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Eat Well, Live Well, Think Well: A Cardiologist’s Review of Prescription Medications for Palpitations

Jack Wolfson DO, FACC Board Certified Cardiologist

May 9, 2023

Are medications truly the answer to frequent heart palpitations? Many conventional doctors would say yes, as evidenced by the millions of Americans taking drugs to treat their irregular heartbeats. But here’s the thing

Are medications truly the answer to frequent heart palpitations? Many conventional doctors would say yes, as evidenced by the millions of Americans taking drugs to treat their irregular heartbeats. But here’s the thing – our bodies are not running low on pharmaceuticals. There are no health conditions in this world created by a drug deficiency. Instead, our bodies are malnourished, exhausted, laden with toxins, and pushed to the limit by stress.

Pharmaceuticals recommended for palpitations often make the situation worse. They slow the heart down, thus allowing MORE extra beats to creep in.

While medications may temporarily alleviate the symptoms of heart palpitations, they’re merely masking a larger problem. Prescription drugs are not the panacea that conventional medicine wants you to believe. These treatments might not give you the outcomes you’re hoping for, and it’s crucial to know that they could lead to several potentially harmful side effects.

It’s time to explore other avenues and consider more sustainable and holistic approaches to addressing this pervasive issue.

Commonly prescribed drugs for heart palpitations


Beta-blockers help our bodies cope with stress by interacting with particular hormones within the nervous system. Often referred to as beta-adrenergic blocking agents, their main objective is to put the brakes on adrenaline—a hormone notorious for causing our hearts to race during high-stress situations. In accomplishing this, beta-blockers decrease heart rate, diminish heart contractions’ intensity, and lower blood pressure.

Stress hormones undoubtedly play a crucial physiological role in our bodies, and it’s not always bad. We depend on that invigorating surge of adrenaline to function. Regrettably, dampening this natural response leads to a host of side effects associated with beta-blockers, which encompass:

  • Overwhelming fatigue

  • Diminished libido

  • Nausea

  • Constipation or diarrhea

  • Disrupted sleep patterns

  • Lightheadedness

  • Depression

  • Erectile dysfunction

  • Weight gain

Beta-blockers can be downright dangerous, making the heart beat much too slowly or causing the blood pressure to bottom out. Furthermore, in some instances, beta-blockers may provoke heart block and exacerbate heart failure.

Commonly prescribed beta-blockers: Metoprolol (Lopressor®), Propranolol (Inderal®), and Atenolol (Tenormin®)

Calcium Channel Blockers

Calcium channel blockers relax the heart muscle and blood vessels, which can help regulate the heart rate and alleviate palpitations. In addition to treating irregular heartbeats, they are often used to treat chest pain and high blood pressure.

Interestingly, calcium channel blockers often cause heart palpitations- the very ailment we are trying to avoid. Other common side effects include:

  • Dizziness

  • Headaches

  • Flushing (warmth or redness in the face)

  • Fatigue

  • Swollen ankles or feet (edema)

  • Constipation

  • Nausea

Commonly calcium-channel blockers: Amlodipine (Norvasc®) Diltiazem (Cardiazem®, Tiazac®, Tiazac® XC ) Felodipine (Plendil®) Nifedipine XL (Adalat XL®)

ACE Inhibitors

ACE inhibitors open, or dilate, the blood vessels, increasing blood flow to organs such as the kidneys, stomach, and heart. These commonly prescribed drugs, which manage high blood pressure and heart failure, have also found their way into treating heart palpitations. While they may not be the primary go-to medication for palpitations, their ability to lower blood pressure and reduce strain on the heart may indirectly decrease the frequency of heart palpitations.

A plethora of side effects accompanies the use of ACE inhibitors, some of which exacerbate the problem we are seeking to alleviate. Among the most notorious side effects is the so-called “ACE cough,” a persistent, dry cough that can make life downright miserable for those afflicted.

Moreover, dizziness, headaches, fatigue, and even kidney problems are among the other unwelcome companions of ACE inhibitor use. These side effects serve as a reminder that, while medications might provide temporary relief, a holistic and sustainable approach to addressing heart palpitations remains the ultimate goal.

Commonly prescribed ACE inhibitors: Lisinopril (Zestril®), Enalapril maleate (Vasotec®), and Fosinopril sodium (Monopril®)

Antiarrythmic Drugs

Sometimes, heart palpitations can be caused by different heart rhythm issues that can make your heart beat too fast, too slow, or in an uneven way. Antiarrhythmics are used for heart palpitations because they address these abnormal heart rhythms. By acting on the heart’s electrical system, they target various channels to reduce irregular beats and slow abnormally fast electrical activity.

Ironically, arrhythmia medications can worsen the problem or lead to additional arrhythmias. Other commonly reported side effects of antiarrhythmics include:

  • Lightheadedness

  • Intense thirst

  • Skin changes

  • Headaches

  • Ear ringing (tinnitus)

  • Photosensitivity

  • Swelling (edema)

  • Visual changes

  • Bowel and bladder difficulties

Commonly prescribed Antiarrhythmics:: Flecainide (Tambocor®), Digoxin (Lanoxin®), and amiodarone (Cordarone®)

Antianxiety Drugs

In many cases, stress and anxiety are the triggers behind heart palpitations. During heightened stress, the body releases adrenaline and other stress hormones that raise the heart rate and trigger abnormal heartbeats. As a result, many doctors prescribe medications to help manage anxiety, which may reduce heart palpitations indirectly.

Anti Anxiety medications come with numerous side effects, which may include the following:

  • Drowsiness, fatigue, or weakness

  • Dizziness or lightheadedness

  • Dry mouth

  • Nausea or upset stomach

  • Memory or concentration problems

  • Low blood pressure (hypotension)

  • Dependency or withdrawal symptoms

Commonly prescribed Anti-anxiety medications: Lorazepam (Ativan®), Alprazolam (Xanax®), Diazepam (Valium®)


Diuretics, often called “water pills,” may seem an unconventional choice for heart palpitations. However, individuals with too much swelling (edema) are often prescribed these drugs. Diuretics indirectly alleviate the strain on the heart by encouraging the elimination of excess fluid and sodium from the body. Theoretically, this reduced workload can help provide a more stable heart rhythm and, in turn, help suppress palpitations.

Unfortunately, diuretics can further add to heart palpitations, as they often contribute to electrolyte imbalances in the body. Other common side effects include:

  • Dizziness or lightheadedness

  • Fatigue or weakness

  • Increased urination

  • Headaches

  • Muscle cramps or spasms

Commonly prescribed Diuretics: Furosemide (Lasix®), Indapamide (Lozide®), and hydrochlorothiazide

Next Steps

There is a time and place for prescription medications. However, it’s crucial to understand that pharmaceutical drugs merely address the tip of the iceberg. By focusing on the symptoms rather than the root cause, we risk overlooking the complex interplay of lifestyle factors, nutritional deficiencies, and stressors contributing to palpitations.

Should you find yourself with a prescription for heart palpitation medications, why not explore a virtual second opinion with one of our seasoned heart specialists at Natural Heart Doctor? Together, we can discuss strategies to taper off your medications and restore your heart’s natural rhythm, paving your way to the 100 year heart. 

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