Withdrawal Headaches: A Patient's Journey with Psychiatric Medications

Discontinuing medication can cause headaches?

Hello: On August 6 of this year, my doctor said I could stop taking my medication.
However, after stopping for a week, I started experiencing headaches, and during the pain, I sometimes found it hard to concentrate.
I thought, the doctor said I could stop the medication, so I endured the headache without taking anything, but the pain persisted.
By August 22, I tried taking the medication again, and after sleeping for a while, the pain went away.
After that, I didn't take any more medication until August 28 when the pain returned, and I took it for three consecutive days before stopping again.
On September 5, I took it for two days, then stopped for a day.
On September 8, I took it again, then stopped for a day.
On September 10, I took it continuously for five days, then stopped for a day.
On September 16, I took it again, then stopped for a day.
On September 18, I took it again and haven't stopped since, because every time I don't take it, I get a headache.
It's strange.
I told my primary physician about my headaches, and he replied that anxiety can also cause headaches.
Due to my previous fear of escalators (which I consulted you about on July 14, 2003), he prescribed me anxiety medication (Xanax) and mentioned that I have anxiety symptoms.
However, I once accidentally saw a diagnosis that stated "specific phobia." This means that my anxiety medication is only treating "specific phobia," and I have tried taking Xanax when I have a headache, but it doesn't help at all; it just makes me want to sleep, and when I wake up, the pain is still there.
I've been seeing him for five years and have become disillusioned with his approach to treatment; he either prescribes medication or treats me like a test subject.
Honestly, I can no longer endure being anyone's test subject.
I dislike my primary physician's yawning while treating me, which is why I have been switching doctors.
However, since my medical records are at that hospital, I haven't changed hospitals, just doctors.
But the other doctor also couldn't understand my condition and advised me not to think about stopping the medication.
What is going on? After years of consultations, I still can't stop the medication.
I started experiencing symptoms in May of 1998, and my primary physician prescribed an antipsychotic medication that starts with a "b" (since I didn't understand English, the medication didn't have a Chinese name at that time and wasn't printed on the bag, so I can't specify which one it was).
After taking it for two months, I experienced tremors and stopped taking it on my own, feeling fine afterward.
In April of 1999, I had another episode, and my primary physician still wanted to prescribe that "b" medication again.
I strongly refused, and he switched me to Dogmatyl, saying I needed to take it for five years.
I complied and didn't stop taking it, but when it came time to stop, I couldn't...
Moreover, I think I took Dogmatyl for about two years, and then I started having irregular menstrual cycles.
When I asked my primary physician about it, he said it wasn't related to the medication.
However, when I consulted a gynecologist, he said that some psychiatric medications can affect menstruation.
Sigh! I really don't know whom to believe.
Because of this, I have been taking birth control pills to regulate my cycle, until recently when a new gynecologist informed me that those birth control pills might lead to infertility.
At that time, I just laughed it off and replied, "Not being able to have children is actually a good thing for me..." Now, all I want is to stop taking medication...

Weiwei, 20~29 year old female. Ask Date: 2003/12/22

Dr. Tang Xinbei reply Psychiatry

Dear Weiwei,
I apologize for the delayed response due to my busy schedule with reports before the New Year.
Regarding the issues you mentioned, some of them may be side effects of medications.
For example, Dogmatyl can cause irregular menstrual cycles in women, and certain medications may lead to tremors in the hands and feet, dizziness due to orthostatic hypotension, or symptoms such as fatigue, weakness, and drowsiness.
Since I am not aware of the specific medications you are taking, their dosages, and administration, I cannot provide you with precise information.
As for the "specific phobia" you mentioned, it refers to an intense fear of a particular object (such as snakes, mice, or cockroaches) or situation (such as riding elevators, standing on high buildings, flying, boating, or speaking or performing in public).
Without knowing your medical history, I cannot make a detailed assessment.
However, this condition can be treated with selective serotonin reuptake inhibitors (SSRIs) combined with some anxiolytics, along with cognitive-behavioral therapy, which has shown good results.
I recommend discussing your condition and treatment options further with your primary physician or requesting a summary of your medical history to consult another doctor.
Wishing you a prosperous and joyful New Year!

Reply Date: 2003/12/22

More Info

Withdrawal headaches can be a challenging and distressing experience for many individuals, particularly those who have been on psychiatric medications for an extended period. Your situation highlights the complexities of managing medication, withdrawal symptoms, and the emotional toll it can take on a person.
When you stop taking psychiatric medications, particularly those that affect neurotransmitter levels in the brain, your body may react with withdrawal symptoms, including headaches. This is often due to the brain's adjustment to the absence of the medication, which it has become accustomed to over time. The symptoms can vary widely among individuals, but headaches are a common complaint.
In your case, it seems that the headaches began shortly after you stopped taking your medication. This could indicate a withdrawal headache, which is characterized by a dull, throbbing pain that can be exacerbated by stress, anxiety, or other emotional factors. Your mention of feeling mentally unfocused during these headaches also aligns with common experiences reported by others undergoing withdrawal.
It's important to recognize that anxiety can also contribute to headaches. Your psychiatrist's comment about anxiety potentially causing headaches is valid; anxiety can lead to muscle tension, which can trigger tension-type headaches. Additionally, the stress of managing your medication and the fear of withdrawal symptoms can create a cycle of anxiety and pain.
Given your history of medication changes and the challenges you've faced with your healthcare providers, it may be beneficial to seek a comprehensive evaluation from a psychiatrist who specializes in medication management and withdrawal. They can help determine whether your headaches are primarily due to withdrawal or if there are other underlying issues that need to be addressed.
In terms of managing withdrawal headaches, here are some strategies that may help:
1. Gradual Tapering: If you haven't already, discuss with your psychiatrist the possibility of tapering off your medication more gradually. This can help minimize withdrawal symptoms, including headaches.

2. Hydration and Nutrition: Ensure you are well-hydrated and consuming a balanced diet. Dehydration and poor nutrition can exacerbate headaches.

3. Stress Management Techniques: Incorporate relaxation techniques such as deep breathing, meditation, or yoga into your routine. These practices can help reduce anxiety and muscle tension, potentially alleviating headache symptoms.

4. Regular Sleep Schedule: Aim for a consistent sleep schedule, as irregular sleep patterns can contribute to headaches.

5. Physical Activity: Engage in regular physical activity, which can help reduce stress and improve overall well-being.

6. Medication Review: If your headaches persist, it may be necessary to review your current medications with your psychiatrist. They may consider prescribing medications specifically for headache relief or adjusting your current regimen to better address your symptoms.

7. Support System: Consider seeking support from a therapist or counselor who can help you navigate the emotional aspects of medication withdrawal and provide coping strategies.

It's crucial to communicate openly with your healthcare provider about your symptoms and concerns. If you feel that your current provider is not adequately addressing your needs, it may be worth seeking a second opinion or finding a specialist who can provide the support you require.
In summary, withdrawal headaches can be a significant hurdle in the journey of managing psychiatric medications. By understanding the potential causes and implementing strategies to cope with these symptoms, you can work towards finding relief and improving your overall mental health. Remember, you are not alone in this journey, and there are professionals who can help guide you through the process.

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