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Case Reports
. 2019 Apr 9:7:2050313X19841825.
doi: 10.1177/2050313X19841825. eCollection 2019.

Use of atypical antipsychotics and risk of hypertension: A case report and review literature

Beatriz Beretta Alves  1 , Giovana de Padua Oliveira  1 , Milton Gabriel Moreira Neto  1 , Roberta Bonamim Fiorilli  1 , Elizabeth do Espírito Santo Cestário  1
Affiliations
Case Reports

Use of atypical antipsychotics and risk of hypertension: A case report and review literature

Beatriz Beretta Alves et al. SAGE Open Med Case Rep. .

Abstract

Atypical antipsychotics is being considered in the treatment of "negative" symptoms of psychoses, such as schizophrenia. In this case report, we presented a case of a patient with psychiatric disorder who developed hypertension soon after starting using atypical antipsychotic. A 53-year-old woman had reported having episodes of tachycardia, nausea, headache and high blood pressure. At the time of the doctor's appointment, the blood pressure was 210/110 mmHg. According to the patient, she made use of simvastatin for dyslipidemia and started taking aripiprazole, an antipsychotic for approximately 40 days before the symptoms. The initial treatment was 20 mg of olmesartan, and examinations were requested. After 2 months, the patient returned with the examinations: altered serum lipids and the other results were normal. Ambulatory blood pressure monitoring showed an average of 24 h of 150/100 mmHg. Blood pressure was measured at the doctor's office; in regular use of 20 mg of olmesartan, it was 156/92 mmHg. The dosage of olmesartan was increased to 40 mg and 1.5 mg of indapamide was initiated. The patient returned after 20 days with a blood pressure of 146/90 mmHg. After approval from the psychiatrist, the Aripiprazole was stopped, and the patient returned 15 days later with blood pressure of 120/80 mmHg. The ambulatory blood pressure monitoring control showed an average of 24 h of 130/78 mmHg. The Dopamine receptors play a role in the regulation of the blood pressure and the alterations in this system can lead to hypertension. D1, D3 and D4 receptors interact with the renin-angiotensin-aldosterone system, while D2 and D5 interact with the sympathetic nervous system in the regulation of PA. The case reported and the literature review bring to light the discussion of the use of atypical antipsychotics and its adverse events. If necessary, the use of these drugs should be followed by careful monitoring of blood pressure.

Keywords: Atypical antipsychotics; hypertension; renin-angiotensin system.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Initial ABPM. SBP: systolic blood pressure; DBP: diastolic blood pressure.
Figure 2.
Figure 2.
Final ABPM. SBP: systolic blood pressure; DBP: diastolic blood pressure.
See this image and copyright information in PMC

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References

    1. Walker ER, McGee RE, Druss BG. Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiatry 2015; 72(4): 334–341. - PMC - PubMed
    1. Daumit GL, Goff DC, Meyer JM, et al. Antipsychotic effects on estimated 10-year coronary heart disease risk in the CATIE schizophrenia study. Schizophr Res 2008; 105(1–3): 175–187. - PMC - PubMed
    1. Zhou X, Keitner GI, Qin B, et al. Atypical antipsychotic augmentation for treatment-resistant depression: a systematic review and network meta-analysis. Int J Neuropsychopharmacol 2015; 18(11): pyv060. - PMC - PubMed
    1. Jesus C, Jesus I, Agius M. A review of the evidence for the use of metformin in the treatment of metabolic syndrome caused by antipsychotics. Psychiatr Danub 2015; 27(Suppl. 1): S489–S491. - PubMed
    1. Golan DE, Tashjian AH, Jr, Armstrong EJ, et al. Principles of pharmacology: the pathophysiologic basis of drug therapy. 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins, 2014.

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