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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by Deneb on April 25, 2010, at 20:51:15
I think I have orthostatic hypotension. Sometimes my vision dims and I go blind temporarily. My hearing is muffled and I feel like I am going to pass out.
Could it be a side effect of my meds? Celexa? Prozac? Risperdal? Propranolol?
Thankfully I have never actually fainted before. I always manage to lean onto something or squat down instead of fall down.
Anyone else have this side effect?
Posted by Emily Elizabeth on April 25, 2010, at 21:49:31
In reply to Orthostatic hypotension? side effect of what med?, posted by Deneb on April 25, 2010, at 20:51:15
Propranolol is designed to decrease BP, so I would imagine that it is a likely culprit. If it is a big problem, perhaps you are on too high of a dose or taking it too often. I'd consult pdoc.
Best,
EE
Posted by SLS on April 25, 2010, at 22:17:14
In reply to Re: Orthostatic hypotension? side effect of what med?, posted by Emily Elizabeth on April 25, 2010, at 21:49:31
The interaction between propranalol (NE beta blocker) and risperidone (NE alpha blocker) produces a synergy to greatly reduce blood pressure.
- Scott
Posted by evenintherain on April 25, 2010, at 22:31:56
In reply to Re: Orthostatic hypotension? side effect of what med?, posted by SLS on April 25, 2010, at 22:17:14
try increasing your fluids and upping your sodium intake? it might help...
Posted by stargazer2 on April 25, 2010, at 22:55:50
In reply to Orthostatic hypotension? side effect of what med?, posted by Deneb on April 25, 2010, at 20:51:15
Yes, many of us have had orthostatic BP to some degree. I bought a BP cuff to monitor my BP just so I know for sure how low it is. I once took my BP and it was 60/40, so you have to be careful of fainting or falling when you get up quickly...push fluids and extra salt will help but the med cuasing the hypotension needs to be reduced or discontinued.
What is your diagnosis and what are you on Propranolol for? What dose? That is an antihypertensive med for poeple with high BP but I think it is also given to peple with anxiety so that might be why you are on it but there are manyother meds for anxiety without making you feel dizzy.
I think I have heard that Celexa and Prozac shouldn't be given together because of serotonin syndrome? Not sure but worth looking into side effects of that.
In any event, you need med changes sooner rather than later. You could check your BP in a drugstore to find out what the BP is.
Call you doc if you haven't already and get your meds adjusted. That can be a very serious side effect since you're not getting enough blood to your head and that will make you pass out.
Feel better..
Posted by Deneb on April 25, 2010, at 23:22:04
In reply to Re: Orthostatic hypotension? side effect of what med?, posted by Emily Elizabeth on April 25, 2010, at 21:49:31
I really like the propranolol. I was actually going to ask for an increase in dose because I find 40 mg doesn't control my tremors all shift at work.
Maybe I was dehydrated.
Posted by Deneb on April 25, 2010, at 23:23:01
In reply to Re: Orthostatic hypotension? side effect of what med?, posted by SLS on April 25, 2010, at 22:17:14
Thanks for the info Scott
Posted by Deneb on April 25, 2010, at 23:24:18
In reply to Re: Orthostatic hypotension? side effect of what med?, posted by evenintherain on April 25, 2010, at 22:31:56
I don't want to increase my sodium as I've read it is unhealthy. I'll try to drink more water.
Posted by Deneb on April 25, 2010, at 23:34:46
In reply to Re: Orthostatic hypotension? side effect of what med?, posted by stargazer2 on April 25, 2010, at 22:55:50
I'm taking meds mostly to prevent depression and control my social anxiety. I also have borderline personality disorder, but I probably don't meet criteria anymore.
I take the propranolol for my social anxiety and my tremors. I have 40 mg pills as needed, but sometimes I take 60 mg.
I've heard of serotonin syndrome too, but I've been on this combo for years and I'm OK. Right now I take 60 mg Prozac, 20 mg Celexa and 0.75 mg Risperdal.
