Ask a doctor on the topic of Internal medicine

Strain on the heart from Opipramol?

November 5, 2014 | 20,00 EUR | answered by Dr. med. Ralf Berg

Hello,
I am a patient with anxiety and also afraid of medication side effects. Last week, I was prescribed Opipramol and took the following doses:
Wednesday: 25 mg in the morning and 25 mg in the evening
Thursday: 25 mg in the morning, 25 mg at noon, and 25 mg in the evening
Friday: 25 mg in the morning and 25 mg at noon
So, a total of 175 mg. I then looked at the package insert and found the following regarding cardiovascular side effects:

\"Rarely, collapse states, heart conduction disorders, and exacerbation of existing heart failure (heart insufficiency) may occur.
Opipramol is associated with a risk of cardiovascular side effects in all age groups. During treatment with Opipramol, certain heart rhythm disturbances may occur (prolongation of the QT interval in the ECG, and possibly even the life-threatening \"Torsades de pointes\").\"

After reading this, I immediately stopped taking the medication, especially since I already have anxiety about my heart. I saw a doctor on Monday, where an ECG and heart ultrasound were performed, and both were okay. Now my question is whether these side effects can still occur afterwards? I took the last dose of the medication on Friday afternoon, saw the doctor on Monday afternoon, but I am still afraid that these issues could still arise. I also have a tingling sensation in my chest area (but I have had this before, probably due to muscle tension according to the doctor, but my mind thinks it might still be from the medication). Therefore, I would really like to know if these side effects can still occur now. The anxiety is driving me crazy.
Thank you in advance!

Dr. med. Ralf Berg

Dear patient,

you should and can relax. Since the heart examinations you have already undergone have not shown any signs so far, there is no reason to expect them after discontinuing the medication.

In general: 1. Fear is a bad advisor. I believe you are aware that fear can limit your options and treatment paths, as it is not the side effects themselves but rather the fear of them occurring in your case that can restrict your possibilities in life. 2. The side effects described in the package insert do not automatically occur upon taking the medication, but rather occur in some patients (the likelihood is now more accurately stated, for example 1 in 10,000 patients, meaning that one patient out of 10,000 may experience this side effect). 3. Opipramol is a modern, well-studied medication that is intended to have a positive effect on your mood. It is considered safe. While it may cause issues with the heart, and worsen an existing heart condition as described, the risk is low for a healthy heart. Many similar medications can have heart-related side effects. You must have the courage and motivation to determine this and take the medication in the prescribed dosage for 8-12 weeks. By then, your fear may have subsided.

I would advise you to have "more courage." To live your life, you must overcome your fear. Opipramol could help you with this, but you must first conquer the fear of taking it.

With best regards, Dr. R. Berg.