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Neuropsychiatric considerations in the treatment of hypertension
S L Rauch1, T A Stern, R M Zusman
1Department of Psychiatry, Massachusetts General Hospital, Boston.
Insights
This review examines the neuropsychiatric effects of antihypertensive medications, offering guidelines for hypertension treatment that consider both beneficial and adverse effects on mental health.
Area of Science:
- Pharmacology
- Neuroscience
- Cardiology
Background:
- Hypertension management requires algorithms considering concurrent conditions and drug interactions.
- Antihypertensive agents possess diverse pharmacological profiles impacting neuropsychiatric function.
Purpose of the Study:
- To review the neuropsychiatric effects of major antihypertensive drug classes.
- To discuss the potential use of antihypertensives in psychiatric conditions.
- To propose hypertension treatment guidelines incorporating neuropsychiatric considerations.
Main Methods:
- Literature review of neuropsychiatric effects of antihypertensive agents.
- Analysis of pharmacological actions and clinical outcomes.
- Synthesis of information to inform treatment guidelines.
Main Results:
- Major antihypertensive classes (ganglionic blockers, centrally acting agents, diuretics, vasodilators, beta-blockers, calcium channel blockers, ACE inhibitors) have distinct neuropsychiatric profiles.
- Both beneficial and adverse neuropsychiatric effects are associated with these agents.
- Some antihypertensives show potential efficacy in treating psychiatric conditions.
Conclusions:
- Neuropsychiatric effects are a critical factor in selecting antihypertensive therapy.
- Guidelines for hypertension treatment should integrate comprehensive neuropsychiatric assessments.
- Informed treatment choices can optimize patient outcomes by managing both blood pressure and mental well-being.
Abstract:
Algorithms have been developed to guide the treatment of simple hypertension. The basic algorithms are modified in the face of concurrent medical conditions, taking into account the various pharmacological effects of antihypertensive agents. This article reviews the neuropsychiatric effects of the major classes of antihypertensive agents (ganglionic blockers, centrally acting agents, diuretics, vasodilators, beta-blockers, calcium channel blockers and angiotensin converting enzyme inhibitors). The purported efficacy of some antihypertensive agents in the treatment of psychiatric conditions is also discussed. Beneficial as well as adverse neuropsychiatric effects are reviewed. In this way, guidelines for the treatment of hypertension are suggested which take into account a broad spectrum of neuropsychiatric considerations.