Is hydralazine (an antihypertensive medication) effective in treating anxiety or panic disorders?

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Last updated: April 10, 2025View editorial policy

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From the Guidelines

No, there is no evidence supporting the use of hydralazine for anxiety or panic attacks. Hydralazine is a direct-acting vasodilator medication primarily used to treat high blood pressure and heart failure, as seen in the guidelines for the prevention, detection, evaluation, and management of high blood pressure in adults 1. It works by relaxing blood vessels, not by affecting neurotransmitters involved in anxiety. The provided evidence focuses on the use of hydralazine in the context of hypertension and heart failure, with no mention of its application in treating anxiety or panic disorders.

For anxiety and panic disorders, first-line pharmacological treatments include:

  • Selective serotonin reuptake inhibitors (SSRIs) like sertraline or escitalopram
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs) like venlafaxine, as discussed in the clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders 1
  • Benzodiazepines like lorazepam for short-term use, as mentioned in the context of distress management in patients with cancer 1

Using hydralazine for anxiety would be inappropriate and potentially harmful, as it could cause side effects like headaches, dizziness, or reflex tachycardia without addressing anxiety symptoms. Anyone experiencing anxiety or panic attacks should consult with a healthcare provider for proper diagnosis and evidence-based treatment options, which typically include both medication and psychotherapy approaches.

From the Research

Evidence for Hydralazine in Anxiety or Panic Attacks

  • There is no direct evidence to support the use of hydralazine for anxiety or panic attacks in the provided studies 2, 3, 4, 5, 6.
  • The studies primarily focus on the treatment of panic disorder and anxiety disorders using selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, and other antidepressants.
  • Hydralazine is not mentioned in any of the studies as a treatment option for anxiety or panic attacks.

Alternative Treatment Options

  • SSRIs and benzodiazepines are standard first-line pharmacologic treatments for panic disorder 2, 4, 5.
  • Other antidepressants, such as serotonin-norepinephrine reuptake inhibitors, may be considered as alternatives to SSRIs 2, 3.
  • Cognitive-behavioral therapy (CBT) is also a strongly supported treatment option for panic disorder 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Panic disorder: A review of treatment options.

Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists, 2021

Research

Selective serotonin-reuptake inhibitors: an update.

Harvard review of psychiatry, 1999

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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