ArticleFrontiers in psychiatry2025
Case Report: Generalized anxiety disorder and hypertension: a bidirectional loop unraveled by integrated management.
Article in Frontiers in psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Novel anxiolytic-antidepressant combinations TF-1 and TF-2 and their intervention mechanisms in a mouse model of comorbid anxiety and depression (CAD).Frontiers in pharmacology · 2026Article
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3 authors.
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Abstract
Background: Generalized anxiety disorder (GAD) and hypertension (HTN) exhibit a clinically significant bidirectional relationship characterized by neuroendocrine dysregulation and autonomic dysfunction. Their comorbidity presents diagnostic and therapeutic challenges due to overlapping symptoms and fragmented care pathways. Case presentation: We report a 61-year-old male with 26-year refractory HTN and new-onset GAD triggered post-thyroidectomy. Despite triple antihypertensive therapy (nifedipine, arotinolol, sacubitril/valsartan), blood pressure (BP) remained uncontrolled (176/105 mmHg) with severe anxiety (HAMA = 36). Secondary HTN investigations were negative. Multimodal management combining pharmacotherapy (escitalopram, tandospirone), transcranial magnetic stimulation (9 sessions), biofeedback (14 sessions), psychotherapy, and lifestyle interventions achieve: mean BP decreased significantly from 176/105 mmHg to 125/72 mmHg during hospitalization; significant anxiety reduction (HAMA = 3), mean BP stabilized at 131/77 mmHg with 50% reduction in antihypertensive dosages, normalization of elevated ACTH (99.9→normal pg/mL) and cortisol (18.7→normal μg/dL) and sustained improvement at 6-month follow-up. Conclusion: This case demonstrates thyroidectomy-induced endocrine disruption as a novel trigger in the GAD-HT bidirectional loop. Multimodal therapy targeting shared neurobiological pathways (HPA axis, autonomic regulation, serotonin signaling) effectively breaks this cycle, underscoring the imperative for integrated mental-cardiovascular care in treatment-resistant cases.
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