Withdrawal Symptoms and Their Impact on Mental Health

Q: Withdrawal Symptoms and Their Impact on Mental Health

Hello, user：<br>1. <br>Could my symptoms be caused by autonomic nervous system imbalance after stopping these medications? The symptoms of autonomic nervous system dysregulation are quite complex and variable, including dizziness, chest tightness, palpitations, difficulty inhalin

Various discomforts experienced by the body after drug withdrawal?

Hello Doctor: I do not have a history of anxiety or depression, have never taken such medications, and do not experience insomnia, headaches, or stiffness in my shoulders and neck.
About a year ago, I felt a sensation of a lump in the esophageal muscles near my vocal cords, which made it difficult to speak and control my muscles for singing (unable to hit high notes or falsetto).
Multiple endoscopies and gastroscopies showed normal results, as did examinations of my vocal cords and speech tests.
I took medications for gastroesophageal reflux prescribed by a gastroenterologist for several months without improvement.
However, due to the persistent uncomfortable sensation in my throat, I sought help from a psychosomatic clinic.
The doctor suggested it might be globus sensation and prescribed various medications including amitriptyline, clonazepam, and others.
After nearly two months, I experienced side effects such as agitation, rapid heartbeat, and insomnia.
Despite three follow-up visits to reduce the medication, there was no improvement, and I suffered from a week of insomnia.
Due to psychological factors, I was afraid to continue the medication, which led to withdrawal symptoms two days later: sharp head pain, numbness in my neck, shoulders, and back, hand tremors, palpitations, and involuntary body movements.
After enduring these symptoms for several days, I vomited and went to the emergency room, where I received a sedative and finally managed to sleep.
However, this marked the beginning of a difficult period: the aforementioned symptoms persisted, with stiffness in my shoulders, neck, and back, making it impossible to work normally.
I rested at home for several months.
Afterward, I visited a family medicine clinic and took medications for several months without improvement, relying on sleeping pills for rest.
It has now been a year, but I still experience involuntary body movements, hand tremors, rapid heartbeat, insomnia, gastrointestinal discomfort, occasional headaches (which have lessened), and stiffness in my shoulders, neck, and back (which has improved somewhat with glucose injections), all of which continue to affect my daily life.
During this year, I have consulted with neurology, cardiology, endocrinology, and pulmonology specialists, and tests including ECGs, blood tests, thyroid checks, CT scans of the head and chest, and MRI of the neck have all returned normal results.
I have been unable to find the cause, which is very distressing, and I feel sad that I have seemingly ruined my previously healthy body.
I would like to ask: 1.
Could the symptoms I am experiencing be due to autonomic nervous system imbalance caused by stopping these medications? 2.
Apart from physical therapy and exercise, is there a way to treat the withdrawal symptoms with medication? 3.
Can I still use medication for treatment after experiencing withdrawal side effects for a year? 4.
(Very distressing) Since every doctor says my case is too complex, which specialty should I consult for further treatment? Are there clinics or facilities that specifically address issues arising from withdrawal side effects? 5.
What additional tests can I undergo to identify the underlying cause? 6.
Should I return to the original clinic that prescribed the antidepressants to inform the doctor about the issues I have experienced since? 7.
If medication treatment is ineffective, will I need to rely on self-recovery to return to a normal state of health? Will this take a long time? (Exercise, routine, diet)

