Can fluvoxamine lower blood pressure? (+3 Tips)

In this article, we will answer some questions, such as “Can fluvoxamine lower blood pressure?”; “How can fluvoxamine lower blood pressure?”; “What does research say?; “How do you know you have low blood pressure due to fluvoxamine?”; “What favours experiencing low blood pressure due to fluvoxamine?; and “What are the risks of using fluvoxamine?” and “What are the tips for using fluvoxamine?”.

Can fluvoxamine lower blood pressure?

Yes, fluvoxamine can lower your blood pressure. This is considered one of its side effects. Patients taking fluvoxamine can experience an increased risk of a slow heart rate or blood pressure. It is one of the least adverse effects that you can experience, which appears in the form of orthostatic hypotension and falls (1).

Fluvoxamine leads to the induction of 5-HT depletion in platelets after long-term use. It increases 5-HT-free circulating levels, leading to an interference in blood pressure levels (2).

The fluvoxamine therapeutic dose starts at 50 mg/day and increases gradually to a maximum dose of 300 mg/day. It is the first-line treatment FDA-approved for obsessive-compulsive disorder, anxiety, and social panic.

Fluvoxamine is a selective serotonin reuptake inhibitor that increases the levels of serotonin in the brain, leading to a calming effect. It is taken orally as a whole capsule or tablet and swallowed as a whole without crushing or chewing.

The period of therapy may take from 4 to 9 weeks. Don’t stop your medicine by yourself; it should be gradually stopped under supervision.

How can fluvoxamine lower blood pressure?

Fluvoxamine reduces cardiac sympathetic and parasympathetic activities (3). Changes appear in the mean heart rate and blood pressure. 

A study reported the relationship between fluvoxamine therapy and hypotension (decreased blood pressure) in elderly patients (4).

Most reported research stated the relationship between fluvoxamine and low blood pressure. This proves that blood pressure monitoring is a must during therapy with fluvoxamine.

In addition to the decrease in blood pressure patients can experience cardiovascular effects. It decreases heartbeats by 4-6 beats/min. This decrease is caused by the central serotonergic effects on the cardiovascular system.

What does research say?

In a randomized double-blind study, thirty-two patients received a daily dose of 180 mg of fluvoxamine for 5 weeks (5). In the evaluation of the side effects, 2 of them suffered postural hypotension. This confirms that a decrease in blood pressure is a rare side effect of fluvoxamine.

There aren’t too many studies concerning the effect of fluvoxamine on blood pressure and the number of patients suffering from such adverse effects. However, we can’t neglect it but we have to mention it.

If you are taking any other medications that lower blood pressure, fluvoxamine should be taken with care. Combinatory therapy can cause severe hypotension which may be fatal.

How do you know low blood pressure is from fluvoxamine?

Notice the symptoms you feel after your dose intake of fluvoxamine. If you feel any of the following symptoms then it is fluvoxamine effect. these symptoms include:

  • blurred or decreased vision.
  • fatigue.
  • dizziness.
  • trouble concentrating.
  • nausea.
  • vomiting.
  • fainting.
  • Lowering in blood pressure appears as a side effect in long-term therapy rather than short-term therapy.

Several additional symptoms are associated with a severe decrease in blood pressure and require emergency medical care. These symptoms include:

  • confusion mainly in elderly patients.
  • being pallor.
  • cold with clammy skin.
  • weak-rapid pulse.
  • shallow-rapid breathing.

What are the risks of using fluvoxamine?

If you are using fluvoxamine, try to follow your doctor’s instructions carefully. If you experience any of the following symptoms, then you need emergency medical care. Call your doctor immediately. These symptoms include:

  • nausea.
  • vomiting.
  • diarrhoea.
  • drowsiness.
  • dizziness.
  • rapid or irregular heartbeats.
  • low blood pressure.
  • liver function disturbances.
  • decreased alertness.
  • convulsions and
  • coma.

Some drugs must be taken with care during therapy with fluvoxamine. These drugs are:

  • Monoamine oxidase inhibitors.
  • Linezolid.
  • Thiorizadine.
  • Tizanidine.
  • Pimozode.
  • Alosetron.
  • Rmalteon.
  • Methadone.
  • Lithium.
  • NSAIDs.
  • Tacrine.
  • Tryptophan.
  • Diltiazem.
  • Serotonergic drugs.

What favours experiencing lower blood pressure due to fluvoxamine?

Several reasons favour experiencing a decrease in blood pressure. These include:

  • Lifestyle: following a healthy lifestyle helps a lot in decreasing the effect of fluvoxamine lowering blood pressure.
  • Genetics: patients with a history of low blood pressure in their family can experience lower blood pressure with fluvoxamine than others.
  • Pregnancy.
  • Dehydration: Low fluid intake in the body leads to a decrease in the total volume of blood. This leads to a decrease in blood pressure. Try to be always hydrated.
  • Resting in bed for long periods.
  • Severe allergic reactions: patients allergic to fluvoxamine can suffer severe hypotension as a response to allergic reactions.
  • internal bleeding.
  • endocrine disorders.
  • diabetes.
  • liver diseases.
  • Cardiovascular problems with fluvoxamine cause a drop in blood pressure.