When I check my BP in the drug store it is normal. Last time I checked it, it was 107/71. I had not taken propranolol before the reading.
I also feel nauseous a lot and take a lot of Gravol.
I think I'm just going to live with it. I haven't actually fainted, so I think it is OK.
Posted by Phillipa on April 25, 2010, at 23:42:47
In reply to Re: Orthostatic hypotension? side effect of what med? » stargazer2, posted by Deneb on April 25, 2010, at 23:34:46
Deneb that's quite a dose of propanolol you might want to try decresing that. But please call your doc and report the temors again and the almost fainting. And get that BP cuff. Phillipa
Posted by Zyprexa on April 26, 2010, at 5:11:32
In reply to Orthostatic hypotension? side effect of what med?, posted by Deneb on April 25, 2010, at 20:51:15
I had that side effect on abilify. I would lye on the couch and get up to go to the bathroom and almost pass out. I've had the same thing on many other psychotropics, just not as bad as the abilify. Could be any one of your meds or all put together. Most likely its all of them.
Posted by stargazer2 on April 26, 2010, at 9:25:50
In reply to Re: Orthostatic hypotension? side effect of what med? » stargazer2, posted by Deneb on April 25, 2010, at 23:34:46
I checked the dose for Propranolol and it said for tremors 40 mg twice a day is a maintanance dose. So if your episodes are happening when you take 60 mg that might be too much at one time for you. If it is something that works well for the tremors, perhaps trying 40 twice a day for a few days might be better tolerated than 60 mg all at once. Good luck.
Posted by sdb on April 26, 2010, at 10:39:02
In reply to Orthostatic hypotension? side effect of what med?, posted by Deneb on April 25, 2010, at 20:51:15
> I think I have orthostatic hypotension. Sometimes my vision dims and I go blind temporarily. My hearing is muffled and I feel like I am going to pass out.
>
> Could it be a side effect of my meds? Celexa? Prozac? Risperdal? Propranolol?
>
> Thankfully I have never actually fainted before. I always manage to lean onto something or squat down instead of fall down.
>
> Anyone else have this side effect?it is most likely propranolol but celexa could contribute too. A betablocker isn't the greatest substance for depression. nadolol is structurally almost the same like propranolol but hydrophil.
a tiny dosage of nadolol say 5mg a day could do the same like propranolol. It works the whole day. Betablockers do have similar sideeffects but they aren't all the same.nadolol can cause dry eyes (better no contact lenses), tiredness like other nonselective agents.
there are some reasons for orthostatic hypotension.
Posted by Deneb on April 26, 2010, at 14:43:45
In reply to Re: Orthostatic hypotension? side effect of what med? » Deneb, posted by Phillipa on April 25, 2010, at 23:42:47
I've been complaining of almost fainting for years. So far I've never actually fainted.
Pdoc just tells me to not take propranolol when I exercise.
I get orthostatic hypotension even when I don't take propranolol. Maybe my other meds cause it.
It just gets really annoying when I almost faint after exercise or after taking a hot bath or something. Rarely the almost fainting is really bad. It has been scary sometimes.
I don't think a BP cuff would help. My blood pressure is normal whenever I measure it.
Posted by Deneb on April 26, 2010, at 14:47:11
In reply to Re: Orthostatic hypotension? side effect of what med?, posted by stargazer2 on April 26, 2010, at 9:25:50
Thanks. I think I will try 40 mg then 20 mg after a couple of hours. I usually just need to stop my tremors for about 6 hours.
Posted by SLS on April 26, 2010, at 15:40:44
In reply to Re: Orthostatic hypotension? side effect of what med? » stargazer2, posted by Deneb on April 26, 2010, at 14:47:11
> Thanks. I think I will try 40 mg then 20 mg after a couple of hours. I usually just need to stop my tremors for about 6 hours.
Do you ingest caffeine? I find that caffeine can make tremors worse.
- Scott
Posted by emmanuel98 on April 26, 2010, at 20:35:19
In reply to Re: Orthostatic hypotension? side effect of what med? » evenintherain, posted by Deneb on April 25, 2010, at 23:24:18
> I don't want to increase my sodium as I've read it is unhealthy. I'll try to drink more water.
