Medication for Anxiety: Common Concerns and Side Effects

Q: Medication for Anxiety: Common Concerns and Side Effects

Hello, Xiao Zhang： Generally, side effects caused by medications tend to become less severe over time as the body adapts. <br>There are many reasons for fatigue, and it is not necessarily caused by medication; anxiety itself can be quite draining, and being in a constant state of

Questions about pharmacological treatment for anxiety disorders?

Hello, doctor.
I am currently a freshman in college, and I often excessively worry about my health (I tend to magnify minor discomforts, search online for disease articles, and remain anxious until symptoms resolve.
If symptoms persist too long, I worry about having a serious illness).
I also have panic disorder, with episodes occurring about once every one to two days for the past three to four years.
Recently, I visited a nearby psychiatric clinic, and after describing my situation, the doctor diagnosed me with panic disorder and anxiety disorder, noting a slight degree of depression but advised not to worry too much.
The doctor prescribed Seroxat CR 12.5 mg, to be taken once daily at bedtime.
I am a bit concerned about developing tolerance to the medication, so I have been taking only half a tablet daily.
I started taking it on Thursday, December 7.
On December 8, I felt no significant changes, but starting December 9 until now, I often wake up feeling groggy and want to stay in bed.
Most of the day, I feel low energy, and in the first few days, my anxiety seemed to worsen, leading to decreased motivation and a sense of lethargy.
Sometimes I also feel lightheaded, but during basketball practice, my athletic performance doesn’t seem to have declined much.

I would like to ask the doctor:
1.
When I mentioned to the doctor during my follow-up that I was taking only half a tablet, the doctor hesitated and said it was okay to try it this way.
Is this dosage too low? (My height is 169 cm and weight is 53 kg).
Will it be ineffective? However, the recent side effects have made it a bit difficult for me to concentrate in class.

2.
For example, if we get fatigued from a common cold and do not rest, the cold can worsen.
What could happen if I do not rest while experiencing fatigue from this medication?
3.
Generally, what is the pattern of these side effects? Do they start strong and then weaken, or do they start weak, become stronger, and then weaken again? Or do they remain constant until the medication takes effect, at which point the side effects disappear? Since I tend to be anxious about my health, I am worried about the persistent lightheadedness.

4.
I used to be on the school team and have slightly reduced my exercise volume, but I still engage in vigorous exercise (team sports) one or two days a week.
Is this level of activity permissible while on medication?
Thank you, doctor, for taking the time to answer my questions.

Xiao Zhang, 10~19 year old female. Ask Date: 2017/12/13

Dr. Liang Sunyuan reply Psychiatry

Hello, Xiao Zhang: Generally, side effects caused by medications tend to become less severe over time as the body adapts.
There are many reasons for fatigue, and it is not necessarily caused by medication; anxiety itself can be quite draining, and being in a constant state of anxiety can also lead to fatigue.
Whether to rest when feeling tired depends on the context, and there is no single standard answer.
However, I understand your concerns.
Our bodies have a considerable ability to regulate themselves, and we do not need to overly worry about every detail that might affect our health.
It is safe to exercise while taking your current medication, so there is no need for concern.
If you still have doubts, I recommend discussing them in person with your physician during your next appointment.
Wishing you all the best.

Reply Date: 2017/12/13

More Info

Hello! Thank you for reaching out with your concerns regarding your medication and its effects. It's understandable to feel anxious about your health, especially when dealing with anxiety and panic disorders. Let's address your questions one by one.

1. Dosage Concerns: You mentioned that you are taking half of the prescribed dose of Seroxat (paroxetine) instead of the full 12.5 mg. While it's common for patients to have concerns about medication dosage, it's essential to follow your doctor's guidance. The effectiveness of the medication can vary from person to person, and sometimes starting at a lower dose can help minimize side effects. However, if you feel that the half dose is not providing the desired effect, it's crucial to communicate this with your doctor. They may suggest adjusting the dosage based on your response to the medication.

2. Fatigue from Medication: It's not uncommon for medications like Seroxat to cause fatigue or drowsiness, especially when you first start taking them. If you don't rest and continue to push through this fatigue, it could lead to increased tiredness and may affect your overall well-being. It's essential to listen to your body; if you're feeling excessively tired, consider allowing yourself some time to rest. Chronic fatigue can also exacerbate anxiety symptoms, so prioritizing self-care is vital.

3. Side Effect Patterns: The experience of side effects can vary widely among individuals. Generally, when starting a new medication, side effects may be more pronounced initially and can either diminish over time as your body adjusts or persist. Some people may experience a "rollercoaster" effect, where side effects fluctuate before stabilizing. It's essential to monitor how you feel and keep an open line of communication with your healthcare provider. If you are consistently feeling unwell or if your anxiety worsens, your doctor may need to reassess your treatment plan.

4. Exercise While on Medication: Engaging in physical activity is generally encouraged, even when taking medication for anxiety or depression. Exercise can help improve mood and reduce anxiety symptoms. However, it's essential to pay attention to how your body responds to both the medication and the physical activity. If you feel dizzy or fatigued during exercise, it may be wise to adjust the intensity or duration of your workouts. Always consult your doctor about your exercise routine, especially when starting a new medication.

In summary, it's crucial to maintain open communication with your healthcare provider regarding your medication, side effects, and overall mental health. If you have concerns about your dosage, side effects, or how to manage your anxiety, don't hesitate to reach out to your doctor. They can provide personalized guidance and support tailored to your needs. Remember, managing anxiety and panic disorders is a journey, and it's okay to seek help along the way. Take care of yourself, and I wish you the best on your path to feeling better!

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