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    Suggest treatment for depression when on BP medication

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Posted on Thu, 29 Jan 2015 in Hypertension and Heart Disease
Question: I have high blood pressure and depression. Limbitrol worked well for my depression, but when I started Blood Pressure Medication It blocked Limbitrol and I felt depressed. After many changes of BP medication, I am taking Micardis 80 MG. My blood pressure is 153/75 and needs a tweak. What other BP medication do not react with Limbitrol and cause depression. Also, I cannot take diurectics.
doctor
Answered by Dr. Shubham Mehta 47 minutes later
Brief Answer:
Change in either antihypertensive or antidepressant should be considered.

Detailed Answer:
Hello
Welcome to HCM.

I can understand your concerns.

Micardis usually donot interact with limbitrol.

In your case, where you are having drug interactions between limbitrol and micardis, I would suggest you the following:

1. Change the antihypertensive. The other drugs which have negligible interactions with limbitrol is atenolol. If not tried earlier, you can use this.

2. Change antidepressant. Escitalopram (SSRI) is an antidepressant with least drug interactions and it is considered quintessential SSRI, that is it has effects only on serotonin receptors.

Additionally, lifestyle modifications like restricting salt intake, avoiding fatty and oily food, regular 30 minutes brisk morning walk and relaxation exercises like deep breathing and meditation can help to control both blood pressure and depression.

Hope this helps.

Feel free to ask further.

Thanks.
Dr. Shubham Mehta,MD.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Shubham Mehta 1 hour later
You have it wrong. Micardis does not make me depressed, It works well with Limbitrol. But my BP is not low enough and I was asking for another BP medicine to add to the Micardis. Atenolol was the first BP medicine and it made me depressed.
doctor
Answered by Dr. Shubham Mehta 9 hours later
Brief Answer:
stick to micardis. donot add another drug.

Detailed Answer:
Sorry for understanding your query wrong.

Thanks for correcting me in follow-up post.

Firstly, may i tell you some latest recommendation for management of high blood pressure:
1. In the general population ages 60 and older, pharmacologic treatment to lower BP should be initiated at a systolic blood pressure (SBP) of 150 mmHg or higher or a diastolic blood pressure (DBP) of 90 mmHg or higher.
2. If goal BP is not reached within a month of initiating treatment, increase the dose of the initial drug or add drug from ACE inhibitors, calcium channel blockers, Angiotensin receptor blockers or diuretics.

Since you have had issues with most of the drug categories recommended, an additional drug from these categories will not be beneficial.

There are other drugs like clonidine and moxonidine which can be used in your case. Discuss this with your doctor.

But as per guidelines and in my opinion, your blood pressure is almost in normal range. An additional drug may cause hypotension and lead to dizziness and lightheadedness.
Limbitrol itself can lower BP.

So you should just stick to micardis and monitor your BP. In case it stay high, moxonidine or clonidine can be considered under doctor's supervision.

Hope this helps.

Sorry for late response.
Wish you goid health.
Thanks.
Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Shubham Mehta

Psychiatrist

Practicing since :2008

Answered : 2004 Questions

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