Does Pristiq cause hypertension? (3+ facts)

In this article, we will address the question of whether Pristiq can cause hypertension by citing relevant research studies. Additionally, we will explore the factors that contribute to hypertension while taking Pristiq and provide precautionary measures to reduce the risk of hypertension while on Pristiq.

Does Pristiq cause hypertension?

Yes, Pristiq can cause an increase in blood pressure. The medication guide for desvenlafaxine states that it can cause an increase in blood pressure as a side effect. (1) While taking Pristiq, it is important to note that changes in blood pressure may not affect everyone in the same way. The impact may differ based on individual circumstances. 

It’s important to note that high blood pressure can be caused by various factors other than medication. Therefore, it is advisable to monitor blood pressure and consult a healthcare professional if any unusual symptoms arise.

Pristiq is an antidepressant which belongs to a class of serotonin-norepinephrine reuptake inhibitors (SNRIs) and is used to treat depression. When antidepressants are prescribed for the long term, they increase the risk of side effects such as hypertension. (2)

If you are taking Pristiq for an extended period of time, it is crucial to attend regular check-ups with your healthcare provider. These check-ups are important to ensure that the medication is working effectively and to monitor any potential side effects.

What does the research suggest? 

Clinical trials, which were designed to evaluate desvenlafaxine’s effect on blood pressure, reported that short-term therapy of desvenlafaxine caused an increase in blood pressure. In these trials, desvenlafaxine at the dose of 10-400mg/day was administered for 8-12 weeks in a group of populations. (3)

In a case study, a 62-year-old woman who had a history of hypertension for 15 years was being treated with losartan 50mg and hydrochlorothiazide 12.5mg. Her BP was maintained at 122/82 mmHg. For her anxiety, she was being treated with desvenlafaxine 50mg/day because of her poor response to other antidepressants. (4)

After two weeks of desvenlafaxine treatment, her blood pressure increased to 200/120 mmHg. Desvenlafaxine was then discontinued, and other antidepressants were introduced in her treatment. After stopping desvenlafaxine, her BP came back to 122/80 mmHg within a few days. Hence, the study concluded that the increase in blood pressure was caused by the drug. (4)

The reports of desvenlafaxine-induced hypertension are rare. The incidence of hypertension caused by desvenlafaxine varies depending on the dosage, with rates of 1.3% at 50mg, 0.7% at 100mg, 1.1% at 200mg, and 2.3% at 400mg. (4)

How does Prisitq cause an increase in blood pressure? 

The effect of antidepressants on blood pressure depends on its mechanism of action. Antidepressants can affect blood pressure by more than one mechanism. SNRI class of antidepressants are known to cause an increase in diastolic blood pressure via an increase in myocardial and vascular sensitivity, which increases the cardiac output of blood and increases blood pressure. (5)

SNRIs such as desvenlafaxine act on the serotoninergic neurons and increase presynaptic serotonin levels. Serotonin has an effect on arterial constriction and vasoconstriction, which directly causes an increase in blood pressure. (5)

Serotonin affects the kidney function of retaining sodium and water during blood filtration by stimulating the release of cortisol and aldosterone. Serotonin causes the kidneys to reabsorb salt and water, which leads to an increased volume, which promotes hypertension. (5)

Along with serotonin, norepinephrine and dopamine also have an effect on blood pressure. The higher the dose of desvenlafaxine, the more it causes an increase in all three neurotransmitters, which has an additional effect on blood pressure. (5)

Desvenlafaxine can cause hypertension even at a lower dose. Caution should be maintained while administrating SNRI in pregnant women in view of pre-eclampsia (hypertension during pregnancy) (5)

What are the factors contributing to hypertension while taking Pristiq?

Apart from medication, hypertension can also be caused by other factors, such as: 

• Pre-existing condition: If you have hypertension, taking Pristiq can increase the likelihood of exacerbating your hypertension. 
• Disease condition: Diseases related to heart, kidney and diabetes can put you at a high risk of acquiring hypertension. 
• Drug interaction: A few medications such as other antidepressants (Lexapro, Xanax, fluvoxamine), stimulants, NSAIDs, etc can cause fluctuations in blood pressure
• Combination therapy: Combination therapy with antidepressants to treat mental illnesses can increase the concentration of serotonin, leading to increased side effects and increased risk of serotonin syndrome.
• Drug withdrawal: A sudden discontinuation of the drug can cause withdrawal symptoms and worsen your condition, along with an increase in blood pressure. 
• Overdose: An increased dose of desvenlafaxine causes serotonin syndrome, and one of the signs of serotonin syndrome is hypertension. 

It is essential to get evaluated for any underlying condition which may contribute to hypertension before discontinuing desvenlafaxine. 

What are the steps to take for Pristiq-induced hypertension? 

Suppose you are experiencing symptoms of hypertension, which include dizziness, lightheadedness, difficulty breathing, nausea, etc. Get your blood pressure checked. If the readings are high, consult your physician for proper management. Before coming to any conclusion, get yourself evaluated by a certified physician for any underlying cause of hypertension. If you have hypertension, make sure you check your blood pressure on a regular basis. 

If the increase in blood pressure is caused by Pristiq, it can be controlled by either decreasing the dose of the drug or by switching to another antidepressant. Any alteration in your regimen should be done under a physician’s guidance. Hence, avoid discontinuing the medication on your own. Attend regular follow-ups to monitor your blood pressure level and evaluate the progress of your treatment. 

In my experience, Pristiq can cause hypertension but is rarely seen in individuals taking the medication. You should be aware that the medication can lead to hypertension. Do not stop taking Pristiq suddenly as it may cause withdrawal symptoms; if you notice any unwanted changes in your condition, make sure you consult your physicain for proper management. 

References