Hello doctor, I have anxiety disorder from the age of 15 (will be 35 by the end of this month). I started having frequent panic attacks and debilitating anxiety after my grandmother's death. Before all this, I had been on Paxil. Six months before, my doctor switched me to Zoloft 50 mg and increased to 100mg and 150mg in the following consecutive months. I am very worried about the possible QTc prolongation and sudden cardiac death. I struggle daily to take Zoloft. I had three ECG. First one was taken before six months, the second one before a month and the third one in this month in which my QTc was 400 to 420. Is Zoloft safe? Will it cause me sudden cardiac death?
Hello. Zoloft (Sertraline) is an effective and safe SSRI (selective serotonin reuptake inhibitor) for managing anxiety disorder. Zoloft is generally considered a low risk for QTc (is an electrocardiogram representation of ventricular depolarization and repolarization) prolongation in healthy people. I can see that you had three ECGs in the last few months with QTc between 400 to 420 which is within normal limits. Zoloft in traditional doses (up to 200 mg daily) usually does not cause any significant increase in QTc. You are only on 150 mg once daily. So highly unlikely to have an adverse reaction. Can I ask why you are particularly worried about QTc prolongation and sudden cardiac death? Do you have any relevant risk factor like a previous heart problem or family history of arrhythmias and heart problems? Were these repeat ECGs done for any specific reason or only because of your anxiety? If you are otherwise healthy, Zoloft is generally safe. If you need any other medication for other reasons, remind your doctor that you are on Zoloft so that they can avoid prescribing medication that can potentially interact together. Also, street drugs are not advisable. Regarding your other query about Ativan (Lorazepam), you can continue gradually weaning till you are off completely. When reduced gradually chances of withdrawal effects are much lesser. It is good that you are stopping Ativan as it is not recommended for long term use. I note that you are currently in therapy. It will help to address your longstanding anxiety and develop better psychological coping strategies. It is common to experience worsening of your symptoms when you lose a loved one. Hopefully, you will recover gradually from the loss. You can also try deep breathing techniques and progressive muscular relaxation for managing stress and anxiety. I will also advise you to discuss your worry about QTc prolongation with your prescribing doctor. He will be able to monitor and advise you accordingly.