The Effects of Pain and Analgesic Medications on Blood Pressure

IASP Terminology. Descriptions of chronic pain syndromes and definitions of pain terms [Internet]. 2011. Available from: https://www.iasp-pain.org/Education/Content.aspx?ItemNumber=1698&navItemNumber=576#Pain. Accessed 1 Aug 2021.

Hasselström J, Liu-Palmgren J, Rasjö-Wrååk G. Prevalence of pain in general practice. Eur J Pain [Internet]. 2002;6(5):375–85. Available from: http://doi.wiley.com/10.1016/S1090-3801%2802%2900025-3. Accessed 1 Aug 2021.

Gregory J, McGowan L. An examination of the prevalence of acute pain for hospitalised adult patients: a systematic review. J Clin Nurs [Internet]. 2016;25(5–6):583–98. Available from: http://doi.wiley.com/10.1111/jocn.13094. Accessed 1 Aug 2021.

Dahlhamer J, Lucas J, Zelaya, C, Nahin R, Mackey S, DeBar L, et al. Prevalence of chronic pain and high-impact chronic pain among adults — United States, 2016. MMWR Morb Mortal Wkly Rep [Internet]. 2018;67(36):1001–6. Available from: http://www.cdc.gov/mmwr/volumes/67/wr/mm6736a2.htm?s_cid=mm6736a2_w. Accessed 1 Aug 2021.

Breivik H, Eisenberg E, O’Brien T. The individual and societal burden of chronic pain in Europe: the case for strategic prioritisation and action to improve knowledge and availability of appropriate care. BMC Public Health [Internet]. 2013;13(1):1229. Available from: http://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-13-1229. Accessed 1 Aug 2021.

Williams B, Mancia G, Spiering W, Rosei EA, Azizi M, Burnier M, et al. practice guidelines for the management of arterial hypertension of the European society of cardiology and the European society of hypertension ESC/ESH task force for the management of arterial hypertension. J Hypertens. 2018;36:2284–309.

Article  Google Scholar 

• Bruehl S, Chung OY, Jirjis JN, Biridepalli S. Prevalence of clinical hypertension in patients with chronic pain compared to nonpain general medical patients. Clin J Pain [Internet]. 2005;21(2):147–53. Available from: http://journals.lww.com/00002508-200503000-00006. Accessed 1 Aug 2021. This analysis investigates the relationship between chronic pain and hypertension, showing that chronic pain is independently associated with an increased prevalence of hypertension and an increased use of antihypertensive medications.

Bruce K, Bruce S. Berne & Levy Physiology. 7th ed. 2017;880.

•• Snowden S, Nelson R. The effects of nonsteroidal anti-inflammatory drugs on blood pressure in hypertensive patients. Cardiol Rev. 2011;19(4):184–91. This useful review discusses the blood pressure effects of Nonsteroidal Anti-Inflammatory Drugs in hypertensive patients.

Article  PubMed  Google Scholar 

•• Turtle EJ, Dear JW, Webb DJ. A systematic review of the effect of paracetamol on blood pressure in hypertensive and non-hypertensive subjects. Br J Clin Pharmacol. 2013;75(6):1396–405. This systematic review analyses available evidence on the blood pressure effects of paracetamol in hypertensive and normotensive individuals.

Hall J. Guyton and Hall textbook of medical physiology. 13th ed. 2015;1168.

Millan MJ. Descending control of pain. Prog Neurobiol. 2002;66(6):355–474.

CAS  Article  PubMed  Google Scholar 

Zhuo M. Descending facilitation. Mol Pain [Internet]. 2017;13:174480691769921. Available from: http://journals.sagepub.com/doi/10.1177/1744806917699212. Accessed 1 Aug 2021.

Saccò M, Meschi M, Regolisti G, Detrenis S, Bianchi L, Bertorelli M, et al. The relationship between blood pressure and pain. J Clin Hypertens. 2013;15(8):600–5.

Article  Google Scholar 

Dworkin BR, Elbert T, Rau H, Birbaumer N, Pauli P, Droste C, et al. Central effects of baroreceptor activation in humans: attenuation of skeletal reflexes and pain perception. Proc Natl Acad Sci USA. 1994;91(14):6329–33.