It's not unhealthy to increase sodium if your blood pressure is low. The only unhealthy thing about salt is it can make your blood pressure too high. When I was taking parnate and perphenizine together, my blood pressure would drop to 60/40 and I'd stuff myself with saltine crackers and water to get it back to normal again. So salt is ok if you have hypotension.
Posted by Deneb on April 27, 2010, at 3:42:57
In reply to Re: Orthostatic hypotension? side effect of what med? » Deneb, posted by SLS on April 26, 2010, at 15:40:44
Yes I ingest caffeine sometimes, probably about 3 times a week or more. I'm actually wondering now if it is the caffeine that is giving me nausea as I often get nauseous after drinking a coffee.
I don't think the propranolol gives me orthostatic hypotension. I took some today and I felt fine.
Posted by Deneb on April 27, 2010, at 3:45:13
In reply to Re: Orthostatic hypotension? side effect of what med?, posted by emmanuel98 on April 26, 2010, at 20:35:19
I've complained to my pdoc/therapist about almost fainting many times. She thinks it is dehydration that is causing it.
Posted by gardenergirl on April 27, 2010, at 12:11:06
In reply to Re: Orthostatic hypotension? side effect of what med?, posted by Deneb on April 27, 2010, at 3:45:13
Could you have hypoglycemic episodes? I get the shakes when my blood sugar is lower. And it happens to me at times even when my blood sugar reads in the "normal" range, albeit the low end of "normal". I think I'm just more sensitive to it.
Do you get any other sensations when you almost faint? I've experienced something similar my whole life, usually when I stand up and stretch, especially if I put my head back even a little bit. I get this tingling feeling in my abdomen around the diaphragm area, and if I don't hold on to something and lower my head a bit, then it can progress to tunnel vision, sort of a buzzing in my ears, and eventually fainting. Often it feels as if my body is jerking a bit as I "recover", though the last time this happened my husband was present, and he said he couldn't see any tremors. Sure felt like it, though.
No doc has ever been able to tell me what's going on. I've had EEG's, tilt table and other testing for benign positional vertigo, and glucose tolerance tests. I just try to be really aware if I get that initial feeling and hold on to something.
Sorry I can't offer more help, just support.
gg
Posted by Deneb on April 28, 2010, at 12:24:48
In reply to Re: Orthostatic hypotension? side effect of what med? » Deneb, posted by gardenergirl on April 27, 2010, at 12:11:06
Thanks for the support GG.
I don't know if they are hypoglycemic episodes. As far as I know, my blood sugar levels have always been normal.
I get the tunnel vision, which turns into temporary blindness and the buzzing in my ears.
I haven't gotten tilt table testing or any other tests besides routine blood tests.
Posted by ed_uk2010 on April 28, 2010, at 14:47:25
In reply to Re: Orthostatic hypotension? side effect of what med? » gardenergirl, posted by Deneb on April 28, 2010, at 12:24:48
Hi Deneb,
Risperdal can certainly cause orthostatic hypotension at high doses, but you're only on a very small dose. Even so, you may notice an improvement when you come off it.
Propranolol does not usually cause orthostatic hypotension, even though it decreases BP.
Fluoxetine and citalopram do not usually affect BP.
Maintaining an adequate fluid and salt intake could be helpful. It's also important to stand up slowly if you've been sitting or lying down for a while.
Posted by Deneb on April 29, 2010, at 2:21:15
In reply to Re: Orthostatic hypotension? side effect of what med? » Deneb, posted by ed_uk2010 on April 28, 2010, at 14:47:25
Thanks for the info!
Hmmm...it seems like my meds are probably not the cause of my orthostatic hypotension. Since I don't get the near fainting all the time I think perhaps my pdoc is right and I was just dehydrated.
I dunno. It is so unpredictable. :/
I'm not increasing my salt intake though, I think lower blood pressure is healthy.
This is the end of the thread.
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