Blood pressure meds
December 8, 2004 11:23 PM   Subscribe

Does anyone else notice a decrease in motivation and/or analytical ability when taking high blood pressure medication such as Hyzaar or Lisinopril? I seem to have bursts of productivity shortly after I run out of pills.
posted by anonymous to Health & Fitness (10 answers total)
I take Lisinopril and have never noticed a difference.
posted by ..ooOOoo....ooOOoo.. at 11:52 PM on December 8, 2004

I'm using Teveten AND Feludor so don't know if they work in the same way. These tablets make me feel so sluggish that the only way I found to deal with the lethargy, is to take them late at night.
posted by Tarrama at 11:57 PM on December 8, 2004

*nod* at Matteo's links.

Tarrama's strategy is one i recommend. Some people adjust and find the effect lessens over time.
posted by reflecked at 5:04 AM on December 9, 2004

Matteo's links are fine, but Hyzaar and lisinopril aren't beta blockers. Hyzaar is an angiotension-2 receptor blocker plus a diuretic, and lisinopril is an ACE inhibitor.

Those medicines aren't supposed to have central nervous system effects, and I dare say I've never had a patient describe same to me - I'm a neurologist, I'm quite attentive to such things. I once had an internal medicine professor say to me, "high blood pressure feels good!" as an explanation for why people don't comply with their meds. But frankly I don't believe it.

If blood pressure is overcontrolled, brain function suffers, but this usually takes the form of short blackouts, not psychiatric changes.

The above is completely off with respect to beta blockers, which do indeed have CNS effects. But if the above are the only meds going, I would suggest searching elsewhere for the source of the problem.
posted by ikkyu2 at 5:16 AM on December 9, 2004

I work with cardiac patients often. Pre and Post CABG surgery, CICU, and Cardiac stepdown. I also work part-time for an Internist. I hear complaints about the "lethargy" effects of ACE inhibitors often; it's not considered to be a problem unless the patient feels like it is markedly affecting their mentation. People often report a lessening or disappearance of that component over a period of a few months.

ikkyu2 makes a good point about overcontrolled BP. That is why taking the medications at night is a useful strategy for some. Sometimes switching to another drug in the same class is helpful. If you haven't discussed it with your MD, you should do that first. Call the office and ask to talk to the nurse about it as a first step.

Beta-blockers have definitely more neuro effects, yes. I regret being hurried and not making the differentiation. I also regret assuming people knew the difference. My apology.

posted by reflecked at 6:25 AM on December 9, 2004

I'm going to go out on a neurological limb here and say that ACE inhibitors don't cause lethargy or impaired mentation, other than their syncopal or pre-syncopal effects directly related to lowered BP.

I'd be interested to learn differently, but I'm a tough sell on this one - showing me a list of side effects published by the drug company isn't going to cut it; as we know, those lists only show things that happened during clinical trials, with no attempt to prove causation.
posted by ikkyu2 at 7:07 AM on December 9, 2004 [1 favorite]

You're not out on a limb, ikkyu2. :) Subjective experiences are just that; the person reporting a symptom experiences what they report. Any new symptom associated with a new medication is worth exploring and remediating if possible. Those subjective symptoms are reasons that people cite for non-compliance with a prescribed medication therapy.

One thing I've found, is that ACE inhibitors, which are usually taken once a day, can have a strong effect in the first few hours after ingestion. Lowering the dosage doesn't usually help; the patient needs the cumulative level of med that the dosage gives. Pre-syncopal is perhaps too strong a word for what has been described to me. People use words like "tired" and "dull". Usually, taking the med at night is the first suggestion their MD makes.

When doing the teaching fr a person who starts a new med, I always emphasize that any new feelings or symptoms can and should be reported. The complaint of "tired" can be merely a need to fine-tune a medication plan, or it could be another problem entirely.

Your knowledge of pharmacology is most likely more thorough than mine. I can only validate fact that subjective symptoms like the ones anonymous (above) report do happen.
posted by reflecked at 11:58 AM on December 9, 2004 [1 favorite]

THE fact.
posted by reflecked at 11:58 AM on December 9, 2004

I take my diuretic and ACE inhibitor in the morning, and I've never noticed anything that I'd consider talking to my doctor about. I'm a morning coffee drinker, so perhaps I'm masking the effect. The pharmacy plasters lots of warning stickers all over the bottles, that's for sure.
posted by tommasz at 12:42 PM on December 9, 2004

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