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Anxiety Medication for Heart Palpitations: What Works, Why It Works, and When to Consider It
- Dr Titilayo Akinsola
- 1 hour ago
- 5 min read
Heart palpitations—those rapid, pounding, or fluttering sensations in your chest—are among the most distressing symptoms people experience during anxiety. Even when you logically know it’s “just anxiety,” the physical intensity can convince your body that something is dangerously wrong. For many individuals, therapy and lifestyle changes help significantly—but when palpitations are persistent, severe, or disruptive, anxiety medication may be necessary to calm the body’s stress response.
At Favor Mental Health, we help patients understand what’s happening inside their bodies, determine whether medication is appropriate, and design treatment plans that address both the root and the symptoms of anxiety. This article explains the best medication options for anxiety-induced heart palpitations, how they work, and how to know when it’s time to consider them.
Understanding Heart Palpitations Caused by Anxiety
When anxiety hits, the brain activates the fight-or-flight response. This triggers a cascade of physiological reactions:
Release of adrenaline
Rapid activation of the sympathetic nervous system
Increased heart rate
Forceful or irregular heartbeat
Heightened awareness of bodily sensations
These biological shifts are normal, but they feel alarming. The fear of the palpitations then worsens anxiety, creating a loop:
Anxiety → palpitations → fear → more anxiety → more palpitations
Medication can help break this cycle by calming the nervous system and reducing the physiological response that fuels the panic.
When Medication for Heart Palpitations May Be Needed
Medication may be appropriate when:
Palpitations are frequent and interfere with daily functioning
You experience panic attacks with cardiac symptoms
Lifestyle and therapeutic strategies haven’t been enough
Palpitations trigger chronic fear or avoidance behaviors
You have co-occurring anxiety disorders (GAD, panic disorder, PTSD)
Sleep is affected by nighttime heart racing
Worry about your heart is worsening your anxiety
A mental health provider will conduct a full evaluation to determine whether the palpitations are purely anxiety-related or if a medical evaluation is needed first.
Types of Anxiety Medications That Help With Heart Palpitations
Medication choices depend on what’s triggering the palpitations, how often they occur, and the individual’s unique psychological and physical profile. Below are the most effective medication classes used clinically at Favor Mental Health.
1. SSRIs (Selective Serotonin Reuptake Inhibitors)
Best for: Chronic anxiety, panic disorder, generalized anxiety disorder, trauma-related anxiety.
SSRIs are one of the most effective long-term treatments for anxiety-related palpitations.
Common SSRIs:
Sertraline
Escitalopram
Fluoxetine
Paroxetine
Citalopram
How SSRIs help with palpitations
Reduce overall anxiety sensitivity
Lower the brain’s stress response
Decrease internal hypervigilance
Prevent panic episodes that trigger fast heartbeat
Improve sleep, reducing nighttime palpitations
SSRIs take several weeks to reach full effect but significantly reduce the frequency and intensity of palpitations over time.
2. SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)
Best for: Anxiety with physical symptoms like muscle tension, body-based anxiety, or chronic palpitations.
Common SNRIs:
Venlafaxine
Duloxetine
Why SNRIs help
Improve mood and anxiety
Reduce the physical overstimulation that fuels palpitations
Help regulate the autonomic nervous system
SNRIs are especially effective when palpitations occur alongside chronic worry or somatic anxiety.
3. Beta Blockers
Best for: Situational or physical-anxiety states with strong bodily symptoms.
Unlike SSRIs and SNRIs—which treat anxiety itself—beta blockers treat the physical symptoms of anxiety.
Common beta blockers:
Propranolol
Atenolol
How beta blockers help with palpitations
Slow the heart rate
Reduce the force of cardiac contractions
Prevent adrenaline from binding to heart receptors
Reduce shaking, sweating, trembling
They are ideal for:
Performance anxiety
Social anxiety triggering heart racing
Isolated episodes of panic
Public speaking
High-stress events
Beta blockers work quickly and are taken as needed, but they do not treat the root anxiety.
4. Hydroxyzine (Antihistamine Anxiolytic)
Best for: Acute anxiety episodes, sleep disturbance, or panic-related palpitations.
Hydroxyzine works within 30 minutes and is non-addictive, making it a safe option for short-term relief.
Clinical benefits
Sedates overactive nerves
Lowers anxiety quickly
Helps with nighttime anxiety and palpitations
Useful when crying, panic, or adrenaline surges occur
Patients who experience nighttime heart racing often benefit from this medication.
5. Benzodiazepines (Short-Term, Highly Controlled Use)
Best for: Severe panic attacks with overwhelming cardiac symptoms—used only when strictly necessary.
Examples:
Lorazepam
Alprazolam
Clonazepam
How benzodiazepines help
Rapidly calm panic
Stop adrenaline surges
Reduce catastrophic thinking
Slow racing heart instantly
Because benzodiazepines carry dependency risks, they are used carefully and only for short-term clinical situations.
How Providers Choose the Right Medication
At Favor Mental Health, medication decisions are personalized, not one-size-fits-all. Providers consider:
Severity of palpitations
Frequency of panic attacks
Co-existing mental health conditions
Sleep quality
Stress levels
Medical history
Sensitivity to medication
Daily functioning and quality of life
The goal is to choose the safest, most effective, and most sustainable option.
Medication + Therapy = Best Results
Medication reduces the physiological symptoms.Therapy reduces the psychological triggers.
This combination targets both sides of the anxiety-palpitations cycle.
Effective therapeutic approaches include:
CBT to reframe catastrophic thoughts about the heart
Exposure therapy for panic
Stress and nervous system regulation
Trauma-informed therapy for individuals with past trauma
Mind–body techniques (breathing, grounding, somatic work)
Together, therapy and medication bring long-term stability.
Lifestyle Support to Enhance Medication Effectiveness
Medication works best when paired with heart- and anxiety-friendly habits:
Reduce caffeine and stimulants
Maintain hydration
Improve sleep consistency
Practice regular nervous-system calming techniques
Increase gentle movement (walks, yoga, stretching)
Avoid excessive alcohol or nicotine
Learn emotional regulation strategies
These practices lower baseline adrenaline and strengthen the body’s resilience.
When to Seek Immediate Medical Help
While anxiety is a common cause of palpitations, seek medical attention if palpitations are accompanied by:
Chest pain
Fainting
Shortness of breath
Irregular heartbeat
Severe dizziness
A history of heart conditions
Favor Mental Health frequently collaborates with primary care and cardiology to ensure total safety and peace of mind.
Favor Mental Health: Your Partner in Anxiety & Heart Palpitation Care
At Favor Mental Health, we understand how terrifying heart palpitations can be—even when they’re caused by anxiety. With over 17 years of experience, we offer:
✔ Comprehensive mental health evaluations
✔ Tailored anxiety treatment plans
✔ Medication management
✔ Therapy for panic, trauma, and chronic stress
✔ Support for sleep and lifestyle changes
✔ Substance abuse treatment
✔ Compassionate, confidential care
Location: Suite 9B, 260 Gateway Drive, Bel Air, MD 21014
Phone: 410-403-3299
You don’t have to endure anxiety-driven heart palpitations alone.With the right treatment plan, your mind and heart can work together in peace again.
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