From the Guidelines
The combination of Atomoxetine (Strattera) and Aripiprazole (Abilify) can potentially cause hypertension in some individuals, and patients taking this combination should have their blood pressure monitored regularly. According to the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults 1, certain medications, including some antidepressants and atypical antipsychotics, can cause elevated blood pressure. While Atomoxetine is not explicitly listed as a medication that may cause elevated blood pressure in the provided guideline, its mechanism of action as a norepinephrine reuptake inhibitor could potentially contribute to increased blood pressure. Aripiprazole, an atypical antipsychotic, is noted in the guideline as having a lower risk of weight gain, diabetes mellitus, and dyslipidemia compared to other atypical antipsychotics, but its impact on blood pressure is not explicitly stated. However, considering the potential additive effects of these medications on blood pressure, monitoring is crucial.
Some key points to consider when taking this combination include:
- Regular blood pressure monitoring, especially during the initial treatment period and after any dose adjustments
- Being aware of symptoms that could indicate elevated blood pressure, such as headaches, dizziness, chest pain, or visual changes, and contacting a healthcare provider immediately if these symptoms occur
- Providing a complete medical history to the doctor before starting these medications, as the risk may be higher in patients with pre-existing cardiovascular conditions
- Possibly implementing lifestyle modifications, such as reducing sodium intake, regular exercise, and stress management techniques, to help manage blood pressure while on these medications, as suggested by the guideline for managing blood pressure 1.
From the Research
Combination of Atomoxetine and Aripiprazole
- The combination of Atomoxetine (Strattera) and Aripiprazole (Abilify) is not directly addressed in the provided studies.
- However, the individual effects of Atomoxetine on blood pressure and heart rate are discussed in several studies 2, 3, 4, 5.
- Atomoxetine has been associated with small but statistically significant increases in blood pressure and heart rate, although these effects are generally considered minor and of little clinical significance 2, 5.
- Aripiprazole, on the other hand, is not mentioned in the provided studies in relation to its effects on blood pressure or heart rate.
Hypertension Risk
- The risk of hypertension associated with the combination of Atomoxetine and Aripiprazole cannot be directly determined from the provided studies.
- However, the study on combination therapy in hypertension suggests that the goal of antihypertensive therapy is to abolish the risks associated with blood pressure elevation without adversely affecting quality of life 6.
- It is possible that the combination of Atomoxetine and Aripiprazole may increase the risk of hypertension, but this would require further study to determine.
Cardiovascular Effects
- The cardiovascular effects of Atomoxetine have been studied in children, adolescents, and adults, and have been found to be minimal 5.
- Atomoxetine has not been associated with QT interval prolongation, and has been found to be well tolerated in short- and long-term studies 3, 4, 5.
- The combination of Atomoxetine and Aripiprazole may have additive effects on blood pressure and heart rate, but this would require further study to determine.