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How to treat hypertension?

Q: My mother has been a hypertension patient for the last 25 years. For the last 5 years she has been taking Amlopres AT and Natrilix SR for BP. Of late she has been having anxiety attacks and has lost her sleep and appetite. She doubts whether or not she will be able to do a particular task. She has been living alone after my father passed away three years back. This was a major setback for us. I keep visiting her there every month for a couple of days. She insists on staying there as her social circle is there. We consulted a psychiatrist who prescribed Stablon 12.5 mg and also advised that the drugs Amlopres AT and Natrilix SR be replaced by some other drug as one causes depression and the other chemical imbalance. Which treatment should I follow?

A:Your mother needs good social support and the best one available is your family. It's difficult to remove a diuretic. Natrilix SR is the safest and one of the most potent diuretics for BP reduction with minimal metabolic side effects. You can remove the atenolol in Amlopress AT and increase the amlodepine to 10 mg once daily. If this combination of 10 mg amlodipine + natrilix does not provide good BP control or leads to swelling of feet (a common but safe side effect of amlodipine), you can bring the amlodipine down to 5 mg and add prazopress XL 2.5 or 5 mg once daily. These changes are best made by your local doctor.

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