Blood pressure changes during short-term fluoxetine treatment

Recent reports of sustained hypertension in some patients receiving venlafa xine have rekindled concerns about antidepressant-induced hypertension. Thi s study examined sitting and standing systolic and diastolic blood pressure , pulse rate, and rate of sustained hypertension in 796 depressed patients (mean +/- SD age, 40 +/- 11 years) taking fluoxetine 20 mg daily for up to 12 weeks. A modest reduction in sitting and standing systolic (p < 0.001) a nd diastolic (p < 0.001) blood pressure measures were observed in the entir e patient sample. Patients with pretreatment diastolic blood pressure < 60 mmHg (N = 32) showed a modest increase in mean diastolic blood pressure (p < 0.001), whereas patients with pretreatment diastolic blood pressure great er than or equal to 90 mmHg and less than or equal to 95 mmHg (N = 57) had a modest reduction in mean diastolic blood pressure (p < 0.001). Patients w ith preexisting, stable cardiovascular disease (including hypertension) (N = 35) showed no significant blood pressure change (p = not significant). Of the patients receiving fluoxetine, 1.7% had sustained hypertension for gre ater than or equal to 3 consecutive clinic visits-a rate significantly lowe r than that previously reported with venlafaxine (4.8%) (chi(2) = 13.3, p < 0.001) and similar to that previously seen with placebo (2.1%). In conclus ion, these data demonstrate a low rate of sustained hypertension (1.7%) dur ing short-term fluoxetine treatment.