CAS  Article  PubMed  PubMed Central  Google Scholar 

Bruehl S, Chung OY, Ward P, Johnson B, McCubbin JA. The relationship between resting blood pressure and acute pain sensitivity in healthy normotensives and chronic back pain sufferers: the effects of opioid blockade. Pain. 2002;100(1–2):191–201.

CAS  Article  PubMed  Google Scholar 

Meller T, Stiehm F, Malinowski R, Thieme K. Baroreflexsensitivität und chronischer Schmerz. Der Schmerz [Internet]. 2016;30(5):470–6. Available from: http://link.springer.com/10.1007/s00482-016-0150-5. Accessed 1 Aug 2021.

• Bruehl S, Olsen RB, Tronstad C, Sevre K, Burns JW, Schirmer H, et al. Chronic pain-related changes in cardiovascular regulation and impact on comorbid hypertension in a general population: the Tromsø study. Pain. 2018;159:119–127. This study demonstrates that chronic pain is associated with an impairment in cardiovascular regulation, thus suggesting that the link between chronic pain and hypertension may at least partly derive from pain-related decrements in cardiovascular regulation.

Kosek E, Ordeberg G. Lack of pressure pain modulation by heterotopic noxious conditioning stimulation in patients with painful osteoarthritis before, but not following, surgical pain relief. Pain. 2000;88(1):69–78.

Article  PubMed  Google Scholar 

Dedier J, Stampfer MJ, Hankinson SE, Willett WC, Speizer FE, Curhan GC. Nonnarcotic analgesic use and the risk of hypertension in US women. Hypertension. 2002;40(5):604–8.

CAS  Article  PubMed  Google Scholar 

Curhan GC, Willett WC, Rosner B, Stampfer MJ. Frequency of Analgesic Use and Risk of Hypertension in Younger Women. Arch Intern Med [Internet]. 2002;162(19):2204. Available from: http://archinte.jamanetwork.com/article.aspx?doi=10.1001/archinte.162.19.2204. Accessed 1 Aug 2021.

Forman JP. Frequency of analgesic use and risk of hypertension among men. Arch Intern Med [Internet]. 2007;167(4):394. Available from: http://archinte.jamanetwork.com/article.aspx?doi=10.1001/archinte.167.4.394. Accessed 1 Aug 2021.

Kurth T, Hennekens CH, Stürmer T, Sesso HD, Glynn RJ, Buring JE, et al. Analgesic use and risk of subsequent hypertension in apparently healthy men. Arch Intern Med [Internet]. 2005;165(16):1903. Available from: http://archinte.jamanetwork.com/article.aspx?doi=10.1001/archinte.165.16.1903. Accessed 1 Aug 2021.

Radack KL. Ibuprofen interferes with the efficacy of antihypertensive drugs. Ann Intern Med [Internet]. 1987;107(5):628. Available from: http://annals.org/article.aspx?doi=10.7326/0003-4819-107-5-628. Accessed 1 Aug 2021.

Pavlicević I, Kuzmanić M, Rumboldt M, Rumboldt Z. Interaction between antihypertensives and NSAIDs in primary care: a controlled trial. Can J Clin Pharmacol [Internet]. 2008;15(3):e372–82. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18953082. Accessed 1 Aug 2021.

Sudano I, Flammer AJ, Périat D, Enseleit F, Hermann M, Wolfrum M, et al. Acetaminophen increases blood pressure in patients with coronary artery disease. Circulation [Internet]. 2010;122(18):1789–96. Available from: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.110.956490. Accessed 1 Aug 2021.

Chalmers JP, West MJ, Wing LMH, Bune AJC, Graham JR. Effects of indomethacin, sulindac, naproxen, aspirin, and paracetamol in treated hypertensive patients. Clin Exp Hypertens Part A Theory Pract [Internet]. 1984;6(6):1077–93. Available from: http://www.tandfonline.com/doi/full/10.3109/10641968409039582. Accessed 1 Aug 2021.

Dunn MJ, Hood VL. Prostaglandins and the kidney. Am J Physiol Physiol [Internet]. 1977;233(3):F169–84. Available from: https://www.physiology.org/doi/10.1152/ajprenal.1977.233.3.F169. Accessed 1 Aug 2021.

