Managing Complex Medication for Mental Health: A Patient's Journey

Q: Managing Complex Medication for Mental Health: A Patient's Journey

Hello： Psychosomatic symptoms need to rule out the influence of mental and physical disorders. <br>Involuntary head shaking and auditory hallucinations require further evaluation for other issues. <br>The medications you are using, including Lyrica, Rifampin, Zyprexa, and Atarax,

Taking Entresto (sacubitril/valsartan), Rifampin, and Zantac (ranitidine) together may lead to potential drug interactions that could affect heart rhythm. It is important to monitor for signs of arrhythmia, which can include palpitations, dizziness, or fainting. If you experience any of these symptoms, consult your healthcare provider immediately?

Hello, doctor.
I have a question.
I was taking Lendormin for about a year, but I stopped taking it on my own.
Recently, I have been experiencing involuntary head shaking (rapid tremors) quite frequently over the past few months.
I visited a neurologist who prescribed Rivotril to take at bedtime.
Later, I tried taking Entacapone during the day, which made me drowsy, so I switched to taking it at night.
The neurologist advised me to choose between Lendormin and Rivotril (both at half a dose).
I found that half a dose of Rivotril was ineffective, so I took a full dose and returned to the psychiatric clinic to explain that Rivotril wasn't working.
At night, when I lie down, I experience auditory hallucinations (if I don't take any sleep aids, I can't sleep due to the sounds).
The doctor then prescribed Xanax, but I'm still confused about whether to take Rivotril or Xanax.
Currently, I'm taking half a dose of Rivotril and half a dose of Xanax, and occasionally I give in to temptation and take a sip of 40% alcohol (just one sip).
Today, I felt a bit strange, but I slept very well and almost forgot to go to work.
However, now I find myself very excited and slightly headachey.
Should I take Panadol? With so many medications, how should I manage them? I'm also worried about not finishing them or taking the wrong medications for too long (they were prescribed for a month).
The neurologist mentioned that the allergy medication I take already contains antihistamines, implying that all these medications are supposed to address my physical and mental health, as well as autonomic nervous system issues, but they haven't been effective (I finished a month’s worth of ENT medication, but I still have post-nasal drip, even though the air quality index outside isn't high).
Additionally, I monitor my blood pressure daily, and my heart rate fluctuates between 77, 88, and 104...
It speeds up when I'm comfortable and normalizes when I'm uncomfortable and dizzy.
Is this all interconnected? I have a congenital disability and have faced bullying at work, which led to psychosomatic symptoms.
I was maliciously terminated from a new job, making it difficult to find work for two years.
Last month, I finally found a new job and am still adapting, but I’m afraid to speak up.

Beth Huang, 30~39 year old female. Ask Date: 2017/07/18

Dr. Cai Qijin reply Psychiatry

Hello: Psychosomatic symptoms need to rule out the influence of mental and physical disorders.
Involuntary head shaking and auditory hallucinations require further evaluation for other issues.
The medications you are using, including Lyrica, Rifampin, Zyprexa, and Atarax, are all sedative-hypnotics, and along with Entresto and antihistamines, they are symptomatic treatments.
The usage seems somewhat confusing.
It is recommended that you visit a psychiatric outpatient clinic for evaluation, bringing along your medications to discuss treatment options with your physician.

Reply Date: 2017/07/18

More Info

Managing complex medication regimens for mental health can be a daunting task, especially when multiple medications are involved, each with its own potential side effects and interactions. Your situation highlights the challenges faced by many individuals dealing with mental health issues, particularly when compounded by physical health concerns and external stressors such as job-related anxiety and past trauma.

Firstly, it’s important to understand the medications you are currently taking and their intended effects. From your description, it seems you have been prescribed several medications, including Rifampicin (利福全), Zolpidem (贊安諾), and possibly others for your mental health symptoms, including sleep disturbances and anxiety. Each of these medications can have significant effects on your central nervous system, and combining them can lead to unpredictable outcomes.

1. Understanding Your Medications:
- Rifampicin is primarily an antibiotic used to treat tuberculosis and other bacterial infections. It is not typically used for mental health conditions, so it’s crucial to clarify with your neurologist why it was prescribed in your case.
- Zolpidem is a sedative primarily used for the short-term treatment of insomnia. It can help you fall asleep but may not address underlying anxiety or other mental health issues.

