Managing Side Effects of Psychiatric Medications: A Guide for Patients - Psychiatry

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Managing side effects of psychiatric medications can be a challenging aspect of treatment for both patients and their caregivers. In your mother's case, she has been prescribed several medications, including Sertraline (often referred to as "思樂康"), Lorazepam (悠然), and a liquid formulation of another medication, which may be a form of a benzodiazepine or an antidepressant. It's important to understand how these medications work, their potential side effects, and what steps can be taken to manage those side effects effectively.


Understanding the Medications
1. Sertraline (思樂康): This is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat depression and anxiety disorders. It works by increasing serotonin levels in the brain, which can help improve mood and reduce anxiety. Common side effects may include nausea, insomnia, sexual dysfunction, and increased heart rate.

2. Lorazepam (悠然): This medication is a benzodiazepine that is often prescribed for anxiety and sleep disorders. It works by depressing the central nervous system, which can help to alleviate anxiety and promote sleep. However, it can also cause drowsiness, dizziness, and respiratory depression, especially when combined with other CNS depressants.

3. Liquid Medication (易復樂水劑): Without specific details, it's difficult to determine the exact medication, but if it's another form of a benzodiazepine or an antidepressant, it may have similar side effects to those mentioned above.


Managing Side Effects
Given your mother's symptoms of increased heart rate (tachycardia) and shortness of breath after starting these medications, it is crucial to address these side effects promptly. Here are some strategies:
1. Monitor Vital Signs: Keep track of her heart rate and any other symptoms she experiences. A resting heart rate of 106 beats per minute is elevated, especially if her baseline is typically in the 80s. If this persists or worsens, it may require immediate medical attention.

2. Hydration and Nutrition: Ensure she stays well-hydrated and maintains a balanced diet. Sometimes, dehydration or poor nutrition can exacerbate side effects.

3. Gradual Adjustment: If the medications are causing significant side effects, it may be necessary to discuss with her physician the possibility of adjusting the dosage or switching to a different medication. This should be done under medical supervision.

4. Avoiding Stimulants: Encourage her to avoid caffeine and other stimulants, as they can increase heart rate and anxiety levels.

5. Relaxation Techniques: Techniques such as deep breathing exercises, meditation, or gentle yoga can help manage anxiety and may reduce the perception of side effects.

6. Follow-Up with Healthcare Provider: Since you mentioned that follow-up appointments are delayed, consider reaching out to the clinic to see if there are any cancellations or if a telehealth appointment is available. It’s essential to communicate any concerning side effects to her healthcare provider as soon as possible.


When to Seek Immediate Help
If your mother experiences severe symptoms such as chest pain, persistent shortness of breath, or any other alarming signs, it is crucial to seek emergency medical care. These could be signs of a serious reaction to the medications.


Conclusion
Managing the side effects of psychiatric medications is an essential part of treatment. While it may take time for the body to adjust to new medications, persistent or severe side effects should not be ignored. Open communication with healthcare providers is vital to ensure that your mother receives the appropriate care and adjustments to her treatment plan. Encourage her to be patient, but also proactive in seeking help when needed.