Medication Consultation
Hello, Doctor: I have been undergoing treatment for panic disorder and depression for five years now.
The symptoms of panic have become more pronounced with age, often causing discomfort in my heart, difficulty breathing, and unexplained muscle pain.
The frequency of panic attacks has increased, especially during rest and sleep, and even medication does not prevent these episodes.
I only take medications like Xanax or Lexapro when I feel really uncomfortable.
Additionally, I frequently experience migraines that can last for more than half a day or even a whole day.
Over-the-counter pain relievers, heat therapy, massage, and sleep do not provide relief in a short time.
Last year, I switched to a different clinic, and the doctor changed many of my medications.
This time, they prescribed "Fioricet" for my headaches, but I found that its function seems different from my main complaints (previously, I took "Ibuprofen," which was quite effective, but the current doctor did not prescribe it for me).
I also switched to "Yongkangxu" for panic treatment, while "Liyou" has been consistently prescribed for my depression and panic.
My previous doctor prescribed "Kangxuping," but it made me feel nauseous, and switching to Liyou has reduced that side effect, although it seems less effective in suppressing panic.
Could you please advise me on how to communicate with my doctor? Are the current medications addressing my symptoms? Thank you!
Chichichiao, 30~39 year old female. Ask Date: 2024/01/05
Dr. Lin Mianzhang reply Psychiatry
Hello Chichichiao: It seems that your symptoms mainly consist of panic depression and headaches.
Regarding the panic depression, both the medication you previously took, Kangxu Ping, and the current one, Liyou, have therapeutic effects.
If the current medication, Liyou, is not providing sufficient relief, you might consider increasing the dosage or combining it with other medications or switching to a different one.
As for the migraines, both Fuyan Kuai and Yiketon are medications used to treat acute pain.
However, based on your description, your migraine attacks occur quite frequently, so I would recommend considering medications that can "prevent" migraine attacks.
There are various options available, including certain cardiovascular medications, antidepressants, and anticonvulsants, which you should discuss with your physician.
Additionally, medication is only one part of the treatment for depression and panic disorders.
I also suggest engaging in psychotherapy to understand the deeper sources of your stress and how to cope with it, as this can lead to more significant improvements.
Wishing you peace and health!
Reply Date: 2024/01/05
More Info
Effective communication with your doctor about panic and depression medications is crucial for managing your mental health effectively. Given your experience with panic disorder and depression over the past five years, it's understandable that you have specific concerns about your symptoms and the medications prescribed to you. Here are some strategies to help you communicate effectively with your healthcare provider:
1. Prepare for Your Appointment: Before your visit, take some time to write down your symptoms, how often they occur, and any triggers you’ve identified. Note the medications you’ve tried, their effects, and any side effects you experienced. This information will provide your doctor with a clearer picture of your situation.
2. Be Honest and Direct: When discussing your symptoms, be as specific as possible. For example, instead of saying "I feel anxious," you might say, "I experience panic attacks that cause heart palpitations and difficulty breathing, especially at night." This level of detail helps your doctor understand the severity and nature of your symptoms.
3. Discuss Medication Effects: Share your experiences with the medications you’ve been prescribed. For instance, you mentioned that "離憂" (Liyou) is less effective for panic than "康緒平" (Kangxu Ping), which caused nausea. Explain how each medication has affected you, both positively and negatively. This feedback is essential for your doctor to make informed decisions about your treatment plan.
4. Ask Questions: Don’t hesitate to ask your doctor about the medications prescribed. For example, you might ask, "How does '伏炎快' (Fuyan Kuai) specifically address my headaches, and why was it chosen over '易克痛' (Yiketon)?" Understanding the rationale behind your treatment can help you feel more involved in your care.
5. Express Your Concerns: If you feel that your current medications are not effectively managing your symptoms, communicate this clearly. You could say, "I still experience panic attacks despite taking '永康緒' (Yongkangxu), and I’m concerned that my treatment isn’t working as it should." This opens the door for your doctor to reassess your treatment plan.
6. Collaborate on Treatment Goals: Discuss your treatment goals with your doctor. For instance, if your primary goal is to reduce the frequency of panic attacks or manage headaches more effectively, let your doctor know. This collaboration can lead to a more tailored treatment approach.
7. Follow Up: After discussing your concerns and treatment options, make sure to schedule follow-up appointments to monitor your progress. If you try a new medication or adjust your dosage, keep track of how you feel and report back to your doctor.
8. Consider a Support Person: If you find it challenging to articulate your concerns, consider bringing a trusted friend or family member to your appointment. They can help you remember important points and provide support during the discussion.
In summary, effective communication with your doctor about panic and depression medications involves preparation, honesty, and collaboration. By clearly expressing your symptoms, experiences with medications, and treatment goals, you can work together with your healthcare provider to find the most effective treatment plan for your needs. Remember, managing mental health is a journey, and open communication is key to navigating it successfully.
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