Managing Anxiety and Medication: Symptoms and Treatment Adjustments

Q: Managing Anxiety and Medication: Symptoms and Treatment Adjustments

Hello Judy： It seems that after adjusting your medication, your initial response has been quite good. <br>Your burping may be due to swallowing air when you take deep breaths out of nervousness. <br>Your medication dosage is within the normal range, and this issue did not occur w

Regarding medications and physiological issues?

I would like to ask—last year, due to high stress, I experienced hyperventilation and muscle spasms in my hands and feet during an emotional episode.
My hands often felt numb and shaky.
After consulting a cardiologist and finding nothing wrong, it turned out to be anxiety and panic, so I started seeing a psychosomatic specialist.
I took medication for about five to six months (Efficacy Plus solution and Zoloft at bedtime) and felt much better, but I stopped taking the medication on my own.
A few months later, the symptoms returned.
When I get nervous, my hands tend to tense up, and I feel shaky.
I constantly feel like I need to take deep breaths to get air into my lungs.
After work, I experience excessive burping, and there’s a tight, sore feeling around my mouth as if my lips are pursed.
At night before bed or in the morning, I feel twitching in my calf and arm muscles.
I have returned for follow-up visits and am taking the same medications (solution and Zoloft).
However, I still experience burping.
After a month, during my follow-up, my medication was adjusted (increased the solution, added Ambien at bedtime, and B12 for muscle twitching and nerve stabilization).
The dosage was changed from 5cc twice a day to 15cc once at dinner.
I felt good after taking it, but on the tenth and eleventh days, I started experiencing burping and tightness again.
My calf muscles still twitch before bed.
Is this due to the medication being too high, or does the medication lose its effectiveness over time? Whenever I start burping, I feel very anxious and uncomfortable.
How can I improve this? Thank you.

Judy, 20~29 year old female. Ask Date: 2021/06/25

Dr. Lin Mianzhang reply Psychiatry

Hello Judy: It seems that after adjusting your medication, your initial response has been quite good.
Your burping may be due to swallowing air when you take deep breaths out of nervousness.
Your medication dosage is within the normal range, and this issue did not occur when you first started taking it, so it is unlikely to be caused by the medication.
These medications do not lose their effectiveness over time.
However, you mentioned experiencing discomfort during stressful situations, so I recommend learning some relaxation techniques.
The most basic technique is diaphragmatic breathing; try to breathe slowly, ideally at a rate of less than 10 breaths per minute.
When you inhale, your abdomen should rise, and when you exhale, it should fall.
This method can help regulate your autonomic nervous system and alleviate your discomfort.
Additionally, consider psychological therapy to help you understand the sources of your stress; you can ask your doctor for a referral to a psychologist.
Wishing you peace and well-being!

Reply Date: 2021/06/25

More Info

Managing anxiety can be a complex journey, especially when symptoms manifest both psychologically and physiologically. Based on your description, it seems you have experienced a range of symptoms including hyperventilation, muscle spasms, and a feeling of tightness in your chest and limbs, which are common in anxiety disorders.

Understanding Symptoms
Anxiety can lead to a variety of symptoms that can be broadly categorized into psychological and physical manifestations. Psychologically, individuals may experience heightened worry, fear, restlessness, or irritability. Physically, anxiety can cause symptoms such as:
- Hyperventilation: This can lead to feelings of lightheadedness, tingling in the extremities, and muscle cramps.

- Muscle Tension: Many people with anxiety report tightness in various muscle groups, which can lead to discomfort and spasms.

- Gastrointestinal Symptoms: Anxiety can also cause digestive issues, such as excessive burping or a feeling of tightness in the stomach.

- Sleep Disturbances: Anxiety often disrupts sleep patterns, leading to insomnia or restless sleep.

Treatment Options
Treatment for anxiety typically involves a combination of medication and therapy.
1. Medications: Common medications include:
- Selective Serotonin Reuptake Inhibitors (SSRIs): Such as fluoxetine (Prozac) or sertraline (Zoloft), which help regulate mood.

- Benzodiazepines: Such as lorazepam (Ativan) or alprazolam (Xanax), which can provide short-term relief from acute anxiety symptoms but are generally not recommended for long-term use due to the risk of dependence.

- Beta-Blockers: Such as propranolol (Inderal), which can help manage physical symptoms like rapid heartbeat.

