Problems that arise after discontinuing medication?
Hello Doctor: I was diagnosed with panic disorder about a year ago.
Recently, after discussing with my doctor, I decided to stop my medication starting the evening of July 14, 2016.
However, starting the second night after stopping the medication, I have been unable to sleep until around 7:30 the next morning, managing only one to two hours of sleep.
Sometimes, my body also experiences slight tremors.
I remember my doctor mentioning that the dosage prescribed was quite low and that I could try stopping the medication directly.
I am still in the process of tapering off, but I would like to ask if my current situation is a withdrawal phenomenon? Should I consult a doctor for a solution? Below are the medications and dosages prescribed: Deanxit oral tablet, once daily, one tablet; Diazepam 5mg oral tablet, once daily, 0.5 tablet; Lorazepam 1mg oral tablet, once daily, one tablet.
Gary Lau, 20~29 year old female. Ask Date: 2016/07/17
Dr. Huang Weiqin reply Psychiatry
Dear Inquirer: Hello! If you are currently having difficulty discontinuing the medication, you may resume the original prescribed dosage.
You can discuss further management with your physician during your next outpatient visit.
I hope this response is helpful.
Thank you for your inquiry, and I wish you peace and health.
Reply Date: 2016/07/17
More Info
When it comes to understanding withdrawal symptoms after stopping anxiety medication, it's important to recognize that these symptoms can vary significantly based on the type of medication, the dosage, the duration of use, and individual patient factors. In your case, you mentioned that you were prescribed Deanxit, Diazepam, and Lorazepam, and you have recently stopped taking them.
Withdrawal symptoms can occur when a person abruptly stops or significantly reduces the dosage of certain medications, particularly benzodiazepines like Diazepam and Lorazepam. These medications work by enhancing the effects of a neurotransmitter called gamma-aminobutyric acid (GABA), which has a calming effect on the brain. When you stop taking these medications suddenly, your brain may react negatively due to the sudden lack of GABA enhancement, leading to withdrawal symptoms.
Common withdrawal symptoms from benzodiazepines can include increased anxiety, insomnia, tremors, sweating, and in some cases, seizures. The symptoms you are experiencing, such as difficulty sleeping, slight tremors, and increased anxiety, could indeed be indicative of withdrawal. However, it is also possible that these symptoms are related to the underlying anxiety disorder itself, which may resurface when the medication is stopped.
Given that you have been off the medication for a short period, it is crucial to monitor your symptoms closely. If your symptoms are mild and manageable, you may not need to seek immediate medical attention. However, if your symptoms worsen or become unmanageable, it is advisable to consult your healthcare provider. They can assess your situation and may recommend a gradual tapering of the medication rather than an abrupt stop, which can help mitigate withdrawal symptoms.
In your case, since you were advised that the dosage was low and that it might be okay to stop, it’s essential to consider that even low doses can lead to withdrawal symptoms, especially if taken for an extended period. It’s also worth noting that the psychological dependence on these medications can develop, leading to a resurgence of anxiety symptoms when the medication is stopped.
If you decide to consult your doctor, they may suggest a few strategies to help manage your symptoms. These could include:
1. Gradual Tapering: Instead of stopping abruptly, your doctor may recommend a gradual reduction in dosage over several weeks or months. This can help your body adjust to the absence of the medication and reduce withdrawal symptoms.
2. Alternative Medications: If your anxiety symptoms are significant, your doctor might consider prescribing alternative medications that have a lower risk of dependence or withdrawal symptoms.
3. Therapeutic Support: Engaging in therapy, such as cognitive-behavioral therapy (CBT), can be beneficial in managing anxiety symptoms without medication. Therapy can provide you with coping strategies and tools to handle anxiety more effectively.
4. Lifestyle Modifications: Incorporating regular exercise, a balanced diet, adequate sleep, and mindfulness practices such as meditation or yoga can also help alleviate anxiety symptoms.
5. Monitoring Symptoms: Keeping a journal of your symptoms can help you and your healthcare provider understand the severity and frequency of your withdrawal symptoms, which can inform treatment decisions.
In conclusion, while your symptoms may be indicative of withdrawal, they could also be related to the underlying anxiety disorder. It is essential to communicate openly with your healthcare provider about your experiences and concerns. They can help you navigate this process safely and effectively, ensuring that you receive the appropriate support and treatment.
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