Effects of dopamine receptor antagonist antipsychotic therapy on blood pressure

Gonsai, N.; Amin, V H; Mendpara, C.; Speth, Robert C.; Hale, Genevieve M

doi:10.1111/jcpt.12649

Cited by 30 publications

(23 citation statements)

References 22 publications

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“…Dopamine receptors, mainly of the kidneys, play a role in the regulation of BP, and alterations in this system can lead to hypertension. 6…”

Section: Discussionmentioning

confidence: 99%

“…Among these receptors, the D1, D3 and D4 interact with the renin-angiotensin-aldosterone system (RAAS), while the receptors (D2 and D5) interact with the sympathetic nervous system in the regulation of PA. Because of these factors, the clinical use of dopaminergic agonists or antagonists may disrupt the regulation of PA leading to hypotension or hypertension, respectively. 6…”

Section: Discussionmentioning

confidence: 99%

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

Alves

Oliveira

Neto

et al. 2019

SAGE Open Medical Case Reports

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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.

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“…Dopamine receptors, mainly of the kidneys, play a role in the regulation of BP, and alterations in this system can lead to hypertension. 6…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Alves

Oliveira

Neto

et al. 2019

SAGE Open Medical Case Reports

View full text Add to dashboard Cite

show abstract

“…Moreover, there does not seem to be an additive effect on blood pressure when combining antipsychotics ( 51 ). The possible small increased risk in hypertension after antipsychotic treatment probably can be attributed to antipsychotic-induced weight gain/obesity ( 81 ) and to the anti-dopaminergic effect of these agents, as all 5 dopamine receptor subtypes (D1–D5) regulate blood pressure ( 78 , 82 ).…”

Section: Hypertensionmentioning

confidence: 99%

Impact of Psychotropic Medication Effects on Obesity and the Metabolic Syndrome in People With Serious Mental Illness

et al. 2020

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People with serious mental illness (SMI), including schizophrenia, bipolar disorder, and major depressive disorder, have a higher mortality rate and shortened life expectancy. This is mainly attributable to physical diseases, particularly cardiovascular diseases (CVDs). Important risk factors for CVDs are obesity and other metabolic abnormalities, which are especially prevalent in people with SMI. Several factors contribute to this increased risk, including unhealthy lifestyles. Psychotropic medication independently further increases this risk. In this review we want to examine the relationship between obesity and other components of the metabolic syndrome and psychotropic medication in people with SMI.

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“…Furthermore, although several AP may directly block central and peripheral adrenoreceptors, leading to vasodilation and hypotension [124,125], a hypertensive effect may actually occur during treatment with AP (especially clozapine) as a result of therapy-induced weight gain as well as of dopamine receptor effect on sympathetic nervous system and sodium excretion [126].…”

Section: Antipsychotic Agentsmentioning

confidence: 99%