the Efficacy and Side Effects of Anxiety Medications

Efficacy and Side Effects of Anxiety Medications

Hello, doctor.
These questions are very important to me, and I hope you can help me answer them.
Thank you.
I have previously taken Lexapro 75 mg (two tablets), Suboxone 50 mg (two tablets), and Cardizem 10 mg (two tablets).
The doctor mentioned a six-month treatment plan, but due to my lack of understanding of the medications, I did not take them consistently, resulting in intermittent use for about a year.
I would like to ask, even though my medication adherence has been unstable, I have been on them for quite some time.
Will the therapeutic effects of the medications still remain in my body? My symptoms are still present.
If I return for treatment, will the duration of the treatment be shorter? Aren't these medications only effective while being taken? Why did the doctor say that six months of treatment would be sufficient? Will the therapeutic effects not disappear? During the medication process, I felt drowsy and lacked energy, which led me to reduce the dosage, but my condition remained the same.
Now that I have completely stopped the medication, I still feel drowsy and lack energy.
How long do the side effects of these medications remain in the body? Why do I still feel drowsy after stopping the medication for a while? Currently, I am taking Suboxone 50 mg (two tablets) due to gastroesophageal reflux.
Does this increase the likelihood of feeling drowsy? Will I not feel drowsy after stopping the medication, or are there other reasons for my fatigue and lack of energy?

jenny, 20~29 year old female. Ask Date: 2024/03/09

Dr. Wu Enliang reply Psychiatry

Netizens are curious about whether the therapeutic effects of medications remain in the body.
A: No, they do not.
Since the symptoms still persist, if treatment is resumed, will the duration of the treatment be shortened? A: The duration of treatment will