Psych drugs and BP's

[Patti 2nd gen RN]

Anybody out there have any experience with psych drugs that also lower BP?? My co-worker and I disagree about giving Xanax to a patient with a BP of 80/50--it was MN, and this is her usual when she refuses to drink water...doc said in her case it was an okay BP so long as she was asymptomatic..I have seen multiple psych Rx's lower BP's even more....any advice out there??

[DaMale Nurse]

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).

[Patti 2nd gen RN]

A woman in her 50's, on methadone as well, and her xanax dose is 0.5 mg q6hrs prn---too much for me....and when I told her if she would rink enought to get it up to 95 systolic, I would give it to her, she said she didn't want to pee that much, and went to sleep!!! Really anxious huh??? Worst experience I ever had with psych rx's droppping BP's was with prn HS trazadone....there fluids didn't make a difference...

[nsgnva]

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.