High Blood Pressure / Hypertension Community
834 Members
Avatar universal

Scared Lexapro will worsen my blood pressure

Hello doctor, I am a 24 year old male who takes Losartan 100, Toprol xl25 and Hydrochlorothiazide 25.

Recently a psychiatrist prescribed me Lexapro 10mg and Xanax 0.5 twice daily to hopefully treat the anxiety/panic disorder that has made my life very difficult the last few years. However I am concerned as I suffer from high blood pressure and racing heartbeat and now I am afraid to take the Lexapro as I fear its going to worsen my not so good blood pressure and heart rate. Is this a valid cause for concern?  I DONT want higher blood pressure and heart rate.

 Should I continue taking the Xanax as prescribed if I dont wish to take the lexa? Also is it possible to just medicate myself on Xanax and skip the antidepressants altogether!? Im not depressed, just anxious and riddled with daily panic attacks.
11 Responses
Avatar universal
I am not a Dr., but as far as I know, escitalopram does not alter the BP.

1124887 tn?1313758491
No doctors here unfortunately.

Escitalopram does not increase BP. If anything, it can lower BP in some people. Of course, some of us can have atypical side effects and reactions towards meds, but that's rare.

SSRIs are effective in treating anxiety. Your anxiety will be a bit worse in the beginning, but after 2-6 weeks it will slowly reduce. Xanax does not treat anything (it just temporarily gives some relief) and is highly addictive. It's not at all a good replacement for Lexapro.

If your BP should increase, just ask your doctor for a dose adjustment on your BP meds.. no worries :)
1475202 tn?1536274577
It is good to have concens about any medications prescribed for you. It is also wise to question your doctors concerning treatment. Your on the right track to living a healthy life.

"is_something_wrong" response is perfect and to add that I would assume the Xanax prescription is temporary. It may take 1 to 4 weeks or longer before you feel the full benefit of Lexapro (Escitalopram) whereas you will feel the benefits of Xanax right away. At this point the xanax should be discontinued.

Here you can find a list of side effects of Lexapro (Escitalpram):


Avatar universal
Im already on 3 very large doses of bp meds at 23. Im not going to take a fourth with even more side effects to take 1 SSRI. Ill try taking the Lexapro tonight, but ive personally read that increased bp is a frequent complaint. Thanks
1475202 tn?1536274577
23 is young to be needing blood pressure medication. I don't know your circumstance but diet can be a very useful tool in lowering your BP. Exercise can be as well but you should always consult your physician before starting any type of exercise.

Often anxiety will raise blood pressure and heart rate. So by treating this it can be as effective as your blood pressure medication depending on your circumstance. It can help you finally enjoy your day to day life instead of suffering with anxiety which may be raising your BP. The SSRI is for long term use and may take 1 to 4 weeks to work its way into your system and prove effective. It is a very popular choice for treatment. Xanax will work within usually a half hour and last for about 6 hours but it is highly addictive and designed for short term use only.

I can sure understand you not wanting to take more pills but once your anxiety is controlled maybe your doctor can readjust your BP medicines. I hope this helps you out.

1475202 tn?1536274577
Below is a list of the medications you are taking and the dosage at which they are prescribed.

25, 50 and 100mg

Toprol-XL dosage
25, 50 and 100mg

12.5, 25, 50, and 100mg

GENERIC NAME: escitalopram


DRUG CLASS AND MECHANISM: Escitalopram is an oral drug that is used for treating depression and generalized anxiety disorder. Chemically, escitalopram is similar to citalopram (Celexa). Both are in the class of drugs called selective serotonin reuptake inhibitors (SSRIs), a class that also includes fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft). SSRIs work by affecting neurotransmitters in the brain, the chemical messengers that nerves use to communicate with one another. Neurotransmitters are made and released by nerves and then travel to other nearby nerves where they attach to receptors on the nerves. Some neurotransmitters that are released do not bind to receptors and are taken up by the nerves that produced them. This is referred to as "reuptake." Many experts believe that an imbalance of neurotransmitters is the cause of depression. Escitalopram prevents the reuptake of one neurotransmitter, serotonin, by nerves, an action which results in more serotonin in the brain to attach to receptors. The FDA approved escitalopram in August 2002.

DRUG INTERACTIONS: All SSRIs, including escitalopram, should not be combined with drugs in the monoamine oxidase (MAO) inhibitor class of antidepressants such as isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl) and procarbazine (Matulane). Such combinations may lead to confusion, high blood pressure, high fevers, tremor or muscle rigidity, and increased activity.

