SSRI Side Effects and Alternatives for Anxiety Management

Drug side effects

Hello, Doctor.
I have mild anxiety and panic symptoms, and I tend to be a nervous person, so I occasionally experience anxiety symptoms such as palpitations, dizziness, unexplained fear, numbness in my hands, or slight trembling.
The doctor prescribed me Enteric-Coated Fluoxetine, which is an SSRI medication.
I would like to ask:
1.
What are the side effects of this medication? I am very afraid of vomiting and dizziness, so I have been hesitant to take it.

2.
Generally, how common are the side effects?
3.
If side effects occur, how long do they typically last?
4.
Additionally, the doctor suggested that I could take a banana sleep aid and consider psychological counseling, which could help me heal without medication.
However, since my symptoms are occasional, what should I do if I experience panic or anxiety again before I see improvement? Can I take Alprazolam? It is a medication that provides immediate relief for anxiety, right? I would appreciate your clarification on these matters.
Thank you very much.

Tss, 30~39 year old female. Ask Date: 2018/06/02

Dr. Qiu Junda reply Psychiatry

Hello.
The side effects of SSRIs are mostly gastrointestinal (such as nausea and vomiting).
It is generally advisable to start with a lower dose to see how you respond, as this can help mitigate side effects, which usually become more tolerable within a week.
As for Anxiolytics, they can also be used to treat anxiety and panic disorders.
I recommend that you continue to follow up with your physician to discuss any medication side effects and to cooperate with the treatment plan for better improvement of your condition.

Reply Date: 2018/06/02

More Info

When it comes to managing anxiety and panic symptoms, understanding the use of SSRIs (Selective Serotonin Reuptake Inhibitors) and their side effects is crucial. SSRIs, such as Lexapro (escitalopram), are commonly prescribed to help alleviate symptoms of anxiety and depression by increasing serotonin levels in the brain. However, it's important to be aware of potential side effects and alternative options for managing anxiety.

1. Common Side Effects of SSRIs
SSRIs can have a range of side effects, although not everyone experiences them. Common side effects include:
- Gastrointestinal Issues: Nausea, vomiting, diarrhea, or constipation are frequent complaints, especially during the initial weeks of treatment.

- Nervousness or Anxiety: Paradoxically, some individuals may experience increased anxiety or agitation when starting SSRIs.

- Sleep Disturbances: Insomnia or drowsiness can occur, depending on the individual and the specific SSRI.

- Sexual Dysfunction: This can include decreased libido, delayed ejaculation, or difficulty achieving orgasm.

- Weight Changes: Some people may experience weight gain or loss.

- Headaches: These can occur as the body adjusts to the medication.

2. Incidence of Side Effects
The likelihood of experiencing side effects varies among individuals. Generally, SSRIs are well-tolerated, and many side effects tend to diminish after the first few weeks of treatment. Studies suggest that around 20-30% of patients may experience side effects, but most are mild and manageable.

3. Duration of Side Effects
If side effects do occur, they often subside within a few days to a few weeks as your body adjusts to the medication. However, if side effects persist or become intolerable, it’s essential to communicate with your healthcare provider. They may adjust the dosage or consider switching to a different medication.

4. Alternatives to Medication
Your doctor’s suggestion of using a combination of lifestyle changes, such as dietary adjustments (like eating bananas for their potassium and magnesium content, which can help with relaxation) and psychological counseling, is a valid approach. Cognitive Behavioral Therapy (CBT) is particularly effective for anxiety and can provide you with tools to manage symptoms without medication.

5. Use of Anxiolytics
Regarding the use of anxiolytics (like Xanax or Ativan), these medications can provide immediate relief from acute anxiety symptoms. However, they are typically prescribed for short-term use due to the risk of dependence and withdrawal symptoms. If you find yourself in a situation where your anxiety is overwhelming, discussing the possibility of using a short-term anxiolytic with your doctor may be beneficial.

Conclusion
In summary, while SSRIs can be effective in managing anxiety symptoms, they come with potential side effects that vary in incidence and duration. It’s crucial to have open communication with your healthcare provider about any concerns you have regarding side effects and to explore alternative or complementary treatments, including therapy and lifestyle changes. If you are considering using anxiolytics for immediate relief, consult your doctor to ensure it aligns with your overall treatment plan. Remember, managing anxiety is a journey, and finding the right combination of treatments can take time.

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