Psych drugs and BP's

Xanax is one of the better ones to give it terms of blood pressure. Although you will probably see a drop it's most likely due to the relief of the anxiety not from the drug. I think your talking about an older pt and so start with the lowest you can give. .125mg is the lowest I've seen but .25mg is the usual starting dose. Although there are a lot of other choices I can't think of another that wouldn't lower blood pressure more or have a lot worse side effect profile, like zyprexa, risperdal, ativan, or seroqul(very bad for bp).

Another thing to keep in mind is the effects of psych meds on BP when you think the drug is no longer in the system. I had a case of a woman who was in her 40's and took 0.5 Ativan one evening. The next day, long after you'd think the drug was metabolized, her BP dropped to 70/40 and she passed out. The doctor switched her to Xanax, and no more BP problems.