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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by AlexSamuel on October 18, 2004, at 1:29:49
Hi
I am suffering from both chronic depressiona and high blood pressure but it is quite unfortunate that I can't take any blood pressure medications. Beta blockers make my depression worse, ace inhibitors stall my libido completely. Medicines I never tried are those alpha blockers, but I have read somewhere, they may also cause depression worse. So Is there any antidepressant with antihypertensive property? If so I could have taken that. Pls help.
Posted by King Vultan on October 18, 2004, at 8:13:00
In reply to Antidepressant with Antihypertensive Properties!, posted by AlexSamuel on October 18, 2004, at 1:29:49
> Hi
>
> I am suffering from both chronic depressiona and high blood pressure but it is quite unfortunate that I can't take any blood pressure medications. Beta blockers make my depression worse, ace inhibitors stall my libido completely. Medicines I never tried are those alpha blockers, but I have read somewhere, they may also cause depression worse. So Is there any antidepressant with antihypertensive property? If so I could have taken that. Pls help.The MAOIs tend to lower blood pressure, but much more so Nardil than Parnate. My blood pressure is close to 140/90 unmedicated and was lowered on Nardil to about 105/65. My heart rate was also lowered from the mid 70's to the 50's. In fact, these effects caused me a great deal of dizziness and weakness problems, and I am in excellent physical shape otherwise. Parnate is not nearly as bad; the last time I checked on the 50 mg/day I am taking, my BP was 120/72, with a pulse of 70. There seems to be no deleterious effects from this, but this is probably not enough of a reduction for your needs.
I've also taken three tricyclics, which also have the ability to lower BP because of their built in alpha-1 blockade. Now, at lower dosages, some of these, such as desipramine, can actually increase BP because of their blockade of norepinephrine reuptake. At higher dosages, the NE reuptake blockade becomes essentially maxed out, and the alpha-1 effect becomes more noticeable. In my case, my BP went down on both desipramine and protriptyline to about 120/80, but I also had to start taking an ACE inhibitor when I was on a combination of Zoloft and desipramine because of a rise in BP to about 160/100. The 120/80 respresents my best guess what my BP would have been on the tricyclic alone and without the effects of the lisinopril ACE inhibitor I was also taking (my total BP was about 105/70).
The problem with the antihypertensive abilities of the tricyclics is the same as it is with pure alpha blockers: the hypotension they generate is mainly of the orthostatic variety. While there was enough of a drop in my case for it to show up in my resting BP, where it is really noticeable is when standing up suddenly or after climbing stairs. I experienced faintness/dizziness probably hundreds of times while on the tricyclics, and this was also a big problem while on Nardil. I never fainted, but many other people who are not in such good cardiovascular condition as I am almost certainly would have at some point.
Todd
Posted by King Vultan on October 18, 2004, at 9:44:53
In reply to Antidepressant with Antihypertensive Properties!, posted by AlexSamuel on October 18, 2004, at 1:29:49
> Hi
>
> I am suffering from both chronic depressiona and high blood pressure but it is quite unfortunate that I can't take any blood pressure medications. Beta blockers make my depression worse, ace inhibitors stall my libido completely. Medicines I never tried are those alpha blockers, but I have read somewhere, they may also cause depression worse. So Is there any antidepressant with antihypertensive property? If so I could have taken that. Pls help.Other ADs with alpha blockades that may reduce your BP are Serzone/nefazodone and trazodone. Other tricyclics besides the ones I listed with strong alpha blockades are imipramine and amitriptyline, and to a lesser extent, nortriptyline. I also take a separate alpha blocker; my experience is that the depressive effect of this is not particularly strong, probably not in the same league as a beta blocker at the dosages alpha blockers are generally used at. However, the effect on BP by alpha blockers is also quite minimal at these dosages and hard to even detect in some cases.
Todd
Posted by smith562 on October 18, 2004, at 21:24:08
In reply to Antidepressant with Antihypertensive Properties!, posted by AlexSamuel on October 18, 2004, at 1:29:49
Hey AlexSamuel,
First, there are several antihypertensive still left that should not cause you severe side effects, namely norvasc, hydrochlorothiazide, cozaar, diltiazem (with mood stablizing properties). I am not sure if the common antidepressant such as MAOIs or TCAs help lower blood pressure or actually cause orthostatic hypotension. I believe most just cause orthostasis ... that is low blood pressure if you stand up too quickly. So most docs do not rely/use antidepressant for bp control. Exercise, low salt, potassium supplements, decrease alcohol and tobacco, weight loss are also helpful for many. Hope this helped! Hope your better soon.
Smith
> Hi
>
> I am suffering from both chronic depressiona and high blood pressure but it is quite unfortunate that I can't take any blood pressure medications. Beta blockers make my depression worse, ace inhibitors stall my libido completely. Medicines I never tried are those alpha blockers, but I have read somewhere, they may also cause depression worse. So Is there any antidepressant with antihypertensive property? If so I could have taken that. Pls help.
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