Managing Sinus Tachycardia, Anxiety, and EPS: Consultation with Healthcare Providers
At the age of 40, I identify as FTM and have been on testosterone for the past 8.5 years. I have a history of schizophrenia diagnosed in 2006, along with generalized anxiety disorder (GAD) diagnosed in 2001. Currently, my medication regimen includes Abilify Maintena at 400mg, Saphris at 5mg, Effexor XR at 300mg, Artane at 5mg (used for extrapyramidal symptoms), Strattera at 60mg, and Topamax at 150mg for weight management and mood stabilization. I weigh 130 pounds and stand 5 feet 3 inches tall, and I also have minor renal impairment that has developed over a decade of lithium use related to diabetes insipidus. In 2006, I was informed of having sinus tachycardia during a routine psychiatric hospitalization, where vitals were taken twice daily. To monitor my heart condition, I've undergone several echocardiograms and wore Holter monitors, which have shown no physical abnormalities, yet my pulse remains elevated. Prior to surgeries (including wisdom teeth removal, tubal ligation, and top surgery) and ECT sessions in 2008 and 2022, I have always had an EKG, an echocardiogram, and a Holter monitor performed. The results before my ECT in 2022 indicated a diagnosis of moderate sinus tachycardia. Experiencing significant anxiety affects me physically; I undergo cognitive behavioral therapy (CBT) and take Effexor to help manage it. My anxiety now largely presents through physical symptoms such as shakiness, rapid heartbeat, gastrointestinal distress, and stuttering. I also deal with extrapyramidal symptoms due to my antipsychotic medications. Despite adhering strictly to my prescribed medication routine, I strive to maintain a level of physical activity in my life. I've come across information suggesting that beta blockers, like propranolol, might alleviate the physical manifestations of anxiety, as well as the EPS linked to antipsychotic medications and sinus tachycardia. Although I remain skeptical about AI resources like chatGPT, I find drugs.com to be a trustworthy source of information. Currently, I'm on a low dosage of Artane to manage EPS, but I dislike its side effects, even though it offers some relief. My blood pressure typically reads around 120/80, occasionally slightly lower. Could this possibly be relevant to my situation? I am curious if a beta blocker would be effective in addressing my issues with tachycardia, anxiety, and EPS. Would it be advisable to consult with my general practitioner (who I've trusted for 12 years) or my psychiatrist (who I've seen for 14 years)? They do share my medical notes with each other, which is very helpful. I have an upcoming appointment with my psychiatrist on July 4 to discuss a blood work requisition and potentially start on Abilify Asimtufii, a new long-acting injectable version of Abilify available in Canada. Alternatively, I might just receive my regular Abilify Maintena injection if they haven't yet introduced Asimtufii. I intend to schedule a visit with my GP around the same timeframe as well.
Answers (1)
6/23/2025, 9:30:52 AM
OpenHealth AI
Thank you for sharing your detailed medical history and concerns. It’s evident that managing your sinus tachycardia, anxiety, and the side effects of your medications is important to you. I understand the complexities you face, and I'm here to help guide you through some considerations regarding your situation.
Main Points:
- Beta blockers may help with your anxiety symptoms and sinus tachycardia.
- Consultation with your healthcare providers is advisable to discuss the medication options tailored to your needs.
Explanation:
- Beta Blockers: Propranolol and similar medications can effectively reduce physical symptoms of anxiety, like rapid heartbeat and shakiness. They can also help with sinus tachycardia. However, these medications should be used under the supervision of a healthcare provider, especially considering your history and existing medications.
- Physical Symptoms of Anxiety: Anxiety often manifests physically, and your cognitive-behavioral therapy (CBT) alongside medication like Effexor is a solid approach. However, if your anxiety continues to lead to significant physical distress, exploring additional options like beta blockers might be worth discussing.
- Extrapyramidal Symptoms (EPS): Since you're already taking Artane for EPS, it's understandable to look for alternatives or add-ons that may relieve these symptoms without unwanted side effects.
Next Steps:
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Prepare for Your Psychiatrist Appointment (July 4):
- List your symptoms: Note how your anxiety and EPS manifest, particularly concerning your heart rate and other physical symptoms.
- Research beta blockers: Have specific questions ready about how they could fit into your treatment plan, especially regarding their impacts on tachycardia and EPS.
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Discuss Concerns with Both Providers:
- After your appointment with the psychiatrist, consider scheduling a visit with your general practitioner (GP) to discuss the potential inclusion of a beta blocker and any concerns about your renal health and medication adjustments.
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Monitor Your Symptoms:
- Keep a symptom diary until your appointments, noting any changes in your heart rate, anxiety levels, and the effectiveness of Artane. This can provide valuable information to your doctors.
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Lifestyle Adjustments:
- Continue with your physical activity as tolerated, as it can help manage anxiety and improve overall mood.
- Practice relaxation techniques (deep breathing, mindfulness, etc.) which can help alleviate immediate anxiety symptoms.
Your approach to tackling these symptoms by seeking effective medication and maintaining clear communication with your healthcare team is essential. You’re not alone in this, and your proactive steps toward managing your health are commendable. If you need more information or have further questions, feel free to reach out.
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