Immediate Action Required: Stop the New Medication and Contact Your Provider Now
You need to contact your provider immediately—ideally today—to report these symptoms and discuss stopping or changing the medication you started Friday night. Your symptoms of severe anxiety, racing thoughts, insomnia, nausea, and significantly elevated blood pressure (164/110 mmHg with heart rate 93) strongly suggest an adverse reaction to the new medication 1, 2.
Why This Is Urgent
Your blood pressure of 164/110 mmHg represents Stage 2 hypertension and requires prompt medical attention, particularly when accompanied by severe anxiety symptoms and occurring acutely after starting a new medication 1.
Many medications can cause drug-induced hypertension and anxiety through various mechanisms, including activation of the sympathetic nervous system, which matches your "fight or flight" sensation 2, 3.
Common culprits that cause these exact symptoms include stimulants (amphetamines, methylphenidate), certain antidepressants (SNRIs, MAOIs), decongestants (pseudoephedrine, phenylephrine), caffeine in high doses, and some herbal supplements 1, 3.
Immediate Steps to Take
Contact Your Provider Today
Call your provider's office immediately and explain you're having severe side effects from the new medication started Friday night—specifically mention the elevated blood pressure, severe anxiety, insomnia, racing thoughts, and nausea 4.
If you cannot reach your provider today, consider going to urgent care or the emergency department, especially given your blood pressure reading of 164/110 mmHg 1.
Do Not Stop Certain Medications Abruptly
If the medication is a beta-blocker, antidepressant, or certain other classes, do NOT stop it suddenly without medical guidance, as abrupt discontinuation can cause rebound hypertension or other serious effects 1.
However, if it's a stimulant, decongestant, or supplement, your provider will likely advise stopping it immediately 1, 3.
Managing Your Acute Anxiety State
Short-Term Anxiety Management
Deep breathing exercises can help activate your parasympathetic nervous system: breathe in slowly for 4 counts, hold for 4 counts, exhale for 6 counts, repeat for 5-10 minutes 5.
If your provider determines the medication should be stopped and your symptoms are severe, they may prescribe a short-acting benzodiazepine like diazepam 5mg to help lower both your blood pressure and anxiety acutely 6.
Avoid caffeine, alcohol, and any other stimulating substances until this resolves 1.
Blood Pressure Management
Your provider may prescribe a short-acting antihypertensive medication to bring your blood pressure down safely while addressing the underlying cause 1.
Do not take any over-the-counter medications without checking with your provider first, as many can worsen hypertension (NSAIDs, decongestants, certain herbal supplements) 1, 3.
Addressing Your Baseline Blood Pressure Concerns
When to Start Blood Pressure Medication
Yes, you should absolutely discuss starting blood pressure medication with your provider if your blood pressure is frequently elevated, even when not experiencing this acute reaction 1, 7.
Blood pressure readings of 130-139/80-89 mmHg indicate Stage 1 hypertension, and readings ≥140/90 mmHg indicate Stage 2 hypertension, both requiring treatment 1, 7.
First Steps for Blood Pressure Management
Your provider should confirm hypertension with multiple readings, ideally including home blood pressure monitoring (target <135/85 mmHg at home confirms hypertension) 8, 7.
First-line medications for most patients include ACE inhibitors, ARBs, calcium channel blockers (like amlodipine), or thiazide diuretics 1, 8, 7.
The choice depends on your specific characteristics (age, race, comorbidities like diabetes or kidney disease) 1, 8.
Critical Pitfalls to Avoid
Do not delay contacting your provider—medication side effects causing severe anxiety and hypertension can worsen and lead to complications 4, 5.
Do not assume you need to "tough it out" or that symptoms will resolve on their own while continuing the medication 4.
Do not take additional medications or supplements to try to counteract these symptoms without medical guidance, as this can lead to dangerous drug interactions 1, 3.
Do not ignore the elevated blood pressure reading—164/110 mmHg requires medical attention, especially with symptoms 1, 6.
What to Tell Your Provider
When you call, clearly state:
- The exact medication name and dose you started Friday night
- All your symptoms: severe anxiety, racing thoughts, insomnia, nausea, feeling stuck in "fight or flight"
- Your blood pressure reading: 164/110 mmHg with heart rate 93
- That symptoms started shortly after beginning the medication
- Any other medications, supplements, or substances you're taking 1, 2, 3
Your symptoms strongly suggest a medication-related adverse effect that needs immediate medical attention—please contact your provider today.