Sertraline and high blood pressure?

[Pamplemousse]

I started taking the above last week, but noticed my blood pressure was very high in the evenings - one day it was 170/95 which prompted a call to 111.

Could the sertraline have caused this?

[Scissel]

I think you made the right decision to call. 170 Systolic blood pressure can sometimes happen but only in spurts, however, the 95 Diastolic blood pressure concerns me.

I was on Sertraline for years and never had that happen. Could it be a different medication? Do you normally have hypertension?

I hope you feel better.

[Pamplemousse]

I think you made the right decision to call. 170 Systolic blood pressure can sometimes happen but only in spurts, however, the 95 Diastolic blood pressure concerns me.

I was on Sertraline for years and never had that happen. Could it be a different medication? Do you normally have hypertension?

I hope you feel better.

Hi there,

yes, I do have hypertension (have had it for years) and it's managed with lisinopril and amlodipine. I'm approaching 57 years old.

Here in the UK the guideline for BP intervention is 180/110 and the out of hours GP I spoke to said he wasn't overly concerned about the 170/95 - now, I stopped taking the Sertraline and tonight it was 146/77 (it was 124/76 in the morning).

I might reintroduce the Sertraline to see if it is that and if so, tell my GP to prescribe me something else although I was in a state of high anxiety for a couple of days when I took that reading.

[panic_down_under]

I spoke to said he wasn't overly concerned about the 170/95 - .

Serotonin mediates blood vessel tone, constriction and dilation, so the increase serotonin activity triggered by sertraline may have caused the BP spike. Both elevated and low BP are listed initial side-effects with a slight drop being the more likely. It is usually temporary diminishing as the med reduces serotonin synthesis and expression. The increased anxiety ADs often cause initially may also have raised your BP.

Serotonergic ADs are mild anticoagulants which may reduce the risk of heart attacks and ischaemic strokes, though they may slightly increase that of the much less common haemorrhagic stroke.

I stopped taking the Sertraline and tonight it was 146/77 (it was 124/76 in the morning)

If you only missed only one dose before taking this reading then it suggests the AD probably wasn't the cause as sertraline blood plasma levels wouldn't have dropped much in the first 24 hours.

I might reintroduce the Sertraline to see if it is that

Cool, but be aware that anxiety from taking it again may also trigger a BP spike.

[Pamplemousse]

Serotonin mediates blood vessel tone, constriction and dilation, so the increase serotonin activity triggered by sertraline may have caused the BP spike. Both elevated and low BP are listed initial side-effects with a slight drop being the more likely. It is usually temporary diminishing as the med reduces serotonin synthesis and expression. The increased anxiety ADs often cause initially may also have raised your BP.

Serotonergic ADs are mild anticoagulants which may reduce the risk of heart attacks and ischaemic strokes, though they may slightly increase that of the much less common haemorrhagic stroke.

Thanks for this, it's much appreciated. For me, the terror lies in the stroke risk - how do you get help when you live alone and can't communicate?

If you only missed only one dose before taking this reading then it suggests the AD probably wasn't the cause as sertraline blood plasma levels wouldn't have dropped much in the first 24 hours.

By this time I'd missed two - does that make a difference?

I'm really in a bad place here: my MH has suffered badly since stopping the citalopram, but it took a long while to manifest itself. What surprised me was how easily I withdrew from it, with no immediate side-effects. However, I am still of the belief it wasn't working in a manner that was helpful.

Now I have a possible solution but I am terrified it will hospitalise me or worse still, kill me.

[panic_down_under]

For me, the terror lies in the stroke risk - how do you get help when you live alone and can't communicate?

The risk is very small and if the AD is causing the BP spike unlikely to last long. Maybe set up a phone system with family, or friends to call you, or you them several times a day to check on you.

By this time I'd missed two - does that make a difference?

Yes, but you would still have had a fair amount of sertraline in your system.

I'm really in a bad place here: my MH has suffered badly since stopping the citalopram, but it took a long while to manifest itself. What surprised me was how easily I withdrew from it, with no immediate side-effects. However, I am still of the belief it wasn't working in a manner that was helpful.

Despite the impression given by support groups like NMP, most have only only mild side-effects when first taking ADs, or withdrawal symptoms when weaning off them. How much citalopram were you taking before quitting?

Now I have a possible solution but I am terrified it will hospitalise me or worse still, kill me.

Very unlikely. SSRIs are often prescribed to heart attack and ischaemic stroke survivors to treat the anxiety and depression that often follows. If it will ease your mind talk to your GP about increasing the dose of one, or both of the BP meds for a few weeks.

[Pamplemousse]

The risk is very small and if the AD is causing the BP spike unlikely to last long. Maybe set up a phone system with family, or friends to call you, or you them several times a day to check on you.

Given I have virtually no friends and I don't really speak to my family, that will be difficult.

Despite the impression given by support groups like NMP, most have only only mild side-effects when first taking ADs, or withdrawal symptoms when weaning off them. How much citalopram were you taking before quitting?

30mg. Then went down to 10mg (it's been covered on here), tapering over six weeks.

Very unlikely. SSRIs are often prescribed to heart attack and ischaemic stroke survivors to treat the anxiety and depression that often follows. If it will ease your mind talk to your GP about increasing the dose of one, or both of the BP meds for a few weeks.

The key word there being survivors.

This is the UK. It's almost impossible to get even a telephone appointment with a GP now - I actually contemplated going to my practice and threatening to open a vein in front of the receptionists that guard the place to get a phone call to force the issue over MH issues. Even e-consults are triaged before a precious GP gets their hands dirty reading one. I'd love to know how they still justify their average GBP98,000 a year salaries.

[panic_down_under]

Given I have virtually no friends and I don't really speak to my family, that will be difficult.

That is a pity. There appear to be organisations such as Revival and Progress Lifeline which do regular welfare checks. Maybe ask your GP to refer you to one in your area.

The key word there being survivors

The point being that SSRIs don't usually adversely affect cardiovascular health even following major trauma to the system.

This is the UK. It's almost impossible to get even a telephone appointment with a GP now - I actually contemplated going to my practice and threatening to open a vein in front of the receptionists that guard the place to get a phone call to force the issue over MH issues. Even e-consults are triaged before a precious GP gets their hands dirty reading one. I'd love to know how they still justify their average GBP98,000 a year salaries.

I don't know enough about the NHS system to suggest anything, but assume there is some way to get help. A&E at the nearest hospital maybe? The social workers at the hospital may be able to advise on the welfare checks too.

[Pamplemousse]

I don't know enough about the NHS system to suggest anything, but assume there is some way to get help. A&E at the nearest hospital maybe? The social workers at the hospital may be able to advise on the welfare checks too.

A&E units are swamped at hospitals - record numbers, in fact; we're getting our winter deluge NOW. Some hospitals are even declaring 'major incidents'. People are now presenting with untreatable cancers because GPs wouldn't see them earlier.

And as for social workers: there's no nice way of saying this as you've been so very helpful... but I'll take my chances ta, as there's no way on God's Earth that I am letting those interfering *******s get a foot in my door

[panic_down_under]

The only other thing I can think of is buying emergency call device that phones either a call centre, or person you know if a button is pressed. Some will also make the call if they detect the wearer is unresponsive.