Can phosphatidylserine (PS) lower heart rate (tachycardia)?

Phosphatidylserine's Effect on Heart Rate

Phosphatidylserine (PS) supplementation does not have established clinical evidence for lowering heart rate (tachycardia) based on current cardiovascular guidelines, and should not be recommended for this purpose.

Mechanism and Evidence Assessment

Phosphatidylserine has been studied primarily for its effects on stress response and the hypothalamic-pituitary-adrenal (HPA) axis, not as a direct heart rate-lowering agent:

• Research shows PS may blunt stress-induced cortisol and ACTH responses 1, 2, 3, but these studies did not demonstrate significant effects on heart rate
• In a controlled study examining PS supplementation during acute stressors, researchers found "PS did not affect heart rate" despite showing effects on stress hormones 2
• One small study reported improved mood with PS supplementation but did not demonstrate significant heart rate reduction 4

Established Treatments for Tachycardia

For patients requiring heart rate control, current cardiovascular guidelines recommend evidence-based medications:

For Supraventricular Tachycardia (SVT):

• First-line: Vagal maneuvers followed by adenosine (6-12 mg IV rapid bolus) 5, 6
• Second-line options:
  • Calcium channel blockers: Diltiazem (15-20 mg IV) or verapamil (2.5-5 mg IV) 5, 6
  • Beta-blockers: Metoprolol, atenolol, propranolol, or esmolol 5, 6

For Inappropriate Sinus Tachycardia (IST):

• Ivabradine has shown effectiveness (2.5-7.5 mg twice daily) and is recommended as reasonable for ongoing management (Class IIa, Level B-R) 5
• Beta-blockers are considered first-line pharmacological therapy for rate control 5

Clinical Implications

While PS shows promise in stress modulation, several important clinical considerations exist:

• The American Heart Association and European Society of Cardiology guidelines do not mention PS as a treatment for tachycardia 5
• For patients with cardiac conditions requiring rate control, established medications with proven efficacy should be used instead of PS
• Recent research has explored potential cardioprotective effects of PS in myocardial ischemia models 7, but this is preliminary and not related to heart rate control

Conclusion

For patients with tachycardia requiring treatment, clinicians should follow established guidelines using proven medications like beta-blockers, calcium channel blockers, or ivabradine depending on the underlying cause. While PS may have benefits for stress response, it has not been shown to significantly reduce heart rate and should not be recommended for this purpose.