Peter, 30~39 year old female. Ask Date: 2021/05/15

Dr. Wu Enliang reply Psychiatry

Hello, user:
1.
Could my symptoms be caused by autonomic nervous system imbalance after stopping these medications? The symptoms of autonomic nervous system dysregulation are quite complex and variable, including dizziness, chest tightness, palpitations, difficulty inhaling, muscle soreness, or globus sensation, among others.
Typically, a psychiatrist is better suited to diagnose this condition.
The causes of autonomic nervous system dysregulation are related to psychological stress and physiological routines.
Based on your description, it is possible that you initially had autonomic nervous system dysregulation, which later worsened due to tension and stress.
Additionally, since you mentioned that you have sought medical help without a clear diagnosis, it seems more like autonomic nervous system dysregulation.
Furthermore, medical research indicates that withdrawal symptoms from medications usually last only a few days to a few weeks and significantly improve over time, typically not extending beyond one or two months.
Therefore, your current symptoms do not appear to be withdrawal symptoms from medication but rather a transformation of the original autonomic nervous system dysregulation symptoms.
The medications you mentioned are indeed used to treat autonomic nervous system dysregulation and can help alleviate stress, mood, and anxiety, thereby improving autonomic nervous system function, not just for anxiety and depression.
2.
Besides physical therapy and exercise, is there a way to treat withdrawal symptoms with medication? As mentioned earlier, your symptoms do not seem to resemble withdrawal symptoms but rather the symptoms of autonomic nervous system dysregulation itself.
You might consider consulting a psychiatrist and taking medications that target the autonomic nervous system to increase serotonin levels and see if that alleviates anxiety and stress.
3.
Can I still treat the side effects of withdrawal after a year by resuming medication? As previously stated, your symptoms do not appear to be withdrawal symptoms but rather symptoms of autonomic nervous system dysregulation.
You might consider consulting a psychiatrist and taking medications that target the autonomic nervous system to increase serotonin levels and see if that alleviates anxiety and stress.
4.
(Very troubling) Since every doctor says my issue is too complex, which specialty should I consult for further treatment? Are there clinics or facilities that specifically treat withdrawal-related side effects? As previously mentioned, your symptoms do not seem to resemble withdrawal symptoms but rather the symptoms of autonomic nervous system dysregulation.
You might consider consulting a psychiatrist and taking medications that target the autonomic nervous system to alleviate anxiety and stress.
Additionally, besides medication, you might consider out-of-pocket options like repetitive transcranial magnetic stimulation (rTMS), and you can inquire about this at psychiatric clinics that offer this service.
5.
What other tests can I undergo to identify the cause (source)? Additional tests, such as out-of-pocket deep psychological counseling to identify psychological stressors and physiological assessments of the autonomic nervous system, are options you might consider.
6.
Do I need to return to the original clinic that prescribed my antidepressants to inform the doctor about the issues I've experienced since? This depends on you; if you wish to return and ask, you certainly can.
However, from a medical perspective, it seems more likely that your long-term symptoms are due to autonomic nervous system dysregulation rather than withdrawal symptoms.
The medications you previously took are indeed used to treat autonomic nervous system dysregulation, but if you have a unique constitution or are concerned about side effects, you might consider seeking treatment at a larger hospital for non-medication options, such as rTMS.
7.
If medication treatment does not effectively improve my symptoms, will I need to self-repair to return to normal bodily function? Will this take a long time? (Exercise, routine, diet) Autonomic nervous system dysregulation is typically a long-term chronic issue related to individual personality, stress, habits, routines, and exercise.
Medication is usually a more direct and rapid method, but you can also adjust your lifestyle, exercise, and change your mindset, although the effects may be slower.
Dr.
Wu Enliang

Reply Date: 2021/05/15

More Info

It sounds like you have been through a very challenging and distressing experience over the past year, and I commend you for seeking help and trying to understand your symptoms. Let’s address your questions one by one, while also providing some context regarding withdrawal symptoms and their impact on mental health.

1. Autonomic Nervous System Imbalance: Yes, it is possible that the symptoms you are experiencing are related to an imbalance in your autonomic nervous system (ANS) due to the abrupt discontinuation of the medications you were prescribed. Medications like antidepressants and anxiolytics can affect neurotransmitter levels in the brain, and when they are stopped suddenly, the body may struggle to readjust, leading to withdrawal symptoms. These can include anxiety, tremors, heart palpitations, and muscle tension, which you have described.

2. Withdrawal Symptoms and Treatment: Withdrawal symptoms can sometimes be managed with medication, but this depends on the specific symptoms and their severity. In some cases, a gradual tapering of the medication under a doctor's supervision can help minimize withdrawal effects. Additionally, medications such as beta-blockers may help with physical symptoms like heart palpitations, while anxiolytics can assist with anxiety. However, it is essential to consult a healthcare professional for a tailored treatment plan.

3. Long-term Effects of Withdrawal: If you have been experiencing withdrawal symptoms for a year, it is crucial to discuss this with a healthcare provider. While some individuals may recover fully from withdrawal symptoms over time, others may experience lingering effects. It is possible to reintroduce medications, but this should be done cautiously and under medical supervision, as it may help alleviate some of the symptoms you are experiencing.

4. Specialized Care: Given the complexity of your symptoms, it would be beneficial to consult with a psychiatrist who specializes in medication management and withdrawal symptoms. They can provide a comprehensive evaluation and create a treatment plan tailored to your needs. Additionally, a neurologist may also be helpful if you continue to experience neurological symptoms.

5. Further Testing: If you feel that your symptoms are not improving, it may be worthwhile to explore additional tests that assess your overall health, including hormone levels, vitamin deficiencies, and other metabolic factors. A thorough evaluation can help identify any underlying issues that may be contributing to your symptoms.

6. Communication with Previous Providers: It is advisable to return to the clinic where you were initially prescribed the medications and discuss the issues you have been experiencing since discontinuation. This can provide your healthcare provider with valuable information to adjust your treatment plan accordingly.

7. Self-Recovery and Lifestyle Changes: While some symptoms may improve with time, lifestyle changes can significantly impact your recovery. Regular exercise, a balanced diet, adequate sleep, and stress management techniques such as mindfulness or cognitive-behavioral therapy (CBT) can be beneficial. Recovery can take time, and it is essential to be patient with yourself as you work towards regaining your health.

In conclusion, your experience with withdrawal symptoms is valid and can significantly impact your mental and physical well-being. It is crucial to seek professional help to navigate this challenging time. A comprehensive approach that includes medical treatment, lifestyle changes, and possibly therapy can help you regain control over your health and improve your quality of life. Remember, you are not alone in this journey, and there are resources available to support you.

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