Posted by Racer on August 14, 2004, at 9:48:42
In reply to ADHD Blood Pressure Meds Cause High BP?, posted by crazychickuk on August 14, 2004, at 6:51:47
This is the answer I posted to this on the Health board, where this originally appeared.
> The problem:
>
> (1) He's had, for many years, very high blood pressure and has several TIAs and there is brain damage. I read that SSRIs and ADHD drugs do raise blood pressure.
>
There are a lot of anti-depressants which tend to lower BP, such as most of the tricyclics. (MAOIs can lower BP, too, but are associated with hypertensive crisis if strict dietary guidelines aren't adhered to.)
> (2) He's quite overweight - probably 70 pounds which we know contribute to high BP. However, I think in part because of mental problems he can't/doesn't lose weight. It's hard for him to exercise in a hot climate and 14 hours a day commuting & working & financial issues.
>
Give your husband a break on these two issues. First of all, if he's on Effexor, it's playing with his thermoregulatory system. It's hard enough to exercise in a hot climate, but add the existing weight problems, the existing BP trouble, and the effects of the Effexor -- he may even be better off not getting all that ambitious.As for the weight issue itself, *many* antidepressant drugs can cause weight gain. When I was taking a combo of Effexor and Prozac, I put on nearly 60 pounds. When I stopped the meds, though, the first 30 or so came off without me making any changes at all in diet or exercise. (My job was physically demanding, and it was quite demoralizing to be that heavy while I was already getting much more than the recommended amount of exercise just going to work. I had stopped getting on scales at all, because it was too upsetting, until one day I climbed on for some reason and saw that I weighed about 30 pounds less than I had expected. Mind you, I am estimating my highest weight, because I didn't have it in me to get onto a scale while the weight was still going up.)
And just because the doctor says that a medication is "not associated with weight gain" doesn't mean that that's true. The SSRIs, for example, are associated with weight gain in a significant percentage of the people who take them. The earlier studies, though, didn't catch that because it's a later-onset side effect that didn't become apparent in the short term studies that all the doctors read. With the exception of Remeron, which causes more initial weight gain, virtually all the newer drugs that cause weight gain don't show this effect until at least six month after starting.
>
> I got into a slightly heated discussion with his neurologist this morning when the neurologist refused to give him an Rx for ADHD med (of any kind) due to BP. He NEEDS a med that helps with that problem to help even out his agitation and curb his appetite. Without it he's in a downward spiral and complications continue. Part of the problem right now has become iatrogenic.
>
This might not be a good idea -- I know much too little about blood pressure, and mine is a bit too low -- but you might want to ask about Strattera. It's marketed as an ADHD med, but it was first developed as an antidepressant. I was on it for depression for a while, and it seemed to help me. It might be worth asking his doctor about it.Has your husband been diagnosed ADHD by a doctor? How recently has that diagnosis been verified? There's something in the back of my mind, but I don't want to offer it without those two questions answered.
> What's bothoring me in particular is that the doctor(s) don't seem to see the cause-and-effect process of continuing the BP meds that cause tremendous weight gain and depression followed by more med for depression followed by less activity and higher BP. Anyone else have a similar expereince or other insights?
>Again, I didn't know that BP meds caused weight gain -- would seem counter intuitive to me, since hypertension can be linked so closely to obesity. Then again, they got what they got.
(And they may not really know about the weight gain. A few months ago, a mental health professional told me that "anti-depressants don't cause weight gain. it's like with birth control pills -- when you take them, you just don't exercise enough and you eat more." Hello? Didn't that whole birth control pill thing get cleared up in the eighties? And hasn't this chick read as many of the recent professional discussions on the A/D topic as I have with my limited public access? The drug companies don't want the bad press of "the fat pill" and the studies are short term -- it takes years for the doctors to figure out the long term effects of any drug, because they have to have access to some people who have taken it long term. And then, too, some doctors still see obesity as a character flaw.)
Yes, lots of similar experiences on these boards. This is actually a question that would likely get a lot of good info on the main babble board if you post it there. There are some meds being tried along side a/ds that cause weight gain, but I can't remember the names -- maybe topamax was one of them? And there are a few a/d that are more weight neutral for a lot of people.
Best luck.
poster:Racer
thread:377374
URL: http://www.dr-bob.org/babble/20040811/msgs/377513.html