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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by CareBear04 on February 3, 2005, at 14:18:14
hi-- i don't know if this post would be more relevant to the health board, but since it is specific to medications, i thought this board was best.
when i run drug interactions on my 16 or so drugs, there are dozens of major interactions and more less severe ones. my blood pressure has been low lately-- between 70 and about 85 systolic-- and many of the interactions note additive hypotensive effects. almost anything combined with propranolol has a warning about fainting and orthostasis, espcially neuroleptics like haldol and seroquel, painkillers like vicodin and percocet, and others like phenergan, remeron, etc. i don't know if my blood pressure is low because of the drugs. i don't take them all regularly as i'm supposed to. my PCP thinks that my hypotension is more related to low weight and deconditioning from being sick. has anyone experienced low blood pressure from the meds or does anyone have any thoughts about dangerous combinations i should avoid or causes of low BP?
thanks so much! any thoughts or speculations would be great!
Posted by banga on February 3, 2005, at 16:32:08
In reply to psych meds and blood pressure, posted by CareBear04 on February 3, 2005, at 14:18:14
I just recently combined Desipramine and Abilify. I had been on desipramine for a while, no problem; but Abilify amplifies the effects of desipramine--and when I added this, for several days I almost felt like I was going to black out when I stood up. (deipramine has orthostatic hypotension as a possible side effect) I lowered the dose of both meds and felt better.
Also, once when I was using clomipramine and alcohol together, I had the same thing, and my pdoc just about fainted himself from fear when he measured my blood pressure!
I know just recently that my pdoc didnt combine two drugs we were considering due to the additive orthostatic hypotension effects.
So yes I can DEFINITELY see with all your meds that the result could be low blood pressure!
Posted by CareBear04 on February 3, 2005, at 19:30:42
In reply to Re: psych meds and blood pressure, posted by banga on February 3, 2005, at 16:32:08
thanks banga! the thing is, i don't really feel like my blood pressure is low anymore. at first, i was really orthostatic-- at worst, i was having 50 point pulse and BP changes from lying down to standing. this could also be due to dehydration. i used to feel really dizzy and shaky and would lie around most of the day. i've been more active lately, and i don't feel very dizzy anymore. i'm not having orthostatic dizziness, lightheadedness, vertigo or anything. but all this time, my pulse has been extra fast to make up for the low blood pressure, so as long as my heart can keep up, my organs and perfusion are ok. today after exercise, my heart rate was around 160bpm. could i be hypotensive and not know it because my heart is working extra hard? could it be that i've gotten used to low BP and have adjusted? how i feel doesn't correspond to the BP readings, but i haven't had it taken in a few weeks. the drugstore ones unfortunately don't work for me because the cuffs are designed for average size arms, not small or big ones.
when your doc took your BP and was shocked, how low was it? are there different threshholds for different people? could one person be walking around with a low BP while another person is in shock with that same reading?
thanks!
Posted by Phillipa on February 3, 2005, at 20:12:18
In reply to Re: psych meds and blood pressure » banga, posted by CareBear04 on February 3, 2005, at 19:30:42
Believe it or not, but the new guidelines now say that a BP over 120/80 Is the beginning of hypertension. While in the hospital, my am BP in bed was 90/64 or there abouts each day. Now they want lower BP's as well as cholesterol etc. Fondly, Phillipa PS By they I mean the AMA .
Posted by banga on February 3, 2005, at 21:45:00
In reply to Re: psych meds and blood pressure » CareBear04, posted by Phillipa on February 3, 2005, at 20:12:18
I don't know what my pressure was....and yes I can imagine it may differ in terms of how low it needs to be to cause a poblem.
With the rapid heart--tachycardia--do you know it is definitely related to low blood pressure? It can also be many other things--for instance tyroid dysfunction to name one I know of. Maybe check your meds to see if any have this as a side effect?....
Posted by banga on February 3, 2005, at 21:52:35
In reply to psych meds and blood pressure, posted by CareBear04 on February 3, 2005, at 14:18:14
PS you said you "ran" various drug interactions on your meds...is there a site where you can do that on the internet?? I could use that.
