“Mrs. A,” a 62-year-old lady diagnosed with generalized anxiety disorder 2½ years ago, presented with prominent anxiety and secondary depressive symptoms. She had received various medications, such as serotonin reuptake inhibitors, mirtazapine, levosulpiride, and tianeptine, without much benefit. She had a 15-year history of hypertension and was being treated with a combination of losartan potassium 50 mg and hydrochlorthiazide 12.5 mg per day, with good control of blood pressure (BP). On physical examination, there was no abnormal finding, and her baseline BP was within normal range (122/82 mmHg, supine, right brachial). Investigations including hemogram, hepatic, and renal functions were normal. In view of the poor response to previous medications, desvanlafaxine was initiated at 50 mg/day. After 2 weeks, her BP increased to 200/120 mmHg (supine, right brachial). Considering desvenlafaxine-induced worsening of hypertension, it was discontinued, and she was started on a combination of escitalopram up to 20 mg/day, buspirone 30 mg/day, along with clonazepam 0.5 mg at bedtime. Within 2 weeks, her BP came down to normal range (122/80 mmHg, supine, right brachial). On the Naranjo Adverse Drug Reaction probability scale,5 her score was 8, suggestive of probable association of desvenlafaxine with increased blood pressure. Cognitive-behavioral therapy was started along with pharmacological treatment, with which there was partial control of anxiety symptoms that were maintained at follow-up.