Know a little about “medicine” | How to use medicine for hypertension and depression?

Ms. Wang, 73, has suffered from high blood pressure for many years and has been taking medication regularly. She was recently diagnosed with depression and her psychiatrist prescribed her venlafaxine tablets, but after taking them, she found that her blood pressure fluctuated greatly. How should she take the medication?

Studies have found that the incidence of depression in hypertensive patients is as high as 20%-30%. The types of antihypertensive drugs that patients with depression choose include: angiotensin II receptor antagonists (ARBs), angiotensin converting enzyme inhibitors (ACEIs) and calcium ion antagonists (CCBs). These drugs can be used for hypertensive patients with anxiety and depression. However, lipophilic beta-blockers and central nervous system inhibitors should be avoided as much as possible for hypertensive patients with depression and depression.

Among antidepressants, tricyclic antidepressants (TCAs) have a complex relationship with hypertension. Their anticholinergic effects can easily cause high blood pressure. They should not be used by patients with hypertension. Instead, anti-anxiety and anti-depressant drugs with high safety and definite efficacy should be given priority, such as selective serotonin reuptake inhibitors (SSRIs), serotonin and noradrenergic reuptake inhibitors (SNRIs), serotonin 1A (5-HT1A) receptor partial agonists, and flupentixol and melitracen. However, it should be noted that SNRI antidepressants venlafaxine can increase blood pressure, and duloxetine can cause postural hypotension. SSRI antidepressants escitalopram can cause postural hypotension; fluoxetine and fluvoxamine are CYP450 3A4 enzyme inhibitors, which can increase the blood concentration of some antihypertensive drugs, enhance the antihypertensive effect, and increase the risk of rhabdomyolysis of statin lipid-lowering drugs.