So you see it is the inter-reaction with other drugs that  commonly cause and increase in blood pressure although an adverse effect to the medication is possible. All medications come with risks of adverse effects.
Avatar universal
Thanks rpoo, tell me about it. I exercise every day and eat right. Some doctors tell me its genetic, others say its because of my anxiety. Secondary causes have been considered as I registered a high cortisol level on several hormone tests.
1475202 tn?1536274577
Hello Dale,
It seems like your doctor is really on top of this. Do your best to follow his/her orders. I was doing some reading concerning a high cortisol level and here is some information I found. Cortisone, also known as the stress hormone, is a naturally occurring hormone produced by the adrenal cortex of the adrenal gland. It seems your doctor may be thinking your stress/anxiety may be causing this elevated hormone "cortisol" in turn this causes many other side effect such as High BP.
Here is what the Mayo clinic has to say about anxiety:
As with many mental health conditions, what causes generalized anxiety disorder isn't fully understood. It may involve naturally occurring brain chemicals (neurotransmitters), such as serotonin, dopamine and norepinephrine. It's likely that the condition has several causes that may include genetics, your life experiences and stress.

Some physical health conditions are associated with anxiety. Examples include:
Gastroesophageal reflux disease (GERD)
Heart disease
Hypothyroidism or hyperthyroidism
Sex drive
1475202 tn?1536274577
Cortisol is a steroid "stress" hormone produced from cholesterol in the two adrenal glands located on top of each kidney. It is released in response to events like waking in the morning, exercising and acute stress. Cortisol helps to maintain blood pressure, and provides energy by stimulating fat and carbohydrate metabolism. When permanently elevated, as it can be in people who are under chronic stress, cortisol can have detrimental effects on weight, immune function and chronic disease risk. Cushing's syndrome is a well-known constellation of signs and symptoms produced by an excessive level of cortisol.

Blood Sugar Imbalance
Cortisol helps to regulate blood sugar levels by regulating insulin release and producing glucose in the liver. When cortisol levels are chronically elevated, insulin production is suppressed and blood sugar levels is consistently elevated. Theoretically, this can increase the risk for type 2 diabetes. A study outlined in the December 2002 issue of the "Journal of Clinical Endocrinology & Metabolism" demonstrated that patients with type 2 diabetes or glucose intolerance exhibit abnormalities in cortisol action.

Cortisol mobilizes carbohydrates and fat for quick energy when we are under stress--the "fight or flight" response. This causes an increase in appetite to replace the carbohydrates and fat. A study published in the January 2001 issue of "Psychoneuroendocrinolgy" showed that people with elevated cortisol levels are associated with increased appetite, cravings for sugar and weight gain. However, elevated cortisol due to temporary stress will not likely cause weight gain.
1475202 tn?1536274577
Gastrointestinal Effects
Elevated cortisol suppresses the parasympathetic nervous system which is responsible for activities like digestion and absorption. As a result, digestion and absorption are compromised--indigestion develops and the mucosal lining becomes inflamed. Unfortunately, this inflammation leads to increased production of cortisol, and the cycle continues.

Immune System
Cortisol functions to reduce inflammation in the body. But if cortisol levels are chronically elevated, it will suppress the immune system. According to Dr. Weinstein in his book "The Stress Effect," this can lead to a number of problems related to suppressed immune system: an increased susceptibility to colds and illnesses, increased risk of cancer and increased tendency to develop food allergies.

Fertility Problems
Elevated cortisol can lead to disruption of normal ovulation and menstrual cycles or erectile dysfunction. Cortisol is produced in the same glands as sex hormones, therefore excess cortisol production may decrease production of sex hormones.

Cardiovascular Disease
In the April 5, 2005, isssue of the "Quarterly Journal of Medicine," Dr. Sher states that elevated cortisol has many effects that promote heart disease. One effect of high cortisol levels is that it directs fat to the visceral regions by activating lipoprotein lipase and inhibiting lipid mobilization, increasing the risk for cardiovascular disease. Cortisol also constricts blood vessels and increases blood pressure, as in the fight-or-flight situation. Over time, this can lead to vessel damage and plaque buildup.

1475202 tn?1536274577
Sorry to have to break this post up so many times but it seems MedHelp is having some temporary issues.

Have an Answer?
Top Healthy Living Answerers
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
14 super-healthy foods that are worth the hype
Small changes make a big impact with these easy ways to cut hundreds of calories a day.
Forget the fountain of youth – try flossing instead! Here are 11 surprising ways to live longer.
From STD tests to mammograms, find out which screening tests you need - and when to get them.
Tips and moves to ease backaches
Here are 12 simple – and fun! – ways to boost your brainpower.