Why Your Medication for Autonomic Dysfunction Suddenly Stopped Working

Long-term medication use can sometimes lead to a sudden loss of efficacy?

Hello Doctor, I was diagnosed with autonomic nervous system dysfunction ten months ago.
The main symptoms I experienced were diarrhea every day after breakfast, discharge of an unknown fluid from my genital area, and difficulty falling asleep at night after lying in bed for a long time.
The doctor prescribed me two medications: Fluoxetine 20 mg to be taken once every morning, and Mocalm to be taken once every morning as well.
The doctor initially mentioned that it would take about four weeks for the medication to be effective.
After taking it for a month, I gradually noticed improvements, and for the past nine months, my symptoms have significantly improved; I no longer experience diarrhea and I can fall asleep quickly at night.
However, I am unsure why, starting two weeks ago and continuing to the present, all of my symptoms have returned.
I am certain that I have been taking my medication on time every day.
In the past two weeks, I have been having a cup of iced drink from 7-11 and a piece of bread for breakfast almost every day.
Could this be the reason for my symptoms returning? Please advise, Doctor.

Dalin, 20~29 year old female. Ask Date: 2018/08/27

Dr. Qiu Junda reply Psychiatry

Hello.
Since you have received treatment from the psychiatry department for your condition, it is recommended that you continue to attend follow-up appointments and discuss any changes in your symptoms with your physician to facilitate your recovery.
Thank you.

Reply Date: 2018/08/27

More Info

It sounds like you've been through quite a journey with your autonomic dysfunction and the medications prescribed to help manage your symptoms. The sudden return of your symptoms after a period of improvement can be frustrating and concerning. Let's explore some potential reasons why your medication might have stopped working effectively and what steps you can take moving forward.

Firstly, it's important to understand that medications like Fluoxetine (an SSRI) and Mocalm (a muscle relaxant) can sometimes lose their effectiveness over time. This phenomenon is known as "tolerance," where your body becomes accustomed to the medication, requiring higher doses to achieve the same effect. However, this is not the only reason for a resurgence of symptoms.
1. Lifestyle Factors: You mentioned that your breakfast routine has included iced drinks and bread from a convenience store. While these foods may not directly cause your symptoms, dietary changes can impact your gastrointestinal health and overall well-being. For instance, consuming high-sugar or high-caffeine beverages can lead to gastrointestinal upset, anxiety, or restlessness, which might exacerbate your symptoms. It might be beneficial to evaluate your diet and consider incorporating more balanced meals that include fiber, protein, and healthy fats.

2. Stress and Anxiety: Autonomic dysfunction is often linked to stress and anxiety levels. If you've experienced increased stress in your life recently, this could contribute to the return of your symptoms. Stress management techniques such as mindfulness, meditation, or cognitive-behavioral therapy (CBT) can be effective in managing anxiety and improving your overall mental health.

3. Medication Adherence: While you mentioned that you have been diligent about taking your medication, it's always worth double-checking that you're taking the correct dosage at the right times. Sometimes, even minor deviations can affect how well the medication works.

4. Underlying Health Issues: It's also possible that there may be other underlying health issues that have developed or worsened, contributing to your symptoms. Conditions such as gastrointestinal disorders, hormonal imbalances, or even infections can mimic or exacerbate autonomic dysfunction symptoms. A thorough evaluation by your healthcare provider may be necessary to rule out any other potential causes.

5. Consultation with Your Doctor: Given the resurgence of your symptoms, it is crucial to consult with your healthcare provider. They can assess your current situation, possibly adjust your medication, or suggest alternative treatments. Sometimes, a combination of medications or the addition of non-pharmacological treatments, such as therapy or lifestyle changes, can provide better symptom management.

6. Gradual Medication Adjustment: If your doctor decides to adjust your medication, it’s important to do so gradually and under supervision. Sudden changes can lead to withdrawal symptoms or a rebound effect, where symptoms return even more intensely.

In conclusion, the return of your symptoms after a period of improvement can be attributed to various factors, including lifestyle changes, stress, medication tolerance, or underlying health issues. It is essential to have an open dialogue with your healthcare provider to explore these possibilities and adjust your treatment plan accordingly. Remember, managing autonomic dysfunction often requires a holistic approach that includes both medication and lifestyle modifications.

Similar Q&A

Managing Anxiety and Autonomic Dysfunction: Medication and Lifestyle Tips

Hello, Doctor. Last October, I underwent autonomic nervous system testing at a health check-up center and was diagnosed with moderate autonomic dysfunction. I suspect this may be related to recent stress and interrupted sleep, accompanied by symptoms of irritability. In February,...

Dr. Wu Enliang reply Psychiatry
1. In my situation, should I not reduce the dosage of Alprazolam, and would it be better to continue taking 0.25 mg twice daily? A: Alprazolam is best used for the short term, but since you are still experiencing anxiety symptoms, you might try taking 0.25 mg twice daily to see i...

Managing Anxiety: Insights on Reducing Medication for Autonomic Dysregulation

Hello Doctor, I have been diagnosed with autonomic nervous system dysfunction by a psychiatrist for several years. My treatment has been going well, and I have been consistently taking half a tablet of Lysteda and half a tablet of Klonopin before bed, with no adverse symptoms. A ...

Dr. Wu Enliang reply Psychiatry
Hello, online friend: If you have concerns, slow down the process of discontinuing the medication. First, stop Jing An Ning, and if everything is still fine, then discontinue it completely after a week. Dr. Wu Enliang

Understanding Autonomic Nervous System Disorders: A Case Study

Dear Dr. Jiang, I would like to inquire about my mother's medical condition. Here is a detailed description: In February and March of last year (2022), my mother suddenly experienced rapid heartbeat, shortness of breath, cold hands, and shaking. She went to a medical facil...

Dr. Jiang Junyi reply Neurology
Dear Mr. Kris, The treatment for hypertension is usually multifaceted. If there is a tendency for sympathetic nervous system overactivity, a beta-blocker may be added. If a single antihypertensive medication is insufficient to control blood pressure, a combination therapy (such ...

Understanding Dopamine Deficiency and Its Impact on Anxiety Medications

In mid-August last year, I started experiencing noticeable symptoms where sometimes while walking, my left foot would suddenly start to twitch involuntarily (possibly due to anxiety or other reasons), or my left foot would suddenly stop while walking. Occasionally, my left leg wo...

Dr. Hong Weibin reply Neurology
You are very diligent! You've done a lot of homework. Occasionally, you experience muscle twitching in your left leg, sometimes accompanied by a tingling sensation, followed by pain in your left thigh. My thought is that it may be due to lumbosacral radiculopathy. Lumbosacra...