Q: I am 39 years old. I was diagnosed with high blood pressure at the age of 34. I weigh 77 kg and I am 5 feet 7 inches tall. I am a vegetarian and teetotaller. I was initially given loprasar 25 mg. Subsequently I was prescribed Tenormin 25 mg. My blood parameters like cholesterol, blood sugar etc. are all normal. My mother also developed high BP at the age of 35. My ECG reads complete Right Bundle Branch Block. The doctor said that RBBB is common and no treatment is necessary. I was also told that the BP is due to anxiety and stress. I was also given Zosert 25 mg along with Tenormin 25 mg. I discontinued Zosert on my own and I am taking Tenormin 25 mg along with Evion 400 mg. I feel disturbed during sleep occasionally. I take half of Anxit 0.25 mg or Rivotril 0.5 mg. I get my BP checked once in 3 months and the readings are around 130/90 or 140/90. I do aerobics for 30 to 45 minutes every day in the evening. Can Tenormin be taken along with Evion? Is it sufficient? Will Right Bundle Branch Block coupled with BP have any adverse affects? Should I continue taking Zosert? Will the consumption of Anxit or Rivotril have any side effects?

A:For control of blood pressure, use of Tenormin (atenolol) 25mg is fine. However, the use of Zosert (sertraline) is both inappropriate as well as potentially dangerous. Sertraline is to be used only by psychiatric patients of panic disorders, major depression and obsessive-compulsive disorder (OCD) and most certainly not for day-to-day routine stress and anxiety. Unfortunately due to aggressive promotion it is being misprescribed. It has a mile-long list of side effects some of which are quite serious such as development of mania, seizures (fits), sexual dysfunction, nervousness, urinary retention, abnormal vision etc. Rivotril (clonazepam) is also not appropriate since it is to be used in epilepsy only. Its misuse for stress is to be avoided. You can take slow release aprazolam (sold under the trade name of Alprocontin Continus) 0.5mg for short term. It is like Anxit but has a longer duration of action. The daily requirement of vitamin E is less than 15mg which comes from food items; so vitamin E supplements (such as Evion 400 mg) are not required. Moreover in the long run excessive vitamin E can cause diarrhoea, abdominal cramps etc. Vitamin E is to be taken only when there is documented deficiency.