AboutDr Alan Galbraith Expertise I can answer most questions on drugs, both medical and "recreational". Answers can be given in either technical or layperson terminology. My main areas of interest are psychiatric, gastrointestinal and cardiovascular drugs.
Experience I have been a university lecturer/head of department for almost thirty years, but am now retired. My research interests were alcohol, smoking and cardiovascular disease.
Organizations Institute of Biology, London.
Publications Principal author of "Fundamentals of Pharmacology" 4th Edition published in November 2003 by Pearson Education, Australia.
Expert: Dr Alan Galbraith Date: 2/3/2008 Subject: Blood pressure spike
Question I recently had three surgeries. Two on my knee, one on my shoulder. I was put on Percocet for several months, and developed a dependency. I was able to wean off gradually using Clonidine. After stopping the drugs, my BP spiked at about 170/100. It stayed there in spite of being on Norvasc 5 m.g., Diovan 160 m.g., and Toprol XL 150 m.g. The doctor increased my Diovan to 320 m.g., and my Toprol to 200 m.g., to no immediate avail.
I had explained that I felt anxious all of the time, and she suggested I try Lexapro. I agreed, and after some mild digestive problems, seem to be doing well on it, except that I am waking up at 3:00 a.m. every day, wide awake. I am still getting 5-6 hours sleep, but dislike awakening so early. I normally get up at 5 a.m.
She also told me not to take the Toprol and the Lexapro together, so I have been taking the Lexapro in the morning, and the Toprol in the late afternoon.
My question is, I have always felt anxious, going back as far as I can remember. Since being on the Lexapro, my BP has been coming down steady, and is now at about 140/80. Is there a possibility that my hypertension has always been due to anxiety, and not another condition that has required BP medicine? I have never felt the BP meds totally solved my problem, hence the fact I am on three of them.
Thank you for offering any solution.
Answer Dear Kevin
I do not really believe that anxiety can cause hypertension so would discount this as as cause. You do not say if you were on any antihypertensive therapy before the clonidine. Clonidine is also a antihypertensive drug although better avoided if at all possible as a control drug as it can have undesirable side effects eg depression. If you are happy on the Lexapro and think it is helping with your anxiety but is causing the partial insomnia perhaps you could be put on another antidepressant which is less likely to cause insomnia eg mirtazepine or trazodone.
It is not unusual for three drugs and even more to be used in the treatment of hypertension.
