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  • Cymbalta Hypertension

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    Old 08-08-2009, 12:51 PM   #1
    bhi1992
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    Cymbalta Hypertension

    Hello,
    I have been on Cymbalta 50/60mg since Jan. Had been on Zoloft for 10 yrs and it stopped working). Also have some neck and back pain that cymbalta has helped with.
    I never had a problem with high blood pressure but I do now and have started on Atenolol 50mg and Lisinopril 10mg and still it has only come down slightly (now 140-180/90-100). My pcp wants me to go off Cymbalta but I am terrified. I also think I am more depressed since starting the Atenolol. Any thoughts on switching?
    Thanks,
    Cheryl

     
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    Old 08-09-2009, 03:41 AM   #2
    Cowsandcows15
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    Re: Cymbalta Hypertension

    Did the Zoloft has help with neck/back pain?

    Since you stated your high blood pressure problem occured after being on Cymbalta, then it does seem linked together. So in my person opinion your best options would be:

    1. Taper off Cymbalta, but switch over to a different SSRI besides Zoloft (like Lexapro, Prozac, etc). Since Zoloft worked for you, but simply stopped working, then what most doctors normally do is switch you to a different medication in the SAME CLASS. Cymbalta isn't an SSRI, but rather a serotonin norepinephrine reuptake inhibitor. So I guess I'm slightly suprised he didn't just switch you from Zoloft, an SSRI, to another SSRI. Maybe he just thought Cymbalta would be best for you, I don't know. Either way, it seems you need off it since it's a possible cause of high-blood pressure. If you taper off, and then switch to an SSRI, there should be minminal to no withdrawl effects (because Cymbalta withdrawl is basically the same as SSRI withdrawl).

    2. If your blood pressure still is high after this, or, if you just need something short-term to change while doing the antidepressant switch - then asked to be changed from Atenolol. Atenolol is an older medication, and a beta-blocker, and one if it's possible side effects is depression. So it very well could really be causing you to feel slightly more depressed. Ask to be switched to a newer type of high-blood pressure medication, such as Benicar, which is associated with far less side effects than older Beta-blockers such as Atenolol.

    3. As for the Lisinopril, if that still helps in lowering the blood pressure then great. If not, there are another type of blood pressure medications that seem to work better. Lisinopril is an ACE inhibitor which can be used to treat high blood-pressure, but there are other classes to also treat high blood pressure such as Clonidine, which is an A2 adrenergic agonist. Both Lisinopril and Clonidine can be used to treat low blood pressure, but since they work differently, yet have the same goal, then if Lisinopril still isn't working good enough then perhaps a switch to Clonidine would work. But of course, if your doctor switches you to Benicar then that very well may be enough to treat your high-blood pressure by itself, and then with the switch back to an SSRI type medication, your problem may be solved.

    Last edited by Cowsandcows15; 08-09-2009 at 03:44 AM.

     
    Old 08-10-2009, 07:08 AM   #3
    bhi1992
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    Re: Cymbalta Hypertension

    Thank you so much for your response. I did not have neck/back pain until after several surgeries involving vocal polyps. That is why they prescribed Cymbalta.
    I see my PCP tomorrow and will mention your suggestions. Would Lexapro be your first suggesation for another SSRI?
    Thanks again and I will keep everyone informed.

     
    Old 08-10-2009, 08:57 AM   #4
    Cowsandcows15
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    Re: Cymbalta Hypertension

    For SSRI's it's pretty much impossible to determine which would work best for someone... Although Lexapro is the MOST selective of all SSRI medications. (meaning it truly only effects serotonin). The previous SSRI med you where on though, Zoloft, at high doses it actually starts to hit some dopamine receptors too. This can be a good or bad thing, just depending on what chemicals need to be altered in the brain. Although Zoloft is by no means strong acting on dopamine at all, only at a higher doses it has a very SLIGHT effect on dopamine.

    Lexapro is also generally thought as to be the fastest kicking in SSRI. And if serotonin is truly the problem, then since Lexapro is the most selective in it's action then it seems like the best option. The only cons of Lexapro is there isn't much room for dosage changing, and it's withdrawal effects if stopping is so-so. It's definitely not the worst, that would go to to Paxil, and Effexor (not an SSRI though) in terms of withdrawal effects.

    But sometimes it's just trial and error when figuring out the right meds, as everyone can react differently to them. Personally I was put on Lexapro, and then switched to Zoloft, which both gave me too much of bothersome side effects. Then I got on Prozac, and that's what's worked the best for me. And in terms of withdrawal from SSRI'S, Prozac has the longest half-life, making discontinuation probably the least harsh of all SSRI'S.

    So if you're looking for an SSRI and only want to have serotonin adjusted, then Lexapro would be one of the top picks I'd say.

    Last edited by Cowsandcows15; 08-10-2009 at 09:02 AM.

     
    Old 08-11-2009, 07:28 AM   #5
    bhi1992
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    Re: Cymbalta Hypertension

    Thanks so much for your advice. I am seeing PCP this am and will keep you informed.

     
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