Medication Changes for Autonomic Nervous System Disorders

Issues with Medications for Treating Autonomic Nervous System Disorders

I was diagnosed with autonomic nervous system dysfunction in early December.
Initially, I was prescribed Escitalopram, but during my recent follow-up appointment, I informed the doctor about my condition, and he did not suggest any changes to my medication.
However, when I mentioned that I occasionally see myself crying from a third-person perspective in a dark environment, crying until I am hoarse while I feel no emotions at that moment, the doctor changed my prescription to Leeyo.
I only asked if I was improving, and the doctor replied that I was not.
I would like to ask the doctor what the differences are between these two medications and whether my worsening symptoms are related to seeing myself cry.
What does it signify? Thank you for your patience in reading and responding.
Thank you.

Hana, 20~29 year old female. Ask Date: 2019/01/08

Dr. Huang Xiaoxian reply Psychiatry

Dear Una, thank you for your question.
The two medications you mentioned have the same generic name and are manufactured by different companies, but they may have different dosages.
You can check the numbers on the prescription; if it changes from 10 mg to 15 mg, the physician's intention may be to increase the dosage to achieve better results, rather than indicating that your symptoms have worsened.
It is advisable to discuss this further with your doctor.
Additionally, seeing yourself cry may indicate that a part of you still feels sadness, while another part wishes to avoid addressing it for the time being, which is why you appear calm on the surface.
Generally, it is recommended to explore and integrate all aspects of yourself, as this can be helpful.
You might consider seeking assistance through psychological counseling.

Reply Date: 2019/01/08

More Info

Understanding medication changes for autonomic nervous system disorders can be complex, especially when dealing with symptoms that may overlap with psychological conditions. In your case, it seems that you were initially prescribed Escitalopram, which is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat anxiety and depression. This medication works by increasing the levels of serotonin in the brain, which can help improve mood and reduce anxiety.

However, it appears that your symptoms persisted or even worsened, leading your doctor to switch your prescription to Leeyo (which is likely a brand name for a different medication, possibly a benzodiazepine or another type of antidepressant). The change in medication could be due to several factors, including the severity of your symptoms, the specific nature of your experiences, and your doctor's assessment of your mental health needs.

The experience you described—seeing yourself cry from a third-person perspective without feeling any emotion—could indicate a dissociative state or a form of depersonalization. This can occur in response to overwhelming stress or emotional pain, and it may be a coping mechanism your mind has developed to deal with distressing feelings. It’s important to communicate these experiences to your healthcare provider, as they can provide valuable insights into your mental health and the appropriateness of your treatment plan.

Regarding the differences between Escitalopram and Leeyo, if Leeyo is indeed a benzodiazepine, it would work quite differently than Escitalopram. Benzodiazepines are typically used for short-term relief of severe anxiety symptoms and can have sedative effects, whereas SSRIs like Escitalopram are generally used for long-term management of anxiety and depression. Benzodiazepines can be effective for immediate relief but carry a risk of dependence and withdrawal symptoms if used long-term.

Your doctor’s decision to change medications may reflect their concern about the effectiveness of Escitalopram for your specific symptoms or a desire to provide you with more immediate relief from anxiety. It’s crucial to have an open dialogue with your healthcare provider about your symptoms, medication side effects, and any concerns you may have regarding your treatment plan.
In addition to medication, consider discussing other therapeutic options, such as cognitive-behavioral therapy (CBT) or mindfulness practices, which can be beneficial in managing symptoms of anxiety and dissociation. These approaches can help you develop coping strategies and address the underlying issues contributing to your autonomic nervous system disorder.

Lastly, if you feel that your symptoms are worsening or if you experience any new or concerning symptoms, do not hesitate to reach out to your healthcare provider for further evaluation and support. Your mental health is important, and finding the right treatment plan may take time and adjustments.

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