Managing Medication: Addressing Neurology Concerns and Side Effects

Medication issues?

Hello, Dr.
Gao.
I recently changed my medication and would like to ask you about the medications I received at the clinic.
In the morning, I take my blood pressure medication along with Nabota 0.5 mg (Mecobalamin), "Shenda" Yulishupan 0.25 mg (taken before bed), Jingde Keqianping 0.5 mg, calcium carbonate 500 mg, and a self-paid supplement called Xinboning.
I have been taking insomnia medication for almost four years, but recently I have experienced excessive sleepiness, dizziness, blurred vision, and memory loss.
I visited an ophthalmologist who said my eyes are fine.
I also mentioned these issues to the doctor at the insomnia clinic, who said that the medications I was prescribed should not cause such symptoms.
I would like to ask, Dr.
Gao, if it is okay for me to only take the medication before bed.
Additionally, I would like to know if taking Nabota 0.5 mg could be causing a tingling sensation in my head, as if blood is rushing out.

Cai Xiansheng, 30~39 year old female. Ask Date: 2016/05/09

Dr. Gao Chunde reply Neurology

If the symptoms started after changing medications, you should inform the original physician to clarify the relationship between the previous medication and the current one that may have caused these symptoms.
If the symptoms were present before the medication change, it may not necessarily be a medication issue, and you should consult a neurologist to evaluate whether there are other underlying conditions causing these symptoms.

Reply Date: 2016/05/09

More Info

Managing medication, especially for neurological concerns, requires careful consideration of the medications prescribed, their mechanisms of action, potential side effects, and how they interact with each other. In your case, you mentioned taking several medications, including mecobalamin (a form of vitamin B12), clonazepam (Klonopin), and other medications for sleep and anxiety. Let's break down your concerns and provide clarity on the medications and their effects.

Understanding Your Medications
1. Mecobalamin (0.5 mg): This is a form of vitamin B12 that is often used to treat neuropathies and improve nerve function. It is generally well-tolerated and has minimal side effects. However, some individuals may experience sensations like tingling or a "pins and needles" feeling, which could be related to the underlying nerve condition rather than the medication itself.

2. Clonazepam (0.25 mg): This medication belongs to the benzodiazepine class and is primarily used for anxiety and seizure disorders. While it can help with anxiety and muscle relaxation, it is not typically used as a first-line treatment for neuropathic pain. Long-term use of benzodiazepines can lead to tolerance, dependence, and withdrawal symptoms upon discontinuation. Side effects may include drowsiness, dizziness, and cognitive impairment, which could explain your feelings of sleepiness, dizziness, and memory issues.

3. Calcium Carbonate (500 mg): This is usually taken as a supplement for bone health or to manage acid reflux. It does not typically interact with your neurological medications but should be taken as directed to avoid gastrointestinal side effects.

4. Other Medications: You mentioned other medications that you have been prescribed for sleep. Many sleep medications can cause sedation, dizziness, and cognitive impairment, especially if taken long-term. If you have been on these medications for four years, it is essential to evaluate their necessity and effectiveness regularly.

Addressing Your Concerns
- Drowsiness and Dizziness: These symptoms can be attributed to several factors, including the medications you are taking, the dosage, and potential interactions between them. Benzodiazepines like clonazepam can cause significant sedation, especially when combined with other sedative medications. It is crucial to discuss these symptoms with your prescribing physician to determine if adjustments to your medication regimen are necessary.

- Visual Disturbances and Memory Issues: While your eye examination was normal, the combination of medications you are taking could contribute to visual disturbances and cognitive issues. Benzodiazepines and certain sleep medications can impair cognitive function, leading to memory problems and confusion. It is advisable to have a thorough review of your medications to assess their appropriateness and explore alternatives if necessary.

- Feeling of Tingling or "Blood Rush": This sensation could be related to your underlying neurological condition or a side effect of mecobalamin. If this sensation persists or worsens, it is essential to consult your healthcare provider for further evaluation.

Recommendations
1. Medication Review: Schedule an appointment with your healthcare provider to review all your medications. Discuss the side effects you are experiencing and consider whether any medications can be reduced or discontinued.

2. Consider Non-Pharmacological Approaches: In addition to medication, consider lifestyle modifications that can improve sleep quality, such as establishing a regular sleep schedule, practicing relaxation techniques, and creating a conducive sleep environment.

3. Monitor Symptoms: Keep a journal of your symptoms, noting when they occur and their severity. This information can be valuable for your healthcare provider in determining the best course of action.

4. Consult a Specialist: If your symptoms persist or worsen, consider consulting a neurologist or a sleep specialist who can provide a more focused evaluation of your neurological health and sleep issues.

In conclusion, managing medications for neurological concerns requires a comprehensive approach that considers the benefits and risks of each medication. Open communication with your healthcare provider is essential to ensure that your treatment plan is safe and effective.

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