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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Deneb on July 8, 2010, at 10:53:34
I bought a new fancy OMRON blood pressure monitor and the lowest reading I've gotten so far is 78/47. Doesn't that seem a bit low? My other readings were about 80/55.
Right now I feel fine, but sometimes I start blacking out. Does that mean my blood pressure gets even lower sometimes?
I am freaking out a little with breaking the 70's barrier.
I read there is no such thing as too low if you feel OK. Is that true?
Someone said the Risperdal might cause postural hypotension, but my blood pressure is low all the time, not just when I stand up (though I think it gets even lower when I stand up).
Posted by Phillipa on July 8, 2010, at 11:05:50
In reply to Is my blood pressure really OK?, posted by Deneb on July 8, 2010, at 10:53:34
Deneb yes I feel it's low and you should let your doc know especially with the blacking out. Phillipa
Posted by SLS on July 8, 2010, at 12:03:11
In reply to Is my blood pressure really OK?, posted by Deneb on July 8, 2010, at 10:53:34
I think I once commented that your drug combination was likely to produce low blood pressure through synergistic interactions. What are you currently taking, and at what dosages?
- Scott
Posted by Deneb on July 8, 2010, at 12:15:10
In reply to Re: Is my blood pressure really OK? » Deneb, posted by SLS on July 8, 2010, at 12:03:11
Right now I take 60 mg Prozac when I wake up (which can be any of the 24 hours in a day lol), 0.75 mg Risperdal, 20 mg Celexa, a multivitamin, fish oil, vitamin D and calcium when I go to bed (which can also be any of the 24 hours lol).
I also take 40 mg propranolol as needed, and 60 mg Inderal LA as needed (though not both at once because they are basically the same med).
What is the synergistic interaction?
Posted by SLS on July 8, 2010, at 12:39:53
In reply to Re: Is my blood pressure really OK?, posted by Deneb on July 8, 2010, at 12:15:10
> Right now I take 60 mg Prozac when I wake up (which can be any of the 24 hours in a day lol), 0.75 mg Risperdal, 20 mg Celexa, a multivitamin, fish oil, vitamin D and calcium when I go to bed (which can also be any of the 24 hours lol).
>
> I also take 40 mg propranolol as needed, and 60 mg Inderal LA as needed (though not both at once because they are basically the same med).
>
> What is the synergistic interaction?A synergistic interaction is a condition where the mechanisms of actions of two different drugs produces an amplified effect that is greater than simply being additive. An example would be the hypotensive effect of combining Risperdal with propranolol (NE alpha-1 blockade and NE beta blockade respectively). You may want to consider either reducing your usage of propranolol or perhaps switching from Risperdal to another AP. Seroquel might be better for anxiety.
- Scott
Posted by ed_uk2010 on July 8, 2010, at 16:20:01
In reply to Re: Is my blood pressure really OK?, posted by Deneb on July 8, 2010, at 12:15:10
Fluoxetine (Prozac) increases the blood level of risperidone (Risperdal). This could lead to an increased risk of hypotension - which is a known adverse effect of risperidone.
Posted by SLS on July 8, 2010, at 19:18:36
In reply to Re: Is my blood pressure really OK?, posted by ed_uk2010 on July 8, 2010, at 16:20:01
> Fluoxetine (Prozac) increases the blood level of risperidone (Risperdal).
You are a wealth of relevant knowledge.
- Scott
Posted by emilyp on July 8, 2010, at 20:47:39
In reply to Re: Is my blood pressure really OK? » Deneb, posted by Phillipa on July 8, 2010, at 11:05:50
Yes it is low. You need to talk to or see your doctor. While asking the board may be easier, without knowing all the facts - not just about the medication but about all of your health issues - it is impossible for anyone to give you a valid answer. And since you have posted this before, it seems to be an on-going problem.
Posted by Deneb on July 9, 2010, at 13:40:05
In reply to Re: Is my blood pressure really OK?, posted by emilyp on July 8, 2010, at 20:47:39
Yeah, I know, I do talk to my doctor, but I guess I'm just not very good at talking to them.
If I am healthy, then I think it's great that I have low BP, but I can't help but have other fears.
Like, what if I have heart failure or something?
I dunno. I guess I am being hypochondriac about this...
I guess it is unlikely since I don't have any trouble breathing and I don't think my ankles are swollen.
But then I read that some people don't have symptoms.
I just wish I knew for sure it is my meds causing my hypotension.
Otherwise, it is very odd that my blood pressure would keep dropping without me getting more in shape or healthier.
It has dropped significantly over the years and months.