Oates JA, FitzGerald GA, Branch RA, Jackson EK, Knapp HR, Roberts LJ. Clinical implications of prostaglandin and thromboxane A 2 formation. N Engl J Med [Internet]. 1988;319(12):761–7. Available from: http://www.nejm.org/doi/abs/10.1056/NEJM198809223191206. Accessed 1 Aug 2021.

Ubeda A, Llopico J, Sanchez MT. Blood pressure reduction in hypertensive patients after withdrawal of effervescent medication. Pharmacoepidemiol Drug Saf [Internet]. 2009;18(5):417–9. Available from: http://doi.wiley.com/10.1002/pds.1701. Accessed 1 Aug 2021.

• Chiam E, Weinberg L, Bailey M, McNicol L, Bellomo R. The haemodynamic effects of intravenous paracetamol (acetaminophen) in healthy volunteers: a double-blind, randomized, triple crossover trial. Br J Clin Pharmacol. 2016;81(4):605–12. This study assesses the hemodynamic effects of intravenous administration of paracetamol, showing a transient blood pressure decrease immediately after infusion which is likely related to vasodilatation.

CAS  Article  PubMed  PubMed Central  Google Scholar 

de Maat MM, Tijssen TA, Brüggemann RJ, Ponssen HH. Paracetamol for intravenous use in medium- and intensive care patients: pharmacokinetics and tolerance. Eur J Clin Pharmacol [Internet]. 2010;66(7):713–9. Available from: http://link.springer.com/10.1007/s00228-010-0806-5. Accessed 1 Aug 2021.

• Krajčová A, Matoušek V, Duška F. Mechanism of paracetamol-induced hypotension in critically ill patients: a prospective observational cross-over study. Aust Crit Care [Internet]. 2013;26(3):136–41. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1036731412000409. Accessed 1 Aug 2021. This small study investigates the mechanism of intravenous paracetamol-induced hypotension in critically ill patients, showing a reduction of both cardiac output and systemic vascular resistance.

Palmer R, Weiss R, Zusman RM, Haig A, Flavin S, MacDonald B. Effects of nabumetone, celecoxib, and ibuprofen on blood pressure control in hypertensive patients on angiotensin converting enzyme inhibitors. Am J Hypertens. 2003;16(2):135–9.

CAS  Article  PubMed  Google Scholar 

Pope JE. A meta-analysis of the effects of nonsteroidal anti-inflammatory drugs on blood pressure. Arch Intern Med [Internet]. 1993;153(4):477. Available from: http://archinte.jamanetwork.com/article.aspx?doi=10.1001/archinte.1993.00410040045007. Accessed 1 Aug 2021.

Johnson A, Simons L, Simons J, Friedlander Y, McCallum J. Non-steroidal anti-inflammatory drugs and hypertension in the elderly: a community-based cross-sectional study. Br J Clin Pharmacol. 1993;35(5):455–9.

CAS  Article  PubMed  PubMed Central  Google Scholar 

Zanchetti A, Hansson L, Leonetti G, Rahn K-H, Ruilope L, Warnold I, et al. Low-dose aspirin does not interfere with the blood pressure-lowering effects of antihypertensive therapy. J Hypertens [Internet]. 2002;20(5):1015–22. Available from: http://journals.lww.com/00004872-200205000-00038. Accessed 1 Aug 2021.

Chrischilles EA, Wallace RB. Nonsteroidal anti-inflammatory drugs and blood pressure in an elderly population. J Gerontol [Internet]. 1993;48(3):M91–6. Available from: https://academic.oup.com/geronj/article-lookup/doi/10.1093/geronj/48.3.M91. Accessed 1 Aug 2021.

Krum H, Swergold G, Curtis SP, Kaur A, Wang H, Smugar SS, et al. Factors associated with blood pressure changes in patients receiving diclofenac or etoricoxib: results from the MEDAL study. J Hypertens [Internet]. 2009;27(4):886–93. Available from: https://journals.lww.com/00004872-200904000-00031. Accessed 1 Aug 2021.

Gurwitz JH. Initiation of antihypertensive treatment during nonsteroidal anti-inflammatory drug therapy. JAMA J Am Med Assoc [Internet]. 1994;272(10):781. Available from: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.1994.03520100043031. Accessed 1 Aug 2021.

