Hypertensive crisis associated with venlafaxine

Khurana, Rahul N.; Baudendistel, Thomas E.

doi:10.1016/s0002-9343(03)00472-8

Cited by 35 publications

(27 citation statements)

References 4 publications

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“…Venlafaxine was stopped and the patient became normotensive. In another study (Khurana & Baudendistel 2003) described a case with hypertensive crisis associated with venlafaxine. Blood pressure was 224/148 mm Hg.…”

Section: Discussionmentioning

confidence: 99%

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Venlafaxine as single therapy associated with hypertensive encephalopathy

Edvardsson

2015

SpringerPlus

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IntroductionHypertensive encephalopathy with the clinicoradiological entity posterior reversible encephalopathy syndrome in the setting of venlafaxine as single therapy has not been reported earlier.Case descriptionA 46-year-old man developed hypertensive encephalopathy associated with venlafaxine as single therapy. Magnetic resonance imaging of the brain, pre and post gadolinium, carried out on day 2, displayed an increased T2 signal in the cortex on both the T2 and FLAIR images throughout the frontal and temporal lobes and in the cerebellum. Venlafaxine therapy was stopped. The patient gradually improved and he became seizure free and the blood pressure successively became normal. A magnetic resonance imaging after six weeks displayed marked regression of the abnormalities. On follow-up after 3 months, his blood pressure had been normal and he had not had any symptoms. The prescribed antiepileptic drug was discontinued as well as antihypertensive treatment. He had not experienced any new symptoms at follow-up after one year.Discussion and evaluationThe patient in this report had hypertensive encephalopathy associated with venlafaxine therapy. The imaging findings are compatible with hypertensive encephalopathy/posterior reversible encephalopathy syndrome. Venlafaxine is a drug used very frequently. Venlafaxine may infrequently induce hypertensive crisis.ConclusionHypertensive encephalopathy may rarely occur in the setting of venlafaxine as single therapy even in low to moderate doses. Patients on venlafaxine should have regular monitoring of blood pressure. Knowledge of the side effects is vital. Venlafaxine must be discontinued if significant hypertension persists.

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Section: Discussionmentioning

confidence: 99%

“…The dose of venlafaxine was only 75 mg/day but that patient also took disulfiram which may have increased the toxicity of venlafaxine. Disulfiram as single therapy can also cause hypertension (Khurana & Baudendistel 2003). A MRI of the brain displayed abnormalities consistent with hypertensive encephalopathy/PRES.…”

Section: Discussionmentioning

confidence: 99%

Venlafaxine as single therapy associated with hypertensive encephalopathy

Edvardsson

2015

SpringerPlus

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“…Despite the prevalence and societal burden of depression, the treatments currently available and their clinical efficacy remain unsatisfactory (Malberg & Blendy, 2005). Various classes of antidepressant drugs, including monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), and selective noradrenaline reuptake inhibitors (SNRIs), may induce serious side effects, such as cardiac toxicity, hypopiesia, sexual dysfunction, body weight gain, and sleep disorders (Antai-Otong, 2004;Baldwin et al, 2006;Khurana & Baudendistel, 2003;Park et al, 2005). Thus, the identification of affordable drugs with few side effects among traditional Chinese medicines has recently gained considerable interest for Chinese investigators.…”

Section: Introductionmentioning

confidence: 99%

Involvement of norepinephrine and serotonin system in antidepressant-like effects of hederagenin in the rat model of unpredictable chronic mild stress-induced depression

Liang

Huang

Wang

et al. 2014

Pharmaceutical Biology

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Objective: This study compared the antidepressant ability of FAE with that of HG in mice and further investigated the antidepressant-like effects and potential mechanisms of HG in rats subjected to unpredictable chronic mild stress (UCMS). Materials and methods: Mice received FAE (50 mg/kg) and HG (20 mg/kg) once a day via intragastric administration (i.g.) for 3 weeks. The anxiolytic and antidepressant activities of FAE and HG were compared using elevated plus maze (EPM) and behavioral despair tests including tail suspension test (TST) and forced swimming test (FST), respectively. Antidepressant effects of HG (5 mg/kg) were assessed using the UCMS depressive rat model. Moreover, the levels of monoamine neurotransmitters and relevant gene expression in UCMS rats' hippocampi were determined through high-performance liquid chromatography with electrochemical detection and real-time polymerase chain reaction techniques. Results: The results of our preliminary screening test suggest that HG at 20 mg/kg, while not FAE at 50 mg/kg, significantly decreased the immobility in both TST and FST compared with the vehicle group when administered chronically; however, there were no significant differences observed between the HG and the FAE group. Chronic administration of HG failed to significantly reverse the altered crossing and rearing behavioral performance, time spent in the open arm and closed entries in the EPM, even if they showed an increased tendency, but HG significantly increased the percent of sucrose preference in the sucrose preference test (SPT) and decreased the immobility time in the FST. HG showed that significant increases of norepinephrine and serotonin levels and exhibited a tendency to increase the expression of 5-hydroxytryptamine (serotonin) 1A receptor mRNA, and to significantly decrease the expression of the mRNA for the serotonin transporter (5-HTT). However, there were no significant differences in the expression of the brain-derived neurotrophic factor. Conclusion: These findings confirm the antidepressant-like effects of HG in a behavioral despair test and UCMS rat model, which may be associated with monoamine neurotransmitters and 5-HTT mRNA expression.

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“…26 Psychotropic medications have diverse effects on BP; the most-widely used are listed in Table 1. [27][28][29][30][31] Assessment of comorbidities and use of medications, including nonprescription drugs, is essential in the evaluation of elderly patients with hypertension. In particular, asking patients whether they have pain and, if so, what type of pain medication they use is important, because these drugs are the most-commonly used medications that increase BP.…”

Section: Introductionmentioning

confidence: 99%

Management of hypertension in the elderly

Pimenta

Oparil

2012

Nat Rev Cardiol

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Hypertension is the most-prevalent modifiable risk factor for cardiovascular morbidity and mortality worldwide. Hypertension is highly prevalent among older adults (≥65 years), and aging of the population will substantially increase the prevalence of this condition. Age-related endothelial dysfunction and increased arterial stiffness contribute to the increased prevalence of hypertension, particularly systolic hypertension, among the elderly. The incidence of some forms of secondary hypertension also increases with age, mainly owing to the use of drugs (especially NSAIDs that have pressor effects) and the presence of chronic kidney disease, obstructive sleep apnea, and renal artery stenosis. Guidelines differ in thresholds and goals for antihypertensive drug therapy in the elderly because of a paucity of high-level evidence from randomized controlled trials and inconsistencies in the definition of 'elderly'. Medical treatment of hypertension reduces cardiovascular morbidity and mortality in the elderly, and all guidelines recommend lifestyle modifications and medical treatment for elderly patients whose blood pressure exceeds prescribed thresholds and who are at moderate or high cardiovascular disease risk. In the absence of comorbidities, which constitute 'compelling indications' for the use of specific antihypertensive drugs or drug classes, no clear evidence exists to support recommendations for the use of particular antihypertensive-drug classes in older adults.

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Hypertensive crisis associated with venlafaxine

Cited by 35 publications

References 4 publications

Venlafaxine as single therapy associated with hypertensive encephalopathy

Venlafaxine as single therapy associated with hypertensive encephalopathy

Involvement of norepinephrine and serotonin system in antidepressant-like effects of hederagenin in the rat model of unpredictable chronic mild stress-induced depression

Management of hypertension in the elderly

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