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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Insomnia Be Managed While On Zoloft And Metoprolol?

I had a heart ablation for history of irregular rhythm in 2016. I have an artificial mitral valve and keep my Coumadin level between 2.5-3.5. I take 12.5 mg Metropolol Succ. daily. My heart beats in 80 s. Normal BP was 120/70. Started taking Zoloft 25 mg for anxiety Dec. 2017 along with Metropolol. March 19, my blood pressure was 150/80. March 31 it was 140/80 and my pacemaker showed a faint irregular beat. April 1 and 2 I have had off and on irregular beating with BP running from 128/80, 124/93,123/76, 142/84 to 158/90. Heart rate in 80 s to 109. I read online that taking Zoloft can increase Metropolol action and that Metropolol can increase Zoloft action. I have noticed that I have to take Zoloft early in day or it keeps me awake at night. I took both in the am today and do not feel at all sleep tonight at bedtime. Please advise.
Thu, 7 Jun 2018
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Neurologist,  's  Response
Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.

I read your question carefully and I understand your concern. It is true that zoloft and metoprolol may interact by zoloft increasing metoprolol levels. However since heart beats are at 80 and blood pressure at 120/70 I do not think that is a problem in your case, no excessive effect of Metoprolol. It doesn't play any role on your sleep issue either. SSRI class of drugs like Zoloft may at times be associated with insomnia, so it may be a factor, it's why it's used in the morning usually. If this is a persisting issue you may discuss with your doctor using instead a sedating antidepressant such as for example Mirtazapine. The other less preferable option would be adding another drug in the evening to promote sleep.

Hope I have answered your query. Let me know if I can assist you further.
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How Can Insomnia Be Managed While On Zoloft And Metoprolol?

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. I read your question carefully and I understand your concern. It is true that zoloft and metoprolol may interact by zoloft increasing metoprolol levels. However since heart beats are at 80 and blood pressure at 120/70 I do not think that is a problem in your case, no excessive effect of Metoprolol. It doesn t play any role on your sleep issue either. SSRI class of drugs like Zoloft may at times be associated with insomnia, so it may be a factor, it s why it s used in the morning usually. If this is a persisting issue you may discuss with your doctor using instead a sedating antidepressant such as for example Mirtazapine. The other less preferable option would be adding another drug in the evening to promote sleep. Hope I have answered your query. Let me know if I can assist you further.