Managing Anxiety with Medications: Concerns About Side Effects - Psychiatry

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Anxiolytic medication


Hello doctor, my gastrointestinal health is poor and I easily get nervous and vomit.
Initially, the doctor prescribed me Metoclopramide, which I took for about six months.
However, I started experiencing panic attacks in the last two months.
Recently, my doctor switched my medication to Clonazepam, stating that it would be more effective for my anxiety symptoms.
However, after taking 20mg, I vomited a little the next day at noon, and my gastrointestinal discomfort persists.
Should I consider changing my medication, or will it improve if I continue taking it?

Mr. Hong, 30~39 year old female. Ask Date: 2023/08/13

Dr. Wu Enliang reply Psychiatry


It is advisable for users to continue taking the medication after meals or reduce the dosage to half a pill.
If it is truly intolerable, then consider switching to a different medication.
- Dr.
Wu En-Liang

Reply Date: 2023/08/13

More Info


Managing anxiety with medications can be a complex process, especially when side effects arise. It's important to understand both the benefits and potential drawbacks of the medications prescribed to you. In your case, it sounds like you've been experiencing gastrointestinal issues alongside anxiety symptoms, which can complicate treatment.

Firstly, it's not uncommon for individuals with anxiety to experience physical symptoms, including gastrointestinal distress. Medications like Mirtazapine (美妥平) and Clonazepam (克憂果) can be effective in managing anxiety, but they may also lead to side effects such as nausea, vomiting, or changes in appetite. The fact that you experienced vomiting after taking Clonazepam could be a sign that your body is reacting negatively to the medication, especially if you already have a sensitive stomach.

When it comes to managing anxiety, the goal is to find a medication that alleviates your symptoms without causing intolerable side effects. If you are experiencing persistent nausea or discomfort, it is crucial to communicate this with your prescribing physician. They may suggest adjusting the dosage, switching to a different medication, or implementing additional strategies to manage your gastrointestinal symptoms.

It's also worth noting that some medications can take time to adjust to, and side effects may diminish after a few days or weeks of consistent use. However, if the side effects are severe or if you feel that your anxiety is not being adequately managed, it may be necessary to explore alternative options sooner rather than later.

In addition to medication, consider integrating other therapeutic approaches into your treatment plan. Cognitive-behavioral therapy (CBT) is a highly effective form of therapy for anxiety disorders and can provide you with tools to manage your anxiety more effectively. Mindfulness practices, relaxation techniques, and lifestyle changes such as regular exercise and a balanced diet can also support your mental health and potentially alleviate some of the gastrointestinal symptoms you are experiencing.

Ultimately, the decision to continue or change your medication should be made in consultation with your healthcare provider. They can help you weigh the benefits of the medication against the side effects you are experiencing and determine the best course of action for your specific situation. Remember, managing anxiety is often a process of trial and error, and it's important to be patient with yourself as you navigate this journey. Your well-being is the priority, and open communication with your healthcare team is key to finding the right balance in your treatment plan.

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