From the Guidelines
Yes, there are anti-anxiety medications that can lower blood pressure, with beta-blockers such as propranolol and clonidine being commonly prescribed options. These medications work by blocking the effects of adrenaline, reducing heart rate and blood pressure while also helping to control physical anxiety symptoms like trembling and rapid heartbeat.
- Beta-blockers, such as propranolol (10-40 mg as needed or 40-120 mg daily for extended release), are commonly prescribed for both anxiety and high blood pressure 1.
- Clonidine, typically prescribed at 0.1-0.3 mg twice daily, is another medication that treats both conditions by reducing sympathetic nervous system activity 1.
- Benzodiazepines like diazepam can temporarily lower blood pressure but aren't recommended for long-term use due to dependency risks 1. It's essential to consult with a healthcare provider before starting any new medication, as some anti-anxiety medications may interact with other blood pressure medications. Regular blood pressure monitoring is also necessary to ensure proper dosing and effectiveness 1.
From the FDA Drug Label
In patients with hypertension, use of propranolol has been associated with elevated levels of serum potassium, serum transaminases, and alkaline phosphatase. ACE Inhibitors: When combined with beta-blockers, ACE inhibitors can cause hypotension, particularly in the setting of acute myocardial infarction. Alpha Blockers: Prazosin has been associated with prolongation of first dose hypotension in the presence of betablockers. Postural hypotension has been reported in patients taking both beta-blockers and terazosin or doxazosin
Propranolol is a beta-blocker that can be used to lower blood pressure in patients with hypertension. It is also used to treat anxiety. The use of propranolol has been associated with hypotension in certain cases, particularly when combined with other medications such as ACE inhibitors or alpha blockers 2.
From the Research
Anti-Anxiety Medications and Blood Pressure
- There are several studies that suggest certain anti-anxiety medications may have a positive effect on lowering blood pressure 3, 4.
- A study published in the American Journal of Hypertension found that antianxiety treatment with oral diazepam decreased blood pressure significantly in patients with excessive hypertension 3.
- Another study published in Current Hypertension Reports found that benzodiazepines, a class of anti-anxiety medications, may have antihypertensive properties and may be used as add-on antihypertensive in a subset of patients in the short term 4.
Specific Medications
- Diazepam, a benzodiazepine, has been shown to decrease blood pressure in patients with excessive hypertension 3.
- Benzodiazepines as a class may have a hypotensive effect via potentiation of the inhibitory effect of gamma-amino butyric acid (GABA) in the central nervous system and vasodilatory properties 4.
- Beta-blockers, which are sometimes used to treat anxiety, do not appear to have a significant effect on lowering blood pressure in patients with anxiety disorders 5.
- Selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) are effective in treating anxiety disorders, but their effect on blood pressure is not well established 6, 7.
Limitations and Future Research
- More clinical trials and mechanistic research are required to ascertain the long-term benefits of anti-anxiety medications on blood pressure 3, 4.
- Further large placebo-controlled studies are required to prove the benefit of anxiolytic agents in lowering blood pressure 3.
- The existing data on the use of beta-blockers for anxiety disorders are limited and inconclusive, and more research is needed to understand their effectiveness and safety 5.