Posted by Elizabeth on October 16, 2001, at 17:39:50
In reply to Re: Blood pressure meds which can worsen depression?, posted by dave_fox on October 15, 2001, at 12:35:31
> > I think that it's *not* nearly as common a phenomenon
> > as it used to be, although it may happen sometimes.
>
>
> I wonder why it is not as common as it used to be? What has changed in the interim to make it less common?Err, I meant "as used to be thought." Sorry about that. (That is, a lot of cases of depression that might have been ascribed to beta blockers in the past probably weren't caused by the b-blockers after all.)
> I am on Ramipril. The doc has very recently increased my dose and is due to review it in a few weeks time. Do you know if the ACE-I meds differ amongst themselves? In other words, if Ramipril fails to work for me then would it be worth trying another from the same group?
That I don't know about -- my knowledge about BP meds only covers the areas relevant to psychiatry, if you know what I mean (e.g., whether they cause depression, how to treat antidepressant-induced hypertension, orthostatic hypotension caused by psych meds, etc.).
> I was surprised to read on the Net (yeah, I know I need to be careful with Net information) that ACE-I drugs work in only about two-thirds of patients. Have you heard this?
It's not that bad a record -- ADs work about equally often.
> Alpha-adrenoceptor blocking drugs:
>
> doxazosin (UK: Cardura)
> indoramin (UK: Baratol)
> prozosin (UK: Prazosin, Hypovase)
> terazosin (UK: Hytrin)Hmm. I was curious because phentolamine is the recommended drug to use for MAOI-associated acute hypertension, but it's not available in a pill in the US. I think a pill form is being studied (or was recently) for erectile dysfunction, of all things.
> It seems best to avoid tempting fate by trying these meds.
If you need medication for cardiovascular disease, you need it. I don't know how bad your BP problem is, whether there might be other ways to fix it, etc. Also don't be too surprised or discouraged if the first thing you try doesn't work by itself.
> I am told that if the ACE meds do not work that a common next step is to augment them with a thiazide diuretic. However, I am aware that these diuretics have a reputation for adverse sexual side effects and unless they are at a low dose then I would be reluctant to try them too soon.
Yeah, the sexual side effects of medications (antidepressants, antihypertensives, etc.) are often considered irrelevant by the physician, but they sure make a difference for patients! I don't know how frequent or serious the problem is with HCTZ, etc. -- maybe you would find the answer on a support group for people with cardiovascular disease, since people here can tell you everything that you want to know (or more than you wanted to know) about antidepressants' sexual side effects....
-elizabeth
poster:Elizabeth
thread:80913
URL: http://www.dr-bob.org/babble/20011015/msgs/81417.html