2. Therapy: Cognitive Behavioral Therapy (CBT) is particularly effective for anxiety disorders. It helps individuals identify and challenge negative thought patterns and develop coping strategies.

Adjusting Medication
It’s not uncommon for individuals to experience fluctuations in their symptoms, even while on medication. This can happen for several reasons:
- Tolerance: Over time, your body may become accustomed to a medication, leading to reduced effectiveness.

- Stressors: New or ongoing stressors in your life can exacerbate anxiety symptoms, necessitating adjustments in treatment.

- Dosage: Sometimes, the dosage may need to be adjusted based on the severity of symptoms.

Side Effects and Concerns
You mentioned experiencing side effects such as muscle twitching and tightness. These can sometimes be related to the medications themselves or the underlying anxiety. It’s crucial to communicate these symptoms to your healthcare provider, as they may need to adjust your treatment plan.
Long-term use of certain medications can have implications for your health, including potential impacts on liver and kidney function. Regular monitoring and open communication with your healthcare provider can help mitigate these risks.

Recommendations
1. Consult Your Doctor: Given that you are experiencing persistent symptoms like hiccups and muscle tightness, it’s essential to discuss these with your healthcare provider. They may want to evaluate whether your current medication regimen is appropriate or if further adjustments are needed.

2. Consider Therapy: If you haven’t already, consider engaging in therapy, particularly CBT, which can provide you with tools to manage anxiety symptoms more effectively.

3. Lifestyle Modifications: Incorporate stress-reducing practices into your daily routine, such as mindfulness meditation, yoga, or regular physical activity, which can help alleviate anxiety symptoms.

4. Monitor Symptoms: Keep a journal of your symptoms, medication changes, and any triggers you notice. This information can be invaluable for your healthcare provider in tailoring your treatment plan.

In summary, managing anxiety is a multifaceted process that often requires adjustments in treatment and lifestyle. Open communication with your healthcare provider is key to finding the most effective approach for you.

Similar Q&A

Managing Anxiety Symptoms: Treatment Options and Coping Strategies

Hello, Doctor. I have been experiencing symptoms of anxiety for nearly ten years. I have undergone psychological counseling and was diagnosed with anxiety disorder. I received short-term therapy from a counselor, but I didn't notice significant improvement, so I stopped the ...

Dr. Zhang Gengjia reply Psychiatry
Hello, A-Tian: Having suffered from anxiety disorder for over ten years must have significantly impacted your daily life. In recent years, the prevalence of anxiety disorders has been on the rise, leading many to seek professional medical care or pharmacological treatment. There...

Managing Anxiety and Focus Issues: Medication Effects and Treatment Duration

Hello, I have been taking medication for 6 months, including Clonazepam, Sertraline, Duloxetine, and the sleep aid Zolpidem. I would like to ask how long the treatment for anxiety disorder typically takes. I have developed a regular exercise routine and practice positive thinking...

Dr. Qiu Junda reply Psychiatry
Hello. The duration of treatment for anxiety disorders (or autonomic nervous system dysregulation) varies from person to person. However, with appropriate treatment, significant improvement can be achieved. If you find it difficult to concentrate, it may sometimes be related to m...

Effective Strategies to Overcome Exam Anxiety and Nervousness

I would like to ask, I often feel uncomfortable or anxious due to exams or unfamiliar environments. Is this because I haven't prepared myself mentally? Are there medical treatments available for these symptoms? Or are there any methods to cope with this? I have an exam comin...

Dr. Chen Wenke reply Psychiatry
Hello: From the issues you've described, it is clear that you have an adjustment disorder, which you often manifest through symptoms of anxiety. Are you someone who tends to be impatient and frequently puts a lot of pressure on yourself, often displaying tense emotions? Indi...

Managing Anxiety: Medication Concerns and Lifestyle Adjustments

Hello Doctor, I visited two different psychiatric clinics during my first year of high school for obsessive thoughts and anxiety. However, I stopped taking the medication due to adverse effects on my body. During that time, I continued counseling through my school's guidance...

Dr. Wu Kunhong reply Psychiatry
Dear netizen, it is commendable that you are actively addressing your illness with diligence, including medication management and psychological adjustment, as well as engaging in activities and interests as coping strategies. If you are considering discontinuing treatment, it is ...