Should You Continue Taking Antidepressants If Blood Pressure Rises?

Should I continue taking Li-Yu if my blood pressure has increased?

Hello, doctor.
A year and a half ago, I experienced high blood pressure of unknown origin, along with long-term insomnia, chest tightness, shortness of breath, night sweats, and other symptoms.
I felt it was due to autonomic nervous system dysregulation, so I sought help from a psychosomatic specialist.
For the first six months, I took one tablet of Rhythmol and one tablet of Eicosapentaenoic Acid (EPA) in the morning and evening, and if needed, I took Lorazepam before bed.
My condition remained stable during that time.
Later, I switched to taking only one tablet of EPA per day.
Initially, I discussed with my doctor the possibility of stopping the medication this year, but some issues at home led to a resurgence of anxiety, resulting in panic upon waking up in the morning.
The doctor prescribed half a tablet of Fuan Yuan to take before bed.
After three days, I noticed my blood pressure dropped significantly to about 88/60.
The doctor then suggested I try Sertraline at a dose of half a tablet per day, but after taking it for three to four days, my blood pressure spiked to 150/100, and I felt very dizzy in the mornings.
I understand that Sertraline is a therapeutic medication that requires time to adjust, but my side effect has been elevated blood pressure.
I am very concerned about whether I should continue taking it.
If I cannot take Sertraline, will my anxiety disorder be impossible to treat completely?

Ai Mi Li, 40~49 year old female. Ask Date: 2022/06/25

Dr. Qiu Junda reply Psychiatry

Hello.
It is relatively uncommon to experience elevated blood pressure as a side effect.
Your increase in blood pressure may not necessarily be related to the medication.
I recommend that you return for a follow-up appointment to discuss this with your physician.
If it is indeed related to this medication, you may consider switching to another medication (there are other types of serotonin medications available) or discontinuing it.
Thank you.

Reply Date: 2022/06/25

More Info

When it comes to managing high blood pressure, especially when it is influenced by emotional fluctuations, it's crucial to adopt a comprehensive approach that includes medication, lifestyle changes, and emotional well-being strategies. Your situation, characterized by high blood pressure, anxiety, and emotional distress, suggests that you may be experiencing a form of psychosomatic disorder, where psychological stress manifests as physical symptoms.

Firstly, it's important to understand that emotional stress can significantly impact blood pressure. When you experience anxiety or anger, your body releases stress hormones like adrenaline, which can cause your heart to beat faster and your blood vessels to constrict, leading to elevated blood pressure. The strategies you mentioned, such as deep breathing and trying to clear your mind, are beneficial in the moment, but they may not be sufficient for long-term management.

In cases where blood pressure spikes due to emotional distress, it is essential to have a plan in place. If you find that your blood pressure is consistently high despite your efforts to manage stress, it is advisable to consult your healthcare provider. They may recommend adjusting your medication or incorporating additional treatments, such as therapy or stress management techniques. Cognitive-behavioral therapy (CBT) can be particularly effective in addressing anxiety and emotional regulation, helping you develop coping strategies for stressful situations.

Regarding your concern about the potential for severe health risks due to high blood pressure, it is true that consistently elevated blood pressure can lead to serious complications, including heart disease, stroke, and kidney damage. Therefore, if you experience a significant spike in blood pressure (e.g., readings above 180/120), it is crucial to seek immediate medical attention. In emergency situations, healthcare providers may administer medications to quickly lower your blood pressure and stabilize your condition.

As for your work environment, engaging in physically demanding jobs like gardening or construction can pose risks if you are experiencing frequent spikes in blood pressure or emotional distress. It may be beneficial to discuss your situation with your employer to explore options for a less stressful work environment or to take breaks when needed. Additionally, practicing stress-reducing activities during your breaks, such as mindfulness or light stretching, can help manage your emotional state throughout the day.

In terms of medication, you mentioned taking various drugs for hypertension, anxiety, and sleep issues. It's important to communicate openly with your healthcare provider about any side effects you experience, such as low blood pressure or increased anxiety. Adjustments to your medication regimen may be necessary to find the right balance that effectively manages both your blood pressure and anxiety without causing adverse effects.

Lastly, if you are considering stopping or changing your antidepressant medication due to rising blood pressure, it is crucial to do so under the guidance of your healthcare provider. Abruptly discontinuing medication can lead to withdrawal symptoms and a resurgence of anxiety or depression. Your provider can help you weigh the benefits and risks of continuing the medication versus exploring alternative treatments.

In summary, managing high blood pressure influenced by emotional factors requires a multifaceted approach that includes medication, lifestyle modifications, and emotional support. Regular follow-ups with your healthcare provider are essential to monitor your condition and make necessary adjustments to your treatment plan. Engaging in stress-reducing activities, seeking therapy, and maintaining open communication with your healthcare team can significantly improve your overall well-being and help you manage your blood pressure effectively.

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