How to manage fluvoxamine low blood pressure?

Low blood pressure from fluvoxamine can be handled with several measures. These measures can include:

  • increase your salt intake in your meals.
  • drink plenty of water or fluids, especially on hot days.
  • don’t stand up suddenly but get up slowly from sitting.
  • eat small frequent meals.
  • Limit drinking alcoholic beverages.
  • avoid drugs that lower blood pressure like diuretics.
  • sit with your legs crossed.
  • avoid sudden movements.
  • limit exposure to hot water that causes vasodilation of blood capillaries leading to low blood pressure.
  • Avoid any medicines that may cause a decrease in blood pressure as diuretics, and antihypertensives.
  • Maybe you need to take some medicine to improve your case and consult your doctor. 
  • Regularly monitor your blood pressure while taking your medicine.

Untreated low blood pressure is a very serious case that can cause shock leading to death. 

What are the tips for using fluvoxamine?

  • Consult your healthcare provider and take your dose at bedtime.
  • Stay informed about research and studies on fluvoxamine.
  • It is recommended to monitor your blood pressure while on fluvoxamine, especially if it is used for a long time.
  • Avoid any behaviour that requires alertness, such as driving or using machinery.
  • Avoid taking caffeine in excessive amounts or with alcohol.
  • Try to drink plenty of water and always keep your body hydrated.
  • Inform your doctor about any drugs you are taking before starting therapy with fluvoxamine.
  • Don’t stop the medicine suddenly, as this can cause withdrawal symptoms and increase the side effects.
  • Physical exercise can help a lot.
  • Try to make your surrounding environment suitable for sleep to avoid insomnia.
  • Fluvoxamine intake doesn’t require adjustment in cases of renal disorders; however, the dose needs to be reduced in cases of liver diseases (6).
  • If you have experienced any suicidal thoughts or mood alterations, immediately ask for medical assistance.

Conclusion

To sum up, taking fluvoxamine can cause a decrease in blood pressure. This is a rare side effect that appears after long-term therapy periods. In my opinion, seek emergency medical care if you experience any unusual feelings, especially if they persist for some time. Avoid any combinatory therapy from yourself. Any suicidal thoughts or behavioural changes need emergent medical care.

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References

1.-

Calvi A, Fischetti I, Verzicco I, Belvederi Murri M, Zanetidou S, Volpi R, Coghi P, Tedeschi S, Amore M, Cabassi A. Antidepressant Drugs Effects on Blood Pressure. Front Cardiovasc Med. 2021 Aug 3;8:704281. doi: 10.3389/fcvm.2021.704281. PMID: 34414219; PMCID: PMC8370473. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8370473/

2.-

Meier CR, Schlienger RG, Jick H. 2001. Use of selective serotonin reuptake inhibitors and risk of developing first-time acute myocardial infarction. Br J Clin Pharmacol. 52:179–84. 10.1046/j.0306-5251.2001.01426.x. https://pubmed.ncbi.nlm.nih.gov/11488775/

3.-

Volkers, A. C., Tulen, J. H. M., van den Broek, W. W., Bruyn, J. A., Passchier, J., & Pepplinkhuizen, L. (2004). Effects of Imipramine, Fluvoxamine and Depressive Mood on Autonomic Cardiac Functioning in Major Depressive Disorder. Pharmacopsychiatry, 37(1), 18–25. https://psycnet.apa.org/record/2004-11290-003

4.-

R. Briggs, D. Carey, T. McNicholas, P. Claffey, H. Nolan, S.P. Kennelly, R.A. Kenny, 2018. The association between antidepressant use and orthostatic hypotension in older people: a matched cohort study, Journal of the American Society of Hypertension, Volume 12, Issue 8, Pages 597-604.e1,
https://doi.org/10.1016/j.jash.2018.06.002.https://www.sciencedirect.com/science/article/pii/S1933171118301633

5.-

Lapoerre YD. Browne M. Horn E. Oyewumi LK, Sarantidis D. et al Feb 1987. Fluvoxamine or Imipramine for Major Affective Disorder?.  Journal of Clinical Psychiatry 48: 65-68.   https://link.springer.com/article/10.1007/BF03291244

6.-

Zhong Z, Wang L, Wen X, Liu Y, Fan Y, Liu Z. 2017. A meta-analysis of effects of selective serotonin reuptake inhibitors on blood pressure in depression treatment: outcomes from placebo and serotonin and noradrenaline reuptake inhibitor controlled trials. Neuropsychiatr Dis Treat. 13:2781–96. 10.2147/NDT.S141832. https://www.dovepress.com/a-meta-analysis-of-effects-of-selective-serotonin-reuptake-inhibitors–peer-reviewed-fulltext-article-NDT

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