Fluoxetine Linked to Small but Significant Blood Pressure Rise

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Frontiers in Medicine Published May 28, 2026 Medically reviewed May 28, 2026 DOI ↗ By Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

Key Takeaway

Fluoxetine may cause small but significant increases in blood pressure; monitor patients accordingly.

A meta-analysis of randomized controlled trials investigated the effect of fluoxetine on blood pressure in 538 participants. The analysis revealed that fluoxetine was associated with statistically significant increases in both systolic and diastolic blood pressure compared to placebo.

The weighted mean difference for systolic blood pressure was 7.47 mmHg (95% CI: 0.14 to 14.80; p = 0.046), and for diastolic blood pressure, it was 4.19 mmHg (95% CI: 0.44 to 7.93; p = 0.028). Subgroup analysis based on treatment duration showed even larger increases: 10.66 mmHg for systolic and 6.65 mmHg for diastolic.

These findings should be interpreted cautiously due to substantial heterogeneity and the limited number of included studies. The clinical relevance of these blood pressure changes may be modest but warrants monitoring in patients prescribed fluoxetine, especially those with cardiovascular risk factors.

Further research is needed to confirm these results and explore potential mechanisms. Clinicians should consider periodic blood pressure checks in patients on fluoxetine therapy.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedMay 2026

View Original Abstract ↓

Background and aimThere are ongoing controversies regarding the impact of fluoxetine on blood pressure (BP), and a comprehensive analysis specifically addressing this relationship is lacking. Given the limited detail in existing literature on BP fluctuations during fluoxetine treatment, we conducted this meta-analysis to evaluate BP variations, providing clinically relevant insights.MethodsA structured and comprehensive review was conducted using systematic review and meta-analytic approaches. Only randomized controlled trials (RCTs) comparing fluoxetine with placebo were included. Exhaustive searches were performed across major scholarly databases, including Scopus, Web of Science, Embase, and PubMed/MEDLINE, covering all records up to July 28, 2025. Pooled estimates were calculated using the DerSimonian and Laird random-effects model, and results were reported as weighted mean differences (WMDs) with corresponding 95% confidence intervals (CIs).ResultsFive RCT arms encompassing a total of 538 participants were included in the current meta-analysis. Fluoxetine treatment was associated with a statistically significant increase in systolic BP (SBP) (WMD: 7.47 mmHg; 95% CI: 0.14 to 14.80; p = 0.046) and diastolic BP (DBP) (WMD: 4.19 mmHg; 95% CI: 0.44 to 7.93; p = 0.028); however, these findings should be interpreted cautiously due to substantial heterogeneity and the limited number of included studies. Subgroup analyses based on treatment duration indicated that increases in SBP (WMD: 10.66 mmHg; 95% CI: 1.53 to 19.80; p = 0.022) and DBP (WMD: 6.65 mmHg; 95% CI: 4.30 to 8.99; p