Solomon DH, Schneeweiss S, Levin R, Avorn J. Relationship between COX-2 specific inhibitors and hypertension. Hypertension [Internet]. 2004;44(2):140–5. Available from: https://www.ahajournals.org/doi/10.1161/01.HYP.0000136134.31846.83. Accessed 1 Aug 2021.

Whelton A, Fort JG, Puma JA, Normandin D, Bello AE, Verburg KM. Cyclooxygenase-2-specific inhibitors and cardiorenal function: a randomized, controlled trial of celecoxib and rofecoxib in older hypertensive osteoarthritis patients. Am J Ther [Internet]. 200;8(2):85–95. Available from: http://journals.lww.com/00045391-200103000-00003. Accessed 1 Aug 2021.

• White WB, Kent J, Taylor A, Verburg KM, Lefkowith JB, Whelton A. Effects of celecoxib on ambulatory blood pressure in hypertensive patients on ACE inhibitors. Hypertension [Internet]. 2002;39(4):929–34. Available from: https://www.ahajournals.org/doi/10.1161/01.HYP.0000014323.99765.16. Accessed 1 Aug 2021. This randomized, double-blind, placebo-controlled study investigated the blood pressure effects of celecoxib as compared to placebo in hypertensive patients with hypertension, revealing no significant effect on the antihypertensive action of the ACE-inhibitor lisinopril.

Whelton A, Lefkowith JL, West CR, Verburg KM. Cardiorenal effects of celecoxib as compared with the nonsteroidal anti-inflammatory drugs diclofenac and ibuprofen. Kidney Int [Internet]. 2006;70(8):1495–502. Available from: https://doi.org/10.1038/sj.ki.5001766.

Yu Y, Stubbe J, Ibrahim S, Song W, Symth EM, Funk CD, et al. Cyclooxygenase-2–dependent prostacyclin formation and blood pressure homeostasis. Circ Res [Internet]. 2010;106(2):337–45. Available from: https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.109.204529. Accessed 1 Aug 2021.

Johnson AG, Nguyen T V, Owe-Young R, Williamson DJ, Day RO. Potential mechanisms by which nonsteroidal anti-inflammatory drugs elevate blood pressure: the role of endothelin-1. J Hum Hypertens [Internet]. 1996;10(4):257–61. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8736458. Accessed 1 Aug 2021.

Knights KM, Winner LK, Elliot DJ, Bowalgaha K, Miners JO. Aldosterone glucuronidation by human liver and kidney microsomes and recombinant UDP-glucuronosyltransferases: inhibition by NSAIDs. Br J Clin Pharmacol [Internet]. 2009;68(3):402–12. Available from: https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2125.2009.03469.x. Accessed 1 Aug 2021.

Mulkerrin E. Increased salt retention and hypertension from non-steroidal agents in the elderly. QJM [Internet]. 1997;90(6):411–5. Available from: https://academic.oup.com/qjmed/article-lookup/doi/10.1093/qjmed/90.6.411. Accessed 1 Aug 2021.

Brueggemann LI, Mackie AR, Mani BK, Cribbs LL, Byron KL. Differential effects of selective cyclooxygenase-2 inhibitors on vascular smooth muscle ion channels may account for differences in cardiovascular risk profiles. Mol Pharmacol [Internet]. 2009;76(5):1053–61. Available from: http://molpharm.aspetjournals.org/lookup/doi/10.1124/mol.109.057844. Accessed 1 Aug 2021.

Zusman RM. Effects of converting-enzyme inhibitors on the renin-angiotensin-aldosterone, bradykinin, and arachidonic acid-prostaglandin systems: correlation of chemical structure and biologic activity. Am J Kidney Dis [Internet]. 1987;10(1 Suppl 1):13–23. Available from: http://www.ncbi.nlm.nih.gov/pubmed/3037886. Accessed 1 Aug 2021.

• Ishiguro C, Fujita T, Omori T, Fujii Y, Mayama T, Sato T. Assesing the effects of non-steroidal anti-inflammatory drugs on antihypertensive drug therapy using post-marketing surveillance database. J Epidemiol. 2008;18(3):119–24. This cohort study assessed assessed the interactions between non-selective non-steroidal anti-inflammatory (NSAIDs) drugs and several classes of antihypertensive drugs, revealing that the effectiveness of antihypertensives is attenuated by NSAIDs, with different effects according to the drug class considered.

