Severe Hypertension on the Background of Buspirone Use

Drug-induced hypertension, though rare, often presents diagnostic challenges, particularly when the causative drug is not typically associated with hypertension. We describe a case involving a 55-year-old woman who presented with anxiety, confusion, and significantly high blood pressure unresponsive to standard treatments. Despite increasing medication doses, her blood pressure remained poorly controlled, leading to an investigation for secondary causes. Elevated plasma and urinary catecholamines were found. It was determined that the recent initiation of buspirone for anxiety was the cause. Discontinuation of buspirone normalized her catecholamine levels and improved blood pressure control. This case underscores the importance of considering drug-induced hypertension, particularly in instances of abrupt and severe blood pressure elevation, where elevated catecholamine levels may suggest conditions such as pheochromocytoma. It highlights the necessity for healthcare practitioners to be vigilant regarding the uncommon side effects of commonly prescribed medications, thereby ensuring accurate diagnosis and appropriate management.