Managing Autonomic Nervous System Disorders: Concerns with Amberning Medication

Issues with taking Ambien for autonomic nervous system dysfunction?

Hello Doctor, I tend to be anxious and overly worried.
Since March of this year, I have noticed issues with autonomic nervous system dysfunction.
The most prominent symptoms include tightness in my neck leading to difficulty swallowing, a fear of swallowing, and during anxious moments, I experience rapid heartbeat, dizziness, and cold extremities.
At that time, I consulted a doctor and started taking Ambien, with a dosage of one pill at bedtime, half a pill in the morning, and half a pill in the evening, totaling two pills a day.
However, I initially took one pill at night and half a pill in the morning, which helped reduce my symptoms, alleviating the tightness in my neck and allowing me to start swallowing normally again.
Eventually, I began taking half a pill at bedtime and half a pill in the morning, which was still somewhat effective.
After three months of this dosage, I thought I would stabilize, but the issues persisted until late May of this year.
One day, after not sleeping well or being overly fatigued—I'm not sure of the cause—my autonomic nervous system dysfunction worsened, with increased dizziness, and my blood pressure and heart rate became elevated, causing significant discomfort.
The tightness in my neck became more severe, and during meal times, I felt more anxious and panicked, making swallowing even more difficult.
I have now returned to the original dosage of two pills a day as prescribed by my doctor, which is still effective but limited.
Therefore, I would like to ask the doctor the following questions:
1.
Has my autonomic nervous system dysfunction worsened, or has my body developed a tolerance to Ambien?
2.
Can Ambien be taken on an empty stomach? Does it harm the stomach? Due to my swallowing issues, I am considering whether to move the timing of the half pill I take during the day to before lunch.
3.
Currently, taking two pills of Ambien daily still results in dizziness and neck tightness.
Does this indicate that the dosage is insufficient? Should I discuss with my doctor the possibility of increasing the dosage to three pills a day, or would it be better to consider other medications for treatment? I personally feel that taking three pills (1.5 mg) daily is quite serious.
Thank you, doctor, for your patience in reading this, and I appreciate your guidance.

Mr. Wu, 40~49 year old female. Ask Date: 2021/06/22

Dr. Cai Zongzhang reply Neurology

Hello Mr.
Wu! Amberning does not harm the stomach and is used for the treatment of anxiety disorders.
It is recommended to discuss the dosage with your physician.

Reply Date: 2021/06/22

More Info

Managing autonomic nervous system disorders can be quite challenging, especially when symptoms such as anxiety, swallowing difficulties, and autonomic dysregulation manifest. Your experience with Amberning (Escitalopram) raises several important considerations regarding medication management and the underlying condition.

Understanding Your Symptoms
1. Autonomic Nervous System Dysfunction: The symptoms you describe, including tightness in the neck, swallowing difficulties, rapid heartbeat, dizziness, and cold extremities, are indicative of autonomic nervous system dysregulation. This can often be exacerbated by stress, anxiety, and fatigue. The fact that your symptoms worsened after a period of poor sleep or fatigue suggests that your body is reacting to stressors, which is common in individuals with autonomic dysfunction.

2. Medication Response: It is not uncommon for patients to experience fluctuations in their symptoms, even while on medication. The initial effectiveness of Amberning may have been due to its anxiolytic properties, but as your symptoms have intensified, it raises the question of whether your body has developed a tolerance to the medication or if your condition has simply worsened.

Addressing Your Questions
1. Increased Severity of Symptoms: The worsening of your symptoms could be attributed to several factors. It may be that your autonomic nervous system dysfunction has become more pronounced due to ongoing stressors or changes in your lifestyle. Alternatively, it is possible that your body has developed a tolerance to Amberning, which can happen with many medications over time. It’s essential to discuss these changes with your healthcare provider, as they can assess your current state and determine the best course of action.

2. Taking Amberning on an Empty Stomach: Generally, Amberning can be taken with or without food. However, if you are experiencing swallowing difficulties, it may be beneficial to take it with food to minimize any potential gastric irritation. If you are considering adjusting the timing of your doses, such as taking the morning dose before lunch, this could help with your swallowing issues, but it’s best to consult your doctor before making any changes.

3. Dosage Concerns: If you are still experiencing significant symptoms despite taking the prescribed dosage, it may indicate that the current dose is insufficient for your needs. Increasing the dosage to three pills per day (1.5 mg) could be a viable option, but this should be done under the guidance of your healthcare provider. They can evaluate your symptoms, consider potential side effects, and determine if a dosage adjustment is appropriate or if a different medication might be more effective.

Additional Considerations
- Therapeutic Monitoring: Regular follow-ups with your healthcare provider are crucial. They can monitor your symptoms, assess the effectiveness of your current treatment plan, and make necessary adjustments.

- Non-Pharmacological Approaches: In addition to medication, consider integrating non-pharmacological strategies such as cognitive-behavioral therapy (CBT), mindfulness practices, and relaxation techniques. These can help manage anxiety and improve your overall coping strategies.

- Lifestyle Modifications: Ensuring adequate sleep, engaging in regular physical activity, and practicing stress-reduction techniques can also play a significant role in managing autonomic nervous system disorders.

Conclusion
Your concerns regarding the management of autonomic nervous system disorders and the use of Amberning are valid and warrant careful consideration. It is essential to maintain open communication with your healthcare provider, who can help tailor your treatment plan to better address your symptoms and improve your quality of life. Remember, managing such conditions often requires a multifaceted approach, combining medication, therapy, and lifestyle changes for optimal results.

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