Article  PubMed  PubMed Central  Google Scholar 

Fogari R, Zoppi A, Carretta R, Veglio F, Salvetti A. Effect of indomethacin on the antihypertensive efficacy of valsartan and lisinopril: a multicentre study. J Hypertens [Internet]. 2002;20(5):1007–14. Available from: http://journals.lww.com/00004872-200205000-00037. Accessed 1 Aug 2021.

Morgan TO, Anderson A, Bertram D. Effect of indomethacin on blood pressure in elderly people with essential hypertension well controlled on amlodipine or enalapril. Am J Hypertens [Internet]. 2000;13(11):1161–7. Available from: https://academic.oup.com/ajh/article-lookup/doi/10.1016/S0895-7061(00)01204-8. Accessed 1 Aug 2021.

Houston MC, Weir M, Gray J, Ginsberg D, Szeto C, Kaihlenen PM, et al. The effects of nonsteroidal anti-inflammatory drugs on blood pressures of patients with hypertension controlled by verapamil. Arch Intern Med [Internet]. 1995;155(10):1049–54. Available from: http://www.ncbi.nlm.nih.gov/pubmed/7748048. Accessed 1 Aug 2021.

• Chen A, Ashburn MA. Cardiac effects of opioid therapy. Pain Med (United States). 2015;16:S27-31. This review provides an overview on the risk of cardiac adverse effects of opioid drugs.

Article  Google Scholar 

Baldo BA, Pham NH. Histamine-releasing and allergenic properties of opioid analgesic drugs: resolving the two. Anaesth Intensive Care. 2012;40(2):216–35.

CAS  Article  PubMed  Google Scholar 

Rosow CE, Moss J, Philbin DM, Savarese JJ. Histamine release during morphine and fentanyl anesthesia. Anesthesiology [Internet]. 1982;56(2):93–6. Available from: https://pubs.asahq.org/anesthesiology/article/56/2/93/26405/Histamine-Release-during-Morphine-and-Fentanyl. Accessed 1 Aug 2021.

Blunk JA, Schmelz M, Zeck S, Skov P, Likar R, Koppert W. Opioid-induced mast cell activation and vascular responses is not mediated by ??-opioid receptors: an in vivo microdialysis study in human skin. Anesth Analg [Internet]. 2004;364–70. Available from: http://journals.lww.com/00000539-200402000-00018. Accessed 1 Aug 2021.

Casale TB, Bowman S, Kaliner M. Induction of human cutaneous mast cell degranulation by opiates and endogenous opioid peptides: evidence for opiate and nonopiate receptor participation. J Allergy Clin Immunol [Internet]. 1984;73(6):775–81. Available from: https://linkinghub.elsevier.com/retrieve/pii/0091674984904470. Accessed 1 Aug 2021.

Philbin DM, Moss J, Akins CW, Rosow CE, Kono K, Schneider RC, et al. The use of H1 and H2 histamine antagonists with morphine anesthesia. Anesthesiology [Internet]. 1981;55(3):292–6. Available from: https://pubs.asahq.org/anesthesiology/article/55/3/292/26347/The-Use-of-H1-and-H2-Histamine-Antagonists-with. Accessed 1 Aug 2021.

Flacke JW, Flacke WE, Bloor BC, Van Etten AP, Kripke BJ. Histamine release by four narcotics: a double-blind study in humans. Anesth Analg [Internet]. 1987;66(8):723–30. Available from: http://www.ncbi.nlm.nih.gov/pubmed/2440351. Accessed 1 Aug 2021.

Zelis R, Mansour EJ, Capone RJ, Mason DT. The cardiovascular effects of morphine. The peripheral capacitance and resistance vessels in human subjects. J Clin Invest. 1974;54(6):1247–58.

Afshari R, Maxwell SRJ, Webb DJ, Bateman DN. Morphine is an arteriolar vasodilator in man. Br J Clin Pharmacol [Internet]. 2009 Apr;67(4):386–93. Available from: https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2125.2009.03364.x. Accessed 1 Aug 2021.

