its own mechanism of action.
- Anxiolytic drugs help you relax and experience fewer palpitations because they act to your nervous system by calming down your episodes your nerve attacks and make you feel better.
- Beta-blockers block the beta receptors in your heart. This makes your heart beat less and your blood pressure to normalize.
- Calcium channel blockers control the size of blood vessels by blocking the entrance of calcium into muscle cells. Calcium helps the muscle cells makes them constrict. All body muscle cells(cardiac and non-cardiac) need calcium to constrict. By preventing constriction blood pressure and heart rate is reduced.
- Diuretics are of different types of classes: thiazides, loop diuretics, potassium sparing diuretics. The name of their class derives from their site of action but the purpose of all of them is to remove the excessive amount of water and sodium in the body by eliminating them due to increased kidney function.
- ACE-inhibitors inhibit or block ACE-receptors which are receptors that stimulate the production of angiotensin II, a hormone that contributes in constriction. They are good for hypertension because they widen the blood vessels and they reduce the heart workload indirectly.
- Anti-arrhythmic drugs act by improving your heart rhythm but they can be dangerous if taken in the wrong dose. They are potent medications so please do not take more than prescribed and if you forget one dose do not double the dose the next time of day because it can be life-threating.
- Some vitamins like C, D etc. help by maintaining your heart health: vitamin B3 alleviates anxiety attacks and reduces heart rate; B12 reduces homocysteine levels which lower the risk for palpitations, C is an antioxidant and D prevents premature contractions, eases heart flutters, provides calmness and decreases oxidative stress that can cause heart palpitations and lowers the risk for arrhythmias.
All drugs have side effects so they must be taken according to your doctor’s advice.
- Anxiolytic drugs can cause drug dependence.
- Beta-blockers are not recommended for cases with circulatory problems in legs and hands because they constrict blood vessels and do not allow the appropriate blood supply. They cause bronchial spasms in asthma and precipitate asthma attacks. Cold hands and feet are common because of reduced circulation.
- Calcium channel blockers can cause headache, nausea, ankle swelling, rash, constipation(verapamil), excessively slow heart rate and blood pressure.
- Diuretics can cause lethargy, rash, impotence, cramps but they are quite uncommon. Note that side effects increase when combined with digitalis. They interact with lithium and they may increase the glucose or uric acid levels in blood. Muscle weakness results by excessive potassium in blood caused by potassium sparing diuretics like spironolactone and others.
- ACE-inhibitors: dry cough is a common side effect. Other side effects vary from the drug name. Captopril may give loss of appetite, cough, weakness, rash.
- Anti-arrhythmic drugs must be taken and monitored carefully because sometimes (5-10% of patients) they can even worsen the arrhythmias they are supposed to treat. Side effects of digoxin are nausea, loss of appetite, confusion, vision disturbances, and even palpitations. Other drugs of this class may have severe side effects.
- Other alternatives like vitamins and other supplements like Q10 enzyme just complete the treatment but they can be useful in some cases.