- The combination of these medications, especially with alcohol, can lead to increased sedation, confusion, and other cognitive impairments. Alcohol can exacerbate the side effects of both medications, leading to increased drowsiness and potential respiratory depression.

2. Managing Side Effects:
- The involuntary head shaking you mentioned could be a side effect of the medications or a separate neurological issue. It’s essential to report this symptom to your healthcare provider, as it may require further evaluation.

- If you are experiencing hallucinations when lying down, this could be a sign of a more serious issue that needs to be addressed. Hallucinations can occur with certain medications, especially when combined with alcohol or if there is an underlying mental health condition.

3. Medication Adherence and Monitoring:
- It’s crucial to take medications as prescribed and not to adjust dosages without consulting your physician. If you feel that a medication is not effective, communicate this with your healthcare provider rather than self-adjusting the dose.

- Regular monitoring of your blood pressure and heart rate is a good practice, especially since you have a history of anxiety and potential cardiovascular concerns. Fluctuations in heart rate can be influenced by anxiety, medication side effects, or even withdrawal from substances like alcohol.

4. Seeking Comprehensive Care:
- Given your complex medical history and the interplay between your mental and physical health, it may be beneficial to have a coordinated care approach. This could involve a psychiatrist, a neurologist, and possibly a psychologist or therapist who can help you navigate your mental health challenges.

- Cognitive Behavioral Therapy (CBT) or other forms of psychotherapy can be effective in managing anxiety and depression, especially when combined with medication. Therapy can provide you with tools to cope with stressors, such as workplace bullying and job-related anxiety.

5. Lifestyle Considerations:
- It’s essential to maintain a healthy lifestyle, including regular exercise, a balanced diet, and good sleep hygiene. These factors can significantly impact your mental health and overall well-being.

- Avoiding alcohol, especially when taking sedatives or other CNS-active medications, is crucial. Alcohol can interfere with the effectiveness of your medications and exacerbate side effects.

In conclusion, managing your mental health medications requires careful consideration and open communication with your healthcare providers. It’s vital to address any side effects or concerns promptly and to seek a comprehensive treatment plan that includes both medication and therapy. Remember, you are not alone in this journey, and there are resources and support systems available to help you navigate these challenges.

Similar Q&A

Navigating Mental Health: A Personal Journey Through Depression and Treatment

Doctor Liu: Hello, I have been dealing with depression for over two years, intermittently receiving treatment. In the past, many friends in the medical field, as well as others, advised me against seeing a psychiatrist, claiming that medication would worsen my condition or that i...

Dr. Liu Guangqi reply Psychiatry
When you stop taking psychiatric medications, you really feel unwell, and this is a problem that must be taken seriously and addressed. It may take some time, and the methods used may change frequently. You might consult different doctors, and what they say may vary somewhat, but...

Managing Anxiety and Medication: A Guide for Mental Health Patients

Hello Doctor: Thank you for your previous response! I have been seeing a psychiatrist for three weeks now, but I feel like there hasn't been much change. My lower back continues to hurt, my neck is still uncomfortable, my sleep is not very stable, and I sometimes experience ...

Dr. Tang Xinbei reply Psychiatry
Dear A-Rong, It seems that your distress is due to taking many medications without noticeable improvement. With your current medications, it generally takes more than ten days to see significant effects. Are you concerned that continuing this way might lead to dependence or addi...

Understanding Medication Changes in Mental Health Treatment: A Patient's Perspective

Hello, doctor. Yesterday, I went for psychotherapy and then visited my attending physician. During the therapy session, I told my therapist that I sometimes have suicidal thoughts, and he relayed this information to my attending physician. That day, my attending physician decided...

Dr. Chen Wenke reply Psychiatry
MIMI faces challenges in treatment that truly trouble many people. However, one thing is certain: treatment is always better than no treatment. We must acknowledge that some individuals may experience suboptimal responses to therapy, and these individuals may require more time an...

Navigating Life with Schizophrenia: A Patient's Journey to Stability

Hello Doctor, I first experienced symptoms at the age of 28, including persecutory delusions, and was diagnosed with paranoid schizophrenia after consulting a psychiatrist. After a period of medication treatment and stabilization, I stopped attending appointments and taking medic...

Dr. Liu Guangqi reply Psychiatry
Being ill and needing to take medication or temporarily leave work is often unavoidable. Facing the environment again requires immense willpower and courage. Once you understand and accept yourself, you can gradually adjust to confront the world. Experiencing low mood is a common...