Does Amlodipine Cause Anxiety?(3 things you can do)

This article discusses whether Amlodipine will cause anxiety, what factors contribute to Amlodipine-induced anxiety and how to manage the adverse effects.

Does Amlodipine cause anxiety?

Amlodipine may cause anxiety. Amlodipine-induced anxiety is unknown but may affect an individual depending on several factors. Amlodipine is an L-type calcium channel blocker used to treat high blood pressure, chest pain and other cardiovascular ailments. Amlodipine is usually not known to cause anxiety, but some people may experience it due to other related factors and triggering factors like a stressful environment.

What does research suggest?

Research about Amlodipine-induced anxiety is limited. There exists a debate about the association of anti-hypertensives in contributing to mood disorders. However, evidence mainly points to calcium channel blockers to alleviate mood disorders like depression and anxiety.

Amlodipine-induced anxiety is limited to the slightest chance of the population experiencing it since it has occurred in only <1% of events (7).

In a 2013 study report, Amlodipine was found to cause tardive dystonic syndrome in two patients. Along with this condition, one patient also had neuropsychiatric issues where anxiety was also reported. The development of symptoms took 4 weeks, and after stopping Amlodipine, there was no occurrence of remission after 3 to 12 months under observation (1).

Though depression and anxiety were reported one month after starting Amlodipine, the question remains whether it is solely caused by Amlodipine because its pharmacological action in causing anxiety is not fully understood. Moreover, the calcium channel blockers are more likely to induce the Parkinsonism effect due to D2 antagonistic action, while comparatively, they are less known to play a role in causing anxiety(1).

In another study, genetic evidence showed a possible link between mood disorders and hypertension. The study emphasised genes CACNA1C and CACNAB2, which influence voltage-gated calcium channels. The CACNAB2 gene was found to replicate as a risk factor for both hypertension and mood disorders like anxiety (2).

To tackle this, they found an L-type calcium channel blocker called “Isradipine” to work against bipolar and mood disorders effectively (2).

Little is understood about calcium and anxiety association since lactate also, at times, has stood as a cause for inducing anxiety. Calcium is believed to play an important role in anxiety by inducing noradrenergic, serotonergic activation or gamma-aminobutyric inactivation in the septohippocampal area, which triggers anxiety (3,4).

Calcium channel blockers were found to inhibit calcium channels that are believed to reduce anxiety (3).

Calcium levels and mood disorders have a close connection to which the action of calcium channel blockers is observed. Good brain penetrability is the major characteristic that helps calcium channel blockers like Verapamil to reduce the incidence of mood disorders. This is where Amlodipine stands exceptional because Amlodipine does not have brain penetrability, thus increasing the risk of neuropsychiatric incidences (5).

What factors can contribute to anxiety caused by Amlodipine?

Amlodipine is not directly linked to causing anxiety. Individual variation can occur depending on various factors like :

• Genetics
• Arterial hypertension (Bp above 140/90mmHg)
• Hypotension
• Older population
• Presence of behavioural disorders
• Neurologic disorders

These factors influence anxiety in some individuals taking Amlodipine. However, sometimes anxiety occurs due to an individual’s existing neurological or psychiatric condition. Anxiety is also observed in individuals with lower blood pressure. Since Amlodipine and other anti-hypertensives can lower your blood pressure, this can be a probable cause for anxiety (6). If there is no history of anxiety before starting Amlodipine, the factors causing it should be analysed by the healthcare provider.

What to do if Amlodipine causes anxiety?

Seek medical help :

If signs of anxiety progress after initiating Amlodipine, it is better to consult your physician regarding the occurrence. Try to analyse and see if Amlodipine alone is the cause since anxiety is not a prevalent side effect. If anxiety persists, decrease or discontinue Amlodipine under your doctor’s advice.

After discontinuing or titrating the dose of Amlodipine, your anxiety might stop gradually, but if the anxiety persists, consult your doctor regarding the problem. You can consider cutting Amlodipine into halves if you find it difficult to swallow under a doctor’s approval.

An alternative medication may help:

Sometimes, your doctor might either provide alternative medication (other calcium channel blockers) or other medicines to tackle your anxiety. Stopping Amlodipine abruptly can worsen your blood pressure. So, it is important to not stop Amlodipine on your own without your doctor’s advice.

Engage in anxiety-relieving activities or join group sessions:

Engaging in activities such as your favourite hobbies or practising yoga can help you reduce your stress and anxiety. You may join therapy sessions or groups that help you reduce your anxiety.

Conclusion:

To conclude, Amlodipine has the slightest occurrence of causing anxiety, and individual factors majorly contribute to causing anxiety. Other existing conditions in an individual, like uncontrolled blood pressure, the older population, and mood disturbances, are more likely to have anxiety. If anxiety develops after initiation of Amlodipine, avoid self-discontinuation or tapering and discuss with your doctor for an alternative treatment or discontinuation of Amlodipine.

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