Managing Medication Side Effects in Anxiety and Autonomic Dysregulation Treatment

Drug side effects

Hello, doctor.
Last year, I took medication for autonomic nervous system dysfunction.
A few weeks ago, I visited a psychiatrist due to anxiety and symptoms related to autonomic nervous system dysfunction.
The doctor prescribed Ebilong (Escitalopram), 5 mg twice daily.
After taking it for two weeks, I experienced slight improvement, but I still have issues like tension and headaches, without any significant side effects.
The doctor mentioned that this medication typically does not cause side effects, so the dosage was increased to the standard adult dose of 10 mg twice daily.
However, after taking one pill this morning, I started feeling dizzy and sleepy, and I'm very concerned that the side effects might interfere with my daily life.
I would like to ask the doctor: Will increasing the dosage cause side effects to appear? How long does it usually take to adapt and see improvement? In the past, I took Yistatin (Sertraline) without any side effects and found it very effective, so I'm worried if I should ask the doctor to switch medications.
😵‍💫

Lisa, 20~29 year old female. Ask Date: 2021/09/23

Dr. Wu Menghuan reply Psychiatry

Hello, 1.
Taking Buspirone may cause side effects such as dizziness and nausea; however, drowsiness is generally less common.
2.
Escitalopram and Buspirone are different medications with distinct mechanisms of action and potential side effects.
It is recommended that you discuss this with your original physician.
Thank you.

Reply Date: 2021/09/23

More Info

Managing medication side effects, especially in the context of anxiety and autonomic dysregulation, can be a complex process. It’s important to understand both the medications being prescribed and the nature of the side effects that may arise.

In your case, you mentioned being prescribed Escitalopram (known as 怡必隆 in Chinese), which is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat anxiety and depression. SSRIs are generally well-tolerated, but they can still produce side effects, especially when the dosage is increased. Common side effects of Escitalopram can include dizziness, fatigue, nausea, and changes in sleep patterns.
When you increase the dosage from 5 mg to 10 mg twice daily, it’s not uncommon to experience some initial side effects, such as dizziness and drowsiness. These effects may occur as your body adjusts to the higher dose. Typically, it can take several days to a few weeks for your body to adapt to a new dosage of medication. During this adjustment period, it’s crucial to monitor how you feel and communicate any concerns with your healthcare provider.

If you are experiencing significant side effects that interfere with your daily life, it is advisable to discuss these with your doctor. They may suggest a few options:
1. Adjustment of Dosage: Sometimes, a lower dose may be more effective for you without causing intolerable side effects. Your doctor might consider reverting to the previous dose or finding a middle ground.

2. Switching Medications: If Escitalopram does not suit you, your doctor may recommend trying another medication. There are various classes of medications for anxiety, including other SSRIs, serotonin-norepinephrine reuptake inhibitors (SNRIs), or even benzodiazepines for short-term relief.

3. Non-Pharmacological Interventions: In addition to medication, therapies such as cognitive-behavioral therapy (CBT) or mindfulness-based stress reduction can be highly effective in managing anxiety and may reduce reliance on medication.

4. Lifestyle Modifications: Incorporating regular physical activity, a balanced diet, and good sleep hygiene can also help manage anxiety symptoms and improve overall well-being.

5. Monitoring and Follow-Up: Regular follow-ups with your healthcare provider are essential to assess the effectiveness of the treatment and make necessary adjustments. Keeping a journal of your symptoms and side effects can provide valuable information for your doctor.

In summary, while increasing the dosage of Escitalopram can lead to side effects, these may diminish over time as your body adjusts. However, if the side effects are bothersome or persistent, it’s crucial to have an open dialogue with your healthcare provider to explore alternative options or adjustments to your treatment plan. Remember, managing anxiety and autonomic dysregulation often requires a multifaceted approach, combining medication, therapy, and lifestyle changes for the best outcomes.

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