Gautret B, Schmitt H. Multiple sites for the cardiovascular actions of fentanyl in rats. J Cardiovasc Pharmacol [Internet]. 1985;7(4):649–52. Available from: http://journals.lww.com/00005344-198507000-00006. Accessed 1 Aug 2021.

Cozzolino D, Sasso FC, Cataldo D, Gruosso D, Giammarco A, Cavalli A, et al. Acute pressor and hormonal effects of β-endorphin at high doses in healthy and hypertensive subjects: role of opioid receptor agonism. J Clin Endocrinol Metab. 2005;90(9):5167–74.

CAS  Article  PubMed  Google Scholar 

• Breeden M, Brieler J, Salas J, Scherrer JF. Antidepressants and incident hypertension in primary care patients. J Am Board Fam Med. 2018;31(1):22–8. This cohort study assessed the association of antidepressants with the development of hypertension, revealing that antidepressant therapy was no longer significantly associated with incident hypertension when controlling for confounders

Article  PubMed  Google Scholar 

•• Zhong Z, Wang L, Wen X, Liu Y, Fan Y, Liu Z. A meta-analysis of effects of selective serotonin reuptake inhibitors on blood pressure in depression treatment: outcomes from placebo and serotonin and noradrenaline reuptake inhibitor controlled trials. Neuropsychiatr Dis Treat. 2017;13:2781–96. This metanalysis investigates the pressor effects of antidepressants, showing no significant impact of SSRI as compared to placebo, while SNRI induced a modest blood pressure increase compared with SSRI.

CAS  Article  PubMed  PubMed Central  Google Scholar 

Thase ME. Effects of venlafaxine on blood pressure. J Clin Psychiatry [Internet]. 1998 Oct 15;59(10):502–8. Available from: http://article.psychiatrist.com/?ContentType=START&ID=10006144. Accessed 1 Aug 2021.

Derby MA, Zhang L, Chappell JC, Gonzales CR, Callaghan JT, Leibowitz M, et al. The effects of supratherapeutic doses of duloxetine on blood pressure and pulse rate. J Cardiovasc Pharmacol [Internet]. 2007;49(6):384–93. Available from: https://journals.lww.com/00005344-200706000-00007. Accessed 1 Aug 2021.

Allard P, Gram L, Timdahl K, Behnke K, Hanson M, Søgaard J. Efficacy and tolerability of venlafaxine in geriatric outpatients with major depression: a double-blind, randomised 6-month comparative trial with citalopram. Int J Geriatr Psychiatry [Internet]. 2004;19(12):1123–30. Available from: https://onlinelibrary.wiley.com/doi/10.1002/gps.1190. Accessed 1 Aug 2021.

Feighner JP. Cardiovascular safety in depressed patients: focus on venlafaxine. J Clin Psychiatry [Internet]. 1995;56(12):574–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8530334. Accessed 1 Aug 2021.

Dawood T, Schlaich M, Brown A, Lambert G. Depression and blood pressure control: all antidepressants are not the same. Hypertension. 2009;54(1): 133272.

Article  Google Scholar 

• Licht CMM, Geus EJCD, Seldenrijk A, Hout HPJV, Zitman FG, Van DR, et al. Depression is associated with decreased blood pressure, but antidepressant use increases the risk for hypertension. Hypertension. 2009;53(4):631–8. This analysis of from the Netherlands Study of Depression and Anxiety demonstrates that depression is associated with lower systolic blood pressure values, while tricyclic antidepressants were associated with higher systolic and diastolic blood pressure and increased risk of hypertension.

CAS  Article  PubMed  Google Scholar 

Ungvari Z, Pacher P, Kecskeméti V, Koller A. Fluoxetine dilates isolated small cerebral arteries of rats and attenuates constrictions to serotonin, norepinephrine, and a voltage-dependent Ca 2+ channel opener. Stroke [Internet]. 1999;30(9):1949–54. Available from: https://www.ahajournals.org/doi/10.1161/01.STR.30.9.1949. Accessed 1 Aug 2021.

Pacher P, Ungvari Z. Selective serotonin-reuptake inhibitor antidepressants increase the risk of falls and hip fractures in elderly people by inhibiting cardiovascular ion channels. Med Hypotheses. 2001;57(4):469–71.

CAS  Article  PubMed 

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