the Strong Side Effects of Psychiatric Medications

Side effects of medications?

Hello Doctor: Recently, every time I eat, my stomach becomes very bloated, and I feel tightness in my chest and heart, especially severe before bedtime.
I have seen many gastroenterologists and taken numerous medications prescribed by them, but there has been no significant improvement.
Due to my physical discomfort, I have started to experience psychological stress; as soon as it gets dark or approaches bedtime, I become increasingly anxious.
On the recommendation of a pharmacist at a nearby pharmacy, I consulted a psychiatrist who said that this is a classic case of psychological impact on physiology and autonomic nervous system dysfunction.
The doctor prescribed Escitalopram, Buspirone, and Yongkang Xu coated tablets.
Although the doctor mentioned the side effects of Escitalopram, I did not expect them to be so intense.
After lunch, I was hit with a wave of nausea and vomiting, which completely diminished my appetite for dinner.
At night, I felt weak all over, somewhat like having a fever or the feeling after taking cold medicine, and it was even harder to fall asleep than usual.
I woke up once in the middle of the night, and the next morning I still felt fatigued and had little appetite.
Is it normal for the side effects of this medication to be so strong? This uncomfortable feeling has surpassed my original post-meal bloating.
It’s the first time I’ve experienced such strong side effects from medication, and it has startled me.

SEAR, 20~29 year old female. Ask Date: 2020/02/11

Dr. Wu Enliang reply Psychiatry

Escitalopram, known by its brand name, may cause gastrointestinal side effects in a small number of individuals when they first start taking it.
However, if one begins with a low dose, such as half a 5 mg tablet taken after meals, side effects are less likely to occur.
Typically, any side effects will diminish and often resolve within 1 to 2 weeks.

Reply Date: 2020/02/11

More Info

It sounds like you're experiencing significant discomfort and distress related to the medications you've been prescribed, particularly with the side effects of the psychiatric medications. Let's break down the situation and discuss the medications you've mentioned, their potential side effects, and how they might relate to your current symptoms.

Understanding the Medications
1. Escitalopram (易思坦): This is an SSRI (Selective Serotonin Reuptake Inhibitor) commonly prescribed for anxiety and depression. While effective for many, it can cause side effects such as nausea, gastrointestinal upset, fatigue, and sleep disturbances. The nausea and loss of appetite you're experiencing could be linked to this medication, especially when starting treatment or adjusting the dosage.

2. Buspirone (舒必朗): This medication is often used to treat anxiety. It can cause dizziness, headaches, and gastrointestinal issues, including nausea. If you are sensitive to medications, the combination of Buspirone and Escitalopram might be contributing to your discomfort.

3. Yongkang Xu (永康緒糖衣錠): This medication is less commonly known, but if it is a form of a tranquilizer or sedative, it could also contribute to feelings of fatigue and lethargy, especially if taken in conjunction with other medications that have sedative effects.

Side Effects and Their Impact
The side effects you're experiencing—nausea, loss of appetite, fatigue, and difficulty sleeping—are indeed concerning, especially since they are impacting your quality of life. It is not uncommon for psychiatric medications to cause gastrointestinal symptoms, particularly when you first start taking them or if the dosage is increased.
The fact that you feel worse after meals and are experiencing tightness in your chest and abdomen could be indicative of a few things:
- Gastrointestinal Sensitivity: Some individuals may have a heightened sensitivity to medications that can exacerbate gastrointestinal symptoms.

- Anxiety and Stress: The psychological stress you're feeling, particularly as it relates to your eating and sleeping patterns, can also manifest physically, leading to symptoms like abdominal bloating and tightness.

- Medication Interactions: If you are taking multiple medications, there is a possibility of interactions that could intensify side effects.

Recommendations
1. Consult Your Doctor: It is crucial to communicate your symptoms to your prescribing physician. They may need to adjust your medication regimen, change dosages, or consider alternative treatments that may have a more tolerable side effect profile.

2. Monitor Your Symptoms: Keep a detailed log of when you take your medications, what you eat, and how you feel afterward. This information can help your doctor identify patterns and make informed decisions about your treatment.

3. Consider Therapy: Alongside medication, therapy can be beneficial in managing anxiety and stress. Cognitive-behavioral therapy (CBT) is particularly effective for anxiety disorders and can help you develop coping strategies.

4. Lifestyle Adjustments: Incorporating relaxation techniques, such as deep breathing exercises, yoga, or mindfulness meditation, may help alleviate some of the anxiety and physical symptoms you're experiencing.

5. Dietary Considerations: Pay attention to your diet. Sometimes, certain foods can exacerbate gastrointestinal symptoms. Eating smaller, more frequent meals may help reduce bloating and discomfort.

Conclusion
Experiencing strong side effects from psychiatric medications can be distressing, but it is essential to remember that these medications can take time to adjust to. Your symptoms are valid, and addressing them with your healthcare provider is the best course of action. They can help you navigate these challenges and find a treatment plan that works for you without compromising your quality of life.

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