Managing Medication Side Effects in Psychiatry: Seeking Solutions

Drug side effects

Hello Dr.
Li, I am currently taking Bupropion, but I am unable to sit still and find myself pacing around.
The doctor has added medication to alleviate the side effects, but taking Bupropion causes visual disturbances, and taking Sertraline and Clonazepam makes me feel drowsy.
Therefore, I have adjusted the timing to take them before bed.
However, when taking Clonazepam, I have doubts and concerns around my menstrual cycle; taking Sertraline makes me sleepy, and sometimes I lie down during the day.
The doctor suggested that if I need to change medications, hospitalization would be advisable, but my mother is worried that a medication change might not be successful and that I would need to be hospitalized indefinitely, so she no longer wants me to adjust my medications (she accompanies me to appointments).
What should I do?

Xiao Jun, 40~49 year old female. Ask Date: 2023/05/18

Dr. Li Guanying reply Psychiatry

Dear Sir/Madam,
From your letter, it is evident that you are experiencing discomfort and distress due to the pressure of changing medications and the possibility of hospitalization.
Whether this is related to the medication Mirtazapine requires a professional diagnosis by a physician.
1.
Facing an uncertain future, somatization disorder is a common condition in modern society.
This is a chronic illness that requires long-term treatment for recovery.
2.
Somatization disorder is characterized by periods of exacerbation, remission, recovery, and relapse.
More than half of patients may experience a recurrence of symptoms even after they have improved.
Due to individual differences in constitution, please discuss your concerns patiently with your physician.
3.
Regarding Mirtazapine, every medication may have side effects.
It is advisable to note the duration and frequency of any discomfort you experience and discuss this with your doctor.
4.
In addition to medication and psychotherapy, repetitive transcranial magnetic stimulation (rTMS) is a non-invasive, anesthesia-free treatment with high safety that does not require hospitalization.
It can improve anxiety and depressive moods.
For patients with treatment-resistant depression or those who cannot tolerate medication side effects, significant improvement in depressive symptoms has been observed after rTMS treatment.
Our clinic is open for consultations from Monday to Friday, both in the morning and afternoon.
We recommend that you consider visiting the clinic for a personal assessment of your symptoms by a physician, so that together you can discuss the best decision for your situation.
Wishing you mental and physical well-being.

Reply Date: 2023/05/18

More Info

Managing medication side effects in psychiatry can be a complex and challenging process, especially when dealing with multiple medications and their interactions. It's essential to approach this situation with a comprehensive understanding of the medications involved, their potential side effects, and the importance of communication with healthcare providers.

Firstly, it's crucial to recognize that psychiatric medications, such as the ones you mentioned (BHL, 安汀復, and 牟静锭), can have various side effects that may affect daily functioning. Common side effects include sedation, dizziness, visual disturbances, and cognitive impairments, which can significantly impact a person's quality of life. For instance, medications like benzodiazepines (e.g., 牟静锭) are known for their sedative effects, which can lead to excessive drowsiness, especially if taken during the day. This can create a cycle where the patient feels the need to rest more, leading to decreased activity levels and potential worsening of depressive symptoms.

In your case, it seems that the combination of medications is causing significant discomfort and distress. The experience of "乱视" (visual disturbances) and excessive sleepiness can be particularly troubling. It's understandable that your mother is concerned about changing medications, especially if she fears that it might lead to a prolonged hospitalization. However, it's essential to address these side effects to improve your overall well-being.

Here are some steps you can consider taking:
1. Open Communication with Your Doctor: It's vital to maintain an open line of communication with your psychiatrist. Discuss the specific side effects you're experiencing and how they impact your daily life. Your doctor may not be aware of the extent of your discomfort, and this information is crucial for making informed decisions about your treatment plan.

2. Medication Review: Request a thorough review of all the medications you are currently taking. Sometimes, side effects can be managed by adjusting dosages, changing the timing of when medications are taken, or switching to alternative medications that may have a more favorable side effect profile. For example, if a medication causes excessive sedation, your doctor might suggest taking it at night instead of during the day.

