Psychiatric Medications: Effects, Side Effects, and Treatment Duration

Medication consultation

Hello, Doctor.
These questions are very important to me, and I hope you can help me answer them.
Thank you.
I was previously taking Lexapro 75 mg (two tablets), Suboxone 50 mg (two tablets), and Cardizem 10 mg (two tablets).
The doctor mentioned a six-month treatment, but due to my lack of understanding of the medications, I did not take them consistently, resulting in intermittent use.
However, it has been almost a year.
I would like to ask the doctor what the effects of these medications are individually? How do they help with anxiety disorders? Although I have not taken the medications consistently, the total amount exceeds six months; will the effects of these medications remain in my body? It wouldn't be for nothing, right? Once the treatment is completed, will there really be no recurrence? My treatment has been intermittent for a year, so why do I still have symptoms? Even if I stop taking these medications, will the effects still persist? Additionally, I have not taken my medications for a while now.
I previously suspected that the medications made me feel lethargic all day, but after stopping, my energy levels are still low.
I would like to know if the side effects should not last that long after discontinuation? What other reasons could cause my lack of energy?

Jin, 10~19 year old female. Ask Date: 2024/02/27

Dr. Qiu Junda reply Psychiatry

Hello.
1.
Lexapro 75mg (also known as Escitalopram) has antidepressant, anxiolytic, and anti-panic properties.
Sucralfate 50mg can be used as a gastric medication, while Atenolol 10mg can reduce heart rate and has anxiolytic effects.
2.
Medications are metabolized daily and do not remain in the body for long; otherwise, there would be no need to take them every day.
Once the medication is discontinued, it will lose its effect shortly after it is metabolized.
3.
Lack of energy may also indicate that the condition has not yet improved.
Please continue to follow up with your doctor and cooperate with the treatment for better improvement.
If you wish to discontinue medication, it is essential to discuss it with your physician.

Reply Date: 2024/02/27

More Info

Understanding psychiatric medications and their effects can be quite complex, especially when dealing with conditions like anxiety and depression. Let's break down your questions regarding the medications you mentioned: Lexapro (Escitalopram), Seroquel (Quetiapine), and Klonopin (Clonazepam), and address your concerns about their effects, side effects, and the implications of discontinuing them.

Effects of the Medications
1. Lexapro (Escitalopram): This medication is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed for anxiety and depression. It works by increasing the levels of serotonin in the brain, which can help improve mood and reduce anxiety. The therapeutic effects typically take a few weeks to manifest fully, and it is often recommended to continue the medication for at least six months after symptoms improve to prevent relapse.

2. Seroquel (Quetiapine): This is an atypical antipsychotic that can also be used to treat anxiety and mood disorders. It has sedative properties and can help with sleep disturbances, which are common in anxiety disorders. However, it is essential to monitor for side effects such as weight gain, sedation, and metabolic changes.

3. Klonopin (Clonazepam): This medication is a benzodiazepine that is effective for short-term relief of anxiety symptoms. It works quickly to reduce anxiety but is not typically recommended for long-term use due to the risk of dependence and withdrawal symptoms.

Side Effects and Treatment Duration
Each of these medications can have side effects, and the combination of them can sometimes amplify these effects. Common side effects include:
- Lexapro: Nausea, fatigue, insomnia, sexual dysfunction, and increased anxiety at the beginning of treatment.

- Seroquel: Drowsiness, dizziness, dry mouth, and potential weight gain.

- Klonopin: Drowsiness, dizziness, fatigue, and potential for dependence.

Regarding treatment duration, while your doctor may have suggested a six-month treatment plan, it is crucial to adhere to the prescribed regimen for optimal results. Discontinuing medication prematurely can lead to a resurgence of symptoms.

Medication Persistence in the Body
You mentioned that you have been inconsistent with your medication. While the effects of these medications can linger in your system for a while, especially if taken over an extended period, the therapeutic benefits may diminish if not taken consistently. The half-life of each medication varies, which affects how long they stay active in your system.

Relapse and Symptoms
It is not uncommon for symptoms to persist even after a year of treatment, especially if the medications were not taken consistently. Anxiety and depression can be chronic conditions that require ongoing management. Stopping medication can lead to a return of symptoms, and the risk of relapse is higher if the treatment is not maintained.

Post-Medication Effects
After discontinuing medication, some side effects may linger, particularly if the medication was taken for an extended period. However, the duration and intensity of these effects can vary widely among individuals. Factors such as the duration of use, dosage, and individual physiology play a significant role.
If you are experiencing low energy or persistent symptoms after stopping medication, it could be due to several reasons, including:
- Withdrawal effects: These can occur after stopping benzodiazepines like Klonopin.

- Underlying condition: The original anxiety or depressive symptoms may still be present.

- Lifestyle factors: Poor sleep, diet, lack of exercise, and stress can all contribute to feelings of low energy.

Recommendations
1. Consult Your Doctor: It is essential to communicate openly with your healthcare provider about your experiences with these medications, including any side effects and your concerns about energy levels.

2. Adherence to Treatment: If your doctor recommends continuing medication, try to adhere to the prescribed regimen. Consistency is key in managing psychiatric conditions.

3. Explore Therapy: In addition to medication, consider therapy options such as cognitive-behavioral therapy (CBT), which can provide tools to manage anxiety and depression effectively.

4. Lifestyle Changes: Incorporate healthy lifestyle changes, such as regular exercise, a balanced diet, and good sleep hygiene, which can significantly impact your mental health.

5. Monitor Symptoms: Keep track of your symptoms and any changes you notice, as this information can be valuable for your healthcare provider in adjusting your treatment plan.

In conclusion, understanding your medications and their effects is crucial for managing your mental health effectively. Open communication with your healthcare provider and adherence to treatment plans can significantly improve your outcomes.

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