Posted by CareBear04 on February 4, 2005, at 1:02:59
In reply to Re: psych meds and blood pressure, posted by banga on February 3, 2005, at 21:45:00
hey-- i don't know, but i think pulse and BP tend to move in opposite directions. when BP falls, the heart tries to work harder to make up for it and to get the blood around. i think this is probably healthier than the conditions when BP and pulse both fall. of my meds, i know that propranolol and maybe benzos lower both. i'm not clear on the specifics. maybe someone else knows? drs in this area, for some reason, rarely check pulses, and neither do nurses. in dozens and dozens of drs visits recently and two hospital stays, i've only had my pulse taken maybe 3 times. i thought pulse was a 'vital" sign as in important! thanks for responding!
Posted by CareBear04 on February 4, 2005, at 1:03:59
In reply to Re: psych meds and blood pressure, posted by banga on February 3, 2005, at 21:52:35
yeah-- drugs.com and then click on interactions. it's the most thorough interactions checker i've found; beats many drs and pharmacists. good luck1
Posted by Minnie-Haha on February 4, 2005, at 10:37:05
In reply to Re: psych meds and blood pressure » CareBear04, posted by Phillipa on February 3, 2005, at 20:12:18
> Believe it or not, but the new guidelines now say that a BP over 120/80 Is the beginning of hypertension...
I wonder how much influence drug companies have had in lowering the cholesterol and blood pressure guidelines. These actions mean potentially thousands -- maybe hundreds of thousands or millions? -- more should be on prescription blood pressure and cholesterol drugs.
Posted by ed_uk on February 4, 2005, at 10:43:19
In reply to Re: psych meds and blood pressure, posted by Minnie-Haha on February 4, 2005, at 10:37:05
Hi,
>I wonder how much influence drug companies have had in lowering the cholesterol and blood pressure guidelines. These actions mean potentially thousands -- maybe hundreds of thousands or millions? -- more should be on prescription blood pressure and cholesterol drugs.
I would expect that they have had a very major influence!!
Ed.
Posted by CareBear04 on February 4, 2005, at 13:58:40
In reply to Re: psych meds and blood pressure » Minnie-Haha, posted by ed_uk on February 4, 2005, at 10:43:19
i bet you're right and the drug companies have lobbied hard to have the FDA guidelines for hypertension lowered. 120/60 seems like a healthy blood pressure for a young person, but i think there is a lot of healthy range around that, especially because it's natural for BP to rise with age. of course it makes sense that the drug companies would hype up the dangers of hypertension in order to create a larger market for drugs that they can price exhorbitantly. even though it's each company for itself as far as profits, i think they work best as sort of a cartel where to agree not to undercut each other and allot shares of the market. i hate the pharm industry! ever since i researched the top drug companies and their pricing of antiretroviral drugs of AIDS, i can't hear about them without wanting to spit! after two years as a mental health patient, i only know that i'll (1) never work for the pharm industry; (2) never work for managed care; and (3) never work in hospital administration. such things we learn as patients...
Posted by Phillipa on February 4, 2005, at 16:55:06
In reply to the evil pharm industry!, posted by CareBear04 on February 4, 2005, at 13:58:40
Good point. If your BP is too low, you feel dizzy. I was always told I had low BP at around 115/70's. Sometimes it goes higher like when I'm nervous. The drug companies are the "culprits", I'm sure. Fondly, Phillipa
Posted by Larry Hoover on February 8, 2005, at 7:14:10
In reply to Re: psych meds and blood pressure, posted by Minnie-Haha on February 4, 2005, at 10:37:05
> > Believe it or not, but the new guidelines now say that a BP over 120/80 Is the beginning of hypertension...
>
> I wonder how much influence drug companies have had in lowering the cholesterol and blood pressure guidelines. These actions mean potentially thousands -- maybe hundreds of thousands or millions? -- more should be on prescription blood pressure and cholesterol drugs.It's not drug company pressure....it's the realization that the adverse effects of hypertension are detectable in what used to be high normal blood pressure. It's no different than the "recalibration" of thyroid hormone levels. TSH of 9 used to be high normal.
The first resorts of treatments for hypertension and high cholesterol are still diet and exercise, not drugs.
Lar
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