Paroxetine Use in Hypertensive Patients

Antihypertensive Medication Considerations

• The European Society of Cardiology recommends first-line antihypertensive medications, including ACE inhibitors, ARBs, dihydropyridine CCBs, and thiazide/thiazide-like diuretics, for patients with hypertension who also require paroxetine 1
• The European Society of Cardiology suggests that beta-blockers should be combined with other antihypertensive drug classes when there are specific indications for their use, such as angina, post-myocardial infarction, or heart failure with reduced ejection fraction 1
• The European Society of Cardiology recommends fixed-dose single-pill combination treatments for patients receiving combination antihypertensive therapy to improve adherence 1

Special Considerations

• Patients taking both paroxetine and antihypertensive medications should take their medications at the most convenient time of day to establish a habitual pattern and improve adherence, as recommended by the European Society of Cardiology 1
• The American Heart Association recommends that in patients with psychiatric disorders, including depression, RAS inhibitors (ACE inhibitors or ARBs) and diuretics are preferred antihypertensive agents due to fewer pharmacological interactions with antidepressants 2
• The American Heart Association suggests that calcium channel blockers and alpha-1 blockers should be used with caution in patients taking SSRIs who may be at risk for orthostatic hypotension 2