3. Consider Non-Pharmacological Interventions: In addition to medication, consider discussing non-pharmacological treatments with your doctor, such as psychotherapy, cognitive-behavioral therapy (CBT), or lifestyle changes (like exercise and dietary adjustments). These approaches can complement medication and help manage symptoms more effectively.

4. Educate Yourself About Your Medications: Understanding the purpose of each medication and its potential side effects can empower you to make informed decisions about your treatment. This knowledge can also help you articulate your concerns more effectively to your healthcare provider.

5. Involve a Support System: Having your mother accompany you to appointments can be beneficial, but it may also be helpful to involve other family members or friends who can provide additional support and perspective. They can help advocate for your needs during discussions with your doctor.

6. Explore Hospitalization as a Last Resort: While your mother may fear hospitalization, it can sometimes be a necessary step to stabilize a patient’s condition and adjust medications safely. If your doctor suggests this, ask for a detailed explanation of the reasons and potential benefits. Understanding the process can alleviate some fears.

7. Seek a Second Opinion: If you feel that your concerns are not being adequately addressed, consider seeking a second opinion from another psychiatrist. Different doctors may have different approaches to managing medications and side effects.

In conclusion, managing medication side effects in psychiatry requires a collaborative approach between the patient, their family, and healthcare providers. By maintaining open communication, reviewing medications, considering non-pharmacological options, and involving a support system, you can work towards finding a treatment plan that minimizes side effects and improves your overall quality of life. Remember, your well-being is the priority, and it's essential to advocate for the care you need.

Similar Q&A

Managing Medication Side Effects: Memory Loss and Focus Issues in Psychiatry

Hello Doctor: Recently, work has been quite challenging, and I find myself making more mistakes than before, which has led to significant stress and feelings of self-doubt regarding my work abilities. I also prefer to avoid contact with others, resulting in a self-isolating state...

Dr. Liang Sunyuan reply Psychiatry
Hello: Some individuals may experience fatigue or difficulty concentrating after taking Rivotril, Alprazolam, or Lozepam. However, abruptly discontinuing these medications can also lead to rebound anxiety or insomnia. A better approach is to discuss this with your physician durin...

Managing Side Effects of Psychiatric Medications: Seeking Alternatives

I am currently taking 3 mg of Abilify, and one of the side effects is severe restlessness. Previously, when I switched to Seroquel, I experienced auditory hallucinations, and during one emergency visit, I had an eye rolling episode, which made my mother strongly oppose changing m...

Dr. Lin Mianzhang reply Psychiatry
Hello, Jun: There are two approaches: one is to add medication to alleviate side effects, and the other is to switch medications. I'm not sure if you are currently taking any medication to manage side effects. I recommend discussing with your physician how to adjust your med...

Understanding Psychiatric Medications: Duration, Side Effects, and Solutions

Hello, Doctor: 1. How many years do psychiatric medications need to be taken for improvement? 2. If psychiatric medications cause irregular menstrual cycles, how can this be addressed? 3. If past physical and mental trauma has resulted in psychological stress, how can this be re...

Dr. Xie Dicheng reply Psychiatry
Hello: 1. The timing of medication intake is related to the disease and symptoms, and it needs to be discussed with the attending physician. 2. It is important to first confirm whether the medication is indeed the cause. If there is a strong suspicion that it is related to the me...

Managing Medication for Schizophrenia: Side Effects and Long-Term Solutions

Hello Doctor, here are the medications I am taking at the clinic. I have been going to bed early and waking up early, getting up at 8 AM and sleeping at 10 PM. Could you please review my medication list and let me know if there is anything I should be aware of? It is inconvenient...

Dr. Wu Enliang reply Psychiatry
Fallep Tablets 2mg is a sleeping pill; it's best to take it sparingly and hope to eventually stop using it. It's important to exercise regularly and control your diet to avoid weight gain. Please arrange for annual blood tests to check blood sugar and lipid levels with ...