Antidepressants and Hypertension
It is known that depression occurs more frequently in individuals with chronic diseases, including those with high blood pressure. In some cases, the condition may require medication as a part of the comprehensive treatment of depression.
Finding the best antidepressant for high blood pressure individuals can be difficult and entails a thorough understanding of the person's mental health problems, comorbid diseases, as well as their regular medications. This is the task of your prescribing physician, with whom you should always consult before changing any medications.
Different Effects on Blood Pressure
There are over 20 antidepressants that are FDA-approved for treating depression and these have varying effects on the body, including the heart and blood pressure. Some medications are less suitable in patients with chronic cardiovascular disease, such as serotonin and norepinephrine reuptake inhibitors (SNRIs), as they may worsen hypertension.
On the other hand, multiple antidepressants are better suited for this group of individuals, such as selective serotonin reuptake inhibitors (SSRIs), which do not primarily affect the adrenergic and dopaminergic systems, which are involved in regulating the blood pressure.
Favorable Antidepressants
SSRIs are frequently the most favorable choice for treating depression in patients with high blood pressure. These medications include Sertraline, Citalopram, Escitalopram, Paroxetine, and Fluoxetine.
Research has shown that these medications have the least effect on the cardiovascular system and as a rule of thumb, SSRIs do not cause increased blood pressure or a higher pulse frequency.
What Is The Best Antidepressant For High Blood Pressure?
In practice, any SSRI will most likely be a suitable option, but this naturally depends on the specific person being treated. Consult your physician to learn more about your own best suitable alternatives.Nonetheless, out of all the SSRIs, Escitalopram stands out as the most reliable option for treating depression in those with high blood pressure, as it lacks any significant drug interactions with commonly used blood pressure medications. However, it should be noted that Escitalopram can prolong QTc time.
Medications That Warrant Caution
Several antidepressants may be less suitable for those with high blood pressure or cardiovascular problems. These are generally avoided if possible in individuals with chronic cardiovascular disease.
1. SNRIs
These medications include Venlafaxine and Desvenlafaxine, as well as Duloxetine to a lesser extent. SNRIs may not only cause high blood pressure, but they can also cause sudden falls in blood pressure when standing up after sitting or lying, something that is known as orthostatic hypotension.
2. Atypical Antidepressants
Some atypical antidepressants may not be suitable for those with problematic blood pressure. One of those medications is Bupropion, which can increase blood pressure as a side effect. Trazodone is another atypical antidepressant, and while it does not cause hypertension, it can often cause orthostatic hypotension, in addition to side effects like dry mouth and a stuffed nose.
3. Older Antidepressants
Almost all older antidepressants, like tricyclic antidepressants (TCA) and monoamine oxidase inhibitors (MAOI), may cause both excessive blood pressure as well as orthostatic hypotension. For this reason, these types of antidepressants are generally avoided in individuals with known cardiovascular problems.
Find An Antidepressant That May Suit You
Antidepressants vary greatly in their mechanism of action and side effects profile. Learning more about them can greatly enhance the overall treatment experience for those on the journey to recover from depression.
You can our free antidepressant quiz which consists of 20 questions. It can help you find a potentially suitable antidepressant for you, which you can further discuss with your psychiatrist.
Last update: February 18, 2024
Disclaimer: The information provided is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider, such as a physician, before starting any new treatment or making changes to your existing treatment plan. Individual responses to treatment may vary, and a healthcare professional can provide personalized guidance based on your specific needs and circumstances. If you are experiencing severe or persistent symptoms of disease or mental illness, seek immediate medical attention.