Autonomic Nervous System Disorders and Medication Concerns

Q: Autonomic Nervous System Disorders and Medication Concerns

Hello Jerry： Benzodiazepines (BZD) are only intended for adjunctive use to help alleviate symptoms of anxiety and tension. <br>If your condition has improved, you may consider tapering the medication or even discontinuing it altogether, as there is no need for continued use. <br>

Issues with medications for autonomic nervous system disorders?

Hello Dr.
Lin,
I have been experiencing eye fatigue for the past two months.
After consulting several different ophthalmologists, my fatigue has improved, but I still often feel tightness in my forehead and eyelids, as well as light sensitivity and shallow sleep (I frequently wake up at night but can fall back asleep quickly).
However, each ophthalmologist has indicated that there are no abnormalities with my eyes and suggested that I need to adjust my mindset.
After discussing with a doctor friend, he believes I may be experiencing autonomic nervous system dysregulation and that my perception of having a problem is the main cause of my discomfort.
I find this perspective reasonable, and after trying to focus on other things, my condition has indeed improved, with much less tightness.
Today, I visited a neurologist at National Taiwan University Hospital, who prescribed me L-theanine and advised me to take half a tablet before bed for two weeks.
He mentioned that if I feel fine after finishing the medication, I may not need to return for a follow-up.
I believe my current symptoms have improved significantly compared to when I initially made the appointment.
I also learned that long-term use of benzodiazepines (BZD) may lead to withdrawal symptoms.
Therefore, I would like to ask you: if I feel symptom-free after taking the medication for a few days, can I stop taking the remaining pills? If I must finish the course, will there be any side effects or withdrawal symptoms? Thank you for your patient response.

Jerry, 20~29 year old female. Ask Date: 2021/02/23

Dr. Lin Mianzhang reply Psychiatry

Hello Jerry: Benzodiazepines (BZD) are only intended for adjunctive use to help alleviate symptoms of anxiety and tension.
If your condition has improved, you may consider tapering the medication or even discontinuing it altogether, as there is no need for continued use.
Since you are only taking half a tablet of Lishuding (Lorazepam) at bedtime, this dosage is quite low, so it is acceptable to stop the medication directly without significant withdrawal symptoms.
Wishing you peace and good health!

Reply Date: 2021/02/23

More Info

Understanding autonomic nervous system (ANS) disorders and the associated medication concerns is crucial for managing symptoms effectively and ensuring overall well-being. Your recent experiences with eye fatigue, forehead tightness, light sensitivity, and sleep disturbances suggest that you may be dealing with an ANS disorder, potentially exacerbated by psychological factors such as anxiety or stress.

The autonomic nervous system regulates involuntary bodily functions, including heart rate, digestion, and respiratory rate. It consists of two main branches: the sympathetic nervous system, which prepares the body for 'fight or flight' responses, and the parasympathetic nervous system, which promotes 'rest and digest' activities. When there is an imbalance in these systems, it can lead to various symptoms, including those you are experiencing.

Your observation that focusing on other activities has improved your symptoms aligns with the understanding that psychological factors can significantly influence ANS disorders. Stress and anxiety can lead to heightened sympathetic activity, resulting in physical symptoms such as muscle tension, fatigue, and sleep disturbances. Therefore, addressing the psychological component is as important as managing the physical symptoms.

Regarding the medication prescribed, it appears you have been given a benzodiazepine (BZD), specifically Lishuding (likely referring to a medication like lorazepam or a similar anxiolytic). Benzodiazepines are effective for short-term relief of anxiety and related symptoms, but they come with potential risks, especially when used long-term. These risks include dependence, tolerance, and withdrawal symptoms upon discontinuation.

If you feel significantly better after a few days of medication, it is understandable to consider stopping the medication early. However, it is essential to approach this decision cautiously. Here are some key points to consider:
1. Consult Your Doctor: Before making any changes to your medication regimen, it is crucial to discuss your feelings and symptoms with your prescribing physician. They can provide personalized advice based on your medical history and current condition.

2. Gradual Tapering: If your doctor agrees that you can stop the medication, they may recommend a gradual tapering schedule rather than an abrupt discontinuation. This approach can help minimize the risk of withdrawal symptoms and allow your body to adjust.

3. Monitoring for Withdrawal Symptoms: If you do decide to stop taking the medication, be aware of potential withdrawal symptoms, which can include increased anxiety, insomnia, irritability, and physical symptoms like tremors or sweating. These symptoms can vary in intensity and duration depending on the individual and the duration of medication use.

4. Alternative Strategies: In addition to medication, consider incorporating non-pharmacological strategies to manage your symptoms. Techniques such as cognitive-behavioral therapy (CBT), mindfulness, relaxation exercises, and regular physical activity can be beneficial in reducing anxiety and improving overall well-being.

5. Follow-Up Care: Even if you feel better, regular follow-up with your healthcare provider is essential to monitor your progress and make any necessary adjustments to your treatment plan.

In conclusion, while it is encouraging that you are experiencing improvements, it is vital to approach any changes to your medication with caution and under the guidance of a healthcare professional. Understanding the interplay between psychological factors and autonomic nervous system disorders can empower you to take an active role in your health and well-being.

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