I worry my anxiety disorder is leading to heart failure. I know it is far fetched, but I still worry.
Posted by SLS on July 9, 2010, at 14:01:28
In reply to Re: Is my blood pressure really OK? » emilyp, posted by Deneb on July 9, 2010, at 13:40:05
I agree with Emily. You should probably let the doctors worry about things so that you don't have to.
- Scott
Posted by ed_uk2010 on July 9, 2010, at 14:14:36
In reply to Re: Is my blood pressure really OK? » emilyp, posted by Deneb on July 9, 2010, at 13:40:05
Deneb,
Low BP does not cause heart failure.
Posted by Deneb on July 9, 2010, at 14:56:11
In reply to Re: Is my blood pressure really OK? » Deneb, posted by ed_uk2010 on July 9, 2010, at 14:14:36
> Deneb,
>
> Low BP does not cause heart failure.Yeah I know. High BP can cause heart failure, but not low. I'm not worrying about low BP causing heart failure, I'm worried that my low BP is an early symptom of heart failure.
I used to have prehypertension and I find it odd that now I have low blood pressure without getting healthier or more in shape.
My anxiety disorder used to cause my blood pressure to sky rocket and my heart rate to increase a lot. It still causes my heart to race, but now my blood pressure doesn't rise much. I'm just worried that all those years of my anxiety took a toll on my heart and now it is failing.
I know this is very unlikely though. My heart rate is usually normal. I would think that heart failure would cause my heart to beat faster to make up for the lack of force?
I can't stop being anxious about my anxiety causing problems. Ironic eh? LOL
Posted by ed_uk2010 on July 10, 2010, at 1:32:40
In reply to Re: Is my blood pressure really OK? » ed_uk2010, posted by Deneb on July 9, 2010, at 14:56:11
>I'm worried that my low BP is an early symptom of heart failure.
As you know, that is extremely unlikely. Do you have a family history of cardiomyopathy? Still, I think you should see your GP because you're obviously very worried about it. Your GP will be able to examine you and reassure you that there are no signs of heart failure.
I expect that your low BP is due to the fluoxetine potentiating the hypotensive effect of risperidone by increasing risperidone blood levels. Alpha-1 antagonists such as risperidone can certainly reduce BP when sitting or lying down as well as when standing - it's not just a case of orthostatic hypotension, although orthostasis does tend to be more prominent.
Posted by Deneb on July 10, 2010, at 17:15:53
In reply to Re: Is my blood pressure really OK? » Deneb, posted by ed_uk2010 on July 10, 2010, at 1:32:40
There is no history of cardiomyopathy, though my Dad does have a larger than normal heart for some reason. I remember my Dad saying that when we had to have physicals to come to Canada about 17 years ago. My Dad had an abnormal EKG, I don't know the details, but later he had a treadmill stress test and I guess everything was normal because nothing ever came of it.
My Mom has never had heart problems, though she does has a history of near fainting episodes.
I know I am just being a hypochondriac about this. I'm always like this.
Pdoc and GP just tell me to get up slowly from sitting and pdoc suggested I exercise.
They don't seem to think my fainting is serious.
From what I've read, it probably isn't.
I guess I should be happy that my blood pressure is low and not high.
Posted by ed_uk2010 on July 10, 2010, at 17:59:04
In reply to Re: Is my blood pressure really OK?, posted by Deneb on July 10, 2010, at 17:15:53
If the risperidone is responsible, reducing the dose should help. Obviously, I do not know whether this would be possible, you would have to discuss that with your psychiatrist. Other antipsychotics which have less effect on BP are available.
>There is no history of cardiomyopathy, though my Dad does have a larger than normal heart for some reason. I remember my Dad saying that when we had to have physicals to come to Canada about 17 years ago. My Dad had an abnormal EKG.........
To be honest, I think your GP is probably correct that it's not serious. Nevertheless, if you are still very concerned, having some further tests might help to put your mind at rest. The doctor might do some blood tests (eg. blood counts, thyroid function etc.) and send you for a chest Xray. If there was any sign of an enlarged heart on the chest Xray, you would need to have an echocardiogram.
Posted by Zyprexa on July 10, 2010, at 22:49:10
In reply to Re: Is my blood pressure really OK?, posted by Deneb on July 10, 2010, at 17:15:53
I'm not a doctor but watch a lot of doctor shows on TV. I belive that low blood pressure is a sign that you are not getting enough blood flow to keep your organs functioning. They are not getting enough oxygen, etc. Could be why you are blacking out.
This is the end of the thread.
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