New to Zoloft and worried about qt prolongation.

[Deepseathree]

I’ve been on and off Prozac for years and after a hiatus of nothing I’ve started my journey on Zoloft. I’m starting below basically a therapeutic dose at 25mg. I can’t shake the worry of qt prolongation. I have a low heart rate to begin annd know that can be a precursor. Though I’ve had EKGs before and nothing has been mentioned. Obviously from my worry and rambling you can see the medication hasn’t taken effect. Anyone else have the worry?

If panic_down_under happens to comment, I just want to say you’re a blessing and you efforts don’t go unnoticed. Even if they don’t comment, they deserve some recognition.

[panic_down_under]

I've been on and off Prozac for years

Then I suggest you consider remaining on antidepressants permanently for there is evidence ADs, especially the SSRIs, may become progressively less effective every time they are stopped and restarted, often requiring higher doses to achieve the previous level of control, or not working at all. They may also produce more severe, and/or different, initial side-effects each time. Two studies, Amsterdam JD, 2016 and Amsterdam JD, 2009, found the likelihood of antidepressants working after each restart drops by between 19-25% (see also: Bosman RC, 2018; Amsterdam JD, 2009; Leykin Y, 2007; Paholpak S, 2002).

I can't shake the worry of qt prolongation.

With the possible exception of citalopram (Celexa) and escitalopram (Lexapro) the prolonged QTc risk from SSRIs is very low even in massive overdose. They may only become problematic when taking other medications with a significant impact on QTc, or in patients with Congenital Long QT Syndrome. Your previous EKGs should have detected the syndrome if it were an issue.

I have a low heart rate to begin annd know that can be a precursor.

How low? Between 60-100 bpm used to be considered the normal resting heart beat range, but recent evidence is suggesting it should be 50-75 bpm. See: What is a Normal Heart Rate? and 5 Heart Rate Myths Debunked.

Obviously from my worry and rambling you can see the medication hasn't taken effect.

I wouldn't expect 25mg to do much. The sertraline therapeutic dose range is 50-200mg/day with most needing to take 100-150mg for optimum results. Given you've been on ADs before you're more likely to need to be at the upper end of the range.

Anyone else have the worry?

Many of 'Dr' Google's patients seem to have QTc worry disorder. It must be something in the bytes.

I just want to say you're a blessing and you efforts don't go unnoticed.

The people who really deserve the thanks are all those in support groups like NMP who have taught me pretty much all of the little I know in the past 30+ years.