Hi AAAAA,

Thanks for your question.

All the medicines prescribed by your doctor last time (clonazepam, pregabalin and pexep CR) are due to your panic attack and for your knowledge i would like to tell you panic disorder is a part of anxiety disorder and any kind of anxiety disorder increase the blood pressure.

Now among this drugs clonazepam and pregabalin doesn't increases blood pressure, instead they can reduce blood pressure and cause postural hypotension in some patient.

But about paroxetine which is a antidepressant can cause mild rise of blood pressure and it also causes increase in cholesterol,triglyceride level and weight gain so better to avoid in hypertensive patient.

About the side effect profile of this three drugs all have common side effects of drowsiness,vertigo,excessive day time sleepiness.

Paroxetine have side effects of constipation,headache,weight gain and sexual dysfunction as common side effects.

Pregabalin have side effects of allergic reaction, swelling of lip,tongue,mouth and burning, numbness in the hand are common side effects.

So in your profile i think paroxetine should be replaced other drugs are very safe and needed in your cases.

Please consult your physician for opinion regarding changing of drugs.

Would you like to know anythings else?please feel free to contact me.

Best wishes,

Dr Sourav Ganguly

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Hi XXXXXXX

Thanks for your query,

Your BP now in normal range and your 2D Echo,stress test,CT coronary artery is normal.

So no need to add any antihypertensive as it may lower your BP and remember propanolol is a antihypertensive as well as a very good anti anxiety drug so very useful in panic disorder. In your case propanolol is the best choice as it act on both hypertension and panic attack.

By the way paroxetine not only raise BP some patients, as i told earlier it also causes increase in cholesterol,triglyceride level and weight gain that is causing harm on hypertensive patients.

So don't add any hypertensive and consult your physician for opinion regarding changing of paroxetine.

Don't worry there are so many other drugs for panic attack which don't increase blood pressure

Would you like to know anything else? Please feel free to contact me.

Best wishes,

Dr Sourav Ganguly

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Hi XXXXXXX

Thanks for your query.

You can replace paroxetin with desvenlafaxine, which is not associated with raised BP and no effect on lipid profile.

Please consult with your physician and on his advice you can change paroxetine to venlafaxine.

Hope I have answered your query. If you have any further questions I will be happy to help
If you do not have any clarifications, you can close the discussion and rate the answer.

Wish you good health.

Best Wishes,

Dr Sourav Ganguly

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