Low Diastolic Blood Pressure After Anxiety Medication: Is It Normal?

Q: Low Diastolic Blood Pressure After Anxiety Medication: Is It Normal?

Hello Mr. <br>Liu： The medication you are taking, Liyou, may potentially cause orthostatic hypotension. <br>I would like to know if you experience dizziness when changing positions. <br>If you do feel unwell, it is advisable to discuss with your physician whether to adjust your m

After taking medication for anxiety, the diastolic blood pressure is low?

Three weeks ago, I experienced palpitations, shortness of breath, and irregular heartbeats, which led me to undergo an examination in the cardiology department, but no issues were found.
Later, I visited a psychosomatic medicine specialist, who diagnosed me with panic disorder and prescribed some medications: 1.
Anxiolytic tablets: half a tablet for breakfast and lunch, and one tablet for dinner.
2.
Lyrica: half a tablet before bedtime.
After taking the medications for over a week, my condition has improved somewhat, but in the past two days, I measured my blood pressure and found that my diastolic pressure at night was only 55, and even during the day, it was only 60.
Previously, my diastolic pressure during the day was around 75-80 and about 70-75 at night.
My systolic pressure is also slightly low, but not as significantly as my diastolic pressure.
Another point of concern is that my pulse pressure during the day is about 45 and about 55 at night, which is also higher than normal values.
Could this be caused by the medication? Is this normal?

Liu Mingfa, 50~59 year old female. Ask Date: 2022/04/29

Dr. Lin Mianzhang reply Psychiatry

Hello Mr.
Liu: The medication you are taking, Liyou, may potentially cause orthostatic hypotension.
I would like to know if you experience dizziness when changing positions.
If you do feel unwell, it is advisable to discuss with your physician whether to adjust your medication.
However, if you only have lower blood pressure without feeling any discomfort, it is fine to continue with your current medication.
If you have any other questions regarding the medication, it is best to discuss them in detail with your physician.
Wishing you safety and good health!

Reply Date: 2022/04/29

More Info

Low diastolic blood pressure (DBP) after starting anxiety medications can be concerning, especially when there is a notable drop from your baseline levels. In your case, you mentioned that your diastolic pressure has decreased to 55 mmHg at night and 60 mmHg during the day, compared to your previous readings of 75-80 mmHg during the day and 70-75 mmHg at night. This significant drop in DBP, particularly when combined with a relatively stable systolic blood pressure (SBP), raises questions about the potential effects of the medications you are taking.

The medications you mentioned, particularly the ones prescribed for anxiety, can indeed have side effects that influence blood pressure. For instance, medications like benzodiazepines (if "安邦錠" refers to a benzodiazepine) can cause sedation and may lead to lower blood pressure in some individuals. Similarly, other anxiety medications, such as selective serotonin reuptake inhibitors (SSRIs) or atypical antipsychotics, can also have varying effects on blood pressure, including orthostatic hypotension (a drop in blood pressure upon standing) or general hypotension.

The fact that your diastolic pressure is lower than normal could be attributed to the medications, especially if you have not experienced such low readings prior to starting them. However, it is essential to consider other factors that could contribute to low blood pressure, such as dehydration, changes in diet, stress levels, or other underlying health conditions.
You also mentioned that your pulse pressure (the difference between systolic and diastolic pressure) is higher than normal, which can indicate that your arteries are under more stress. A high pulse pressure can sometimes be seen in conditions where the heart is under strain or in cases of arterial stiffness, which is more common in older adults. However, it is less common to see a scenario where the systolic pressure is normal or slightly low while the diastolic pressure is significantly low.

In terms of whether this is "normal," it is crucial to understand that while some fluctuations in blood pressure can occur due to medication adjustments, consistently low diastolic readings should not be ignored. If you are experiencing symptoms such as dizziness, fainting, or fatigue, it is essential to consult with your healthcare provider. They may consider adjusting your medication dosage or switching to a different medication that may not have the same impact on your blood pressure.

In conclusion, while low diastolic blood pressure can be a side effect of anxiety medications, it is essential to monitor your symptoms closely. If you are feeling unwell or if your blood pressure readings remain low, please reach out to your healthcare provider for further evaluation. They may recommend additional tests or adjustments to your treatment plan to ensure your safety and well-being. Regular follow-ups and open communication with your healthcare team are vital in managing both your anxiety and any potential side effects from medications.

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