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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 56381
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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Hello, I am a 41 year old female who has been on Zoloft for

Resolved Question:

Hello,
I am a 41 year old female who has been on Zoloft for 17 years usually at about 175 mg. Last April, I started Klonopin as well because I was experiencing some added anxiety. For the last 6 months, I have been on 200mg of Zoloft and between 1.0 and 1.5 mg of Klonopin daily. For the last 20 years, my blood pressure has always been around 110/70. After starting the Klonopin, I noticed my blood pressure has dropped to about 90/60 - sometimes a little lower, sometimes a little higher. During the last 6 months, I have experienced Vertigo from time to time. When I tilt my head a certain way, the room tilts or when I lay down flat the room tilts. This does not happen every day but sporadically - for a few days here and there. Could the vertigo be happening because the Klonopin has lowered my blood pressure? And if so, is OK to keep taking the Klonopin? Do you thing the vertigo is related to the Klonopin. Prior to taking Klonopin, I never experienced Vertigo in my whole life and my blood pressure was always around 110/70. I have no other health problems. Last year, I had blood work done and all was fine. Last year, I had a TKA and it was perfect.
Submitted: 10 months ago.
Category: Medical
Expert:  Dr. Thomas, MD replied 10 months ago.
Hello

I am Dr. Thomas, double board certified physician with over 20 years of clinical experience. I will help you with your question and any follow up questions you have.

It can be because of the klonopin as a side effect, the zoloft, or because this is simply not enough blood pressure for you.

You need a work up.
Including an EKG and maybe a holter monitor.

The other possibility here is that you have developed heart rhythm problems, and it is not the blood pressure directly.

You need orthostatic blood pressure checks to help rule out autonomic dysfunction.


If nothing shows up, inner ear exam by ENT.


Does this all make sense?

I have thrown a lot at you quickly here, so.
Use reply to let me know if you have further questions.
Please do not forget a positive rating.

Customer: replied 10 months ago.

Hi Dr. Thomas,


Last year (December 2012) when I was only on 175mg of Zoloft, I had blood work done - all was fine. I had an EKG and the doctor said it was so perfect he wanted to frame it on the wall. I also had a stress test which came out a 4 from 1 - 5 with 5 being the best. The doctor told me my heart bpm and rhythm was excellent during and after the stress test. So, I am thinking it is not the Zoloft since I have been on it for 17 years. I am 5'4 and I weigh 127 lbs. When you say, I may have developed heart rhythm problems, would it be because of the Klonopin based on my very good medial history?


 


 

Expert:  Dr. Thomas, MD replied 10 months ago.
I am saying it is a possibility, and in situations like this, when the other tests have been unrevealing it is normal to go to an event monitor.

you can develop side effects to medicines at any time.
of they can stop working as well.
Use reply to let me know if you have further questions.
Please do not forget a positive rating.
Customer: replied 10 months ago.

I am planning a full physical this Friday. If it turns out that if I have developed any heart abnormalites due to the Klonopin, do you think most likely that can be reversed if I wean off the Klonopin? I think it is too much of a coincidence that all these symptoms started after taking the Klonopin back in April. My psychiatrist who is a MD insists it is not the Klonopin causing my low blood pressure and Vertigo. I will show him your answer that one can develop side effects to medicine at any time. He insists that I would have the Vertigo every day and it would have started immediately back in April. What do you think about his opinion?

Expert:  Dr. Thomas, MD replied 10 months ago.
It would be more likely due to the zoloft, although low blood pressure can be from klonipin, and yes, even simply changing the medication might take care of it if this is the case.
I think exactly what I have stated above.
Show that to your doc.


Use reply to let me know if you have further questions.
Please do not forget a positive rating when done.
Customer: replied 10 months ago.

Thank you for your feedback. I really wish I did not have to be on any medicine at all. Medicine is great when needed but the less one is on, the better off they are. Do you think I should go to the Doctor today or should I wait until Friday? Is this an urgent matter?

Expert:  Dr. Thomas, MD replied 10 months ago.
Today is always better then tomorrow with a new development.

Use reply to let me know if you have further questions.
Please do not forget a positive rating when done.
Customer: replied 10 months ago.

Thank you very much for all the information. Have a good day.

Expert:  Dr. Thomas, MD replied 10 months ago.
You are welcome any time.
Any questions.
dt
Use reply to let me know if you have further questions.
Please do not forget a positive rating when done.
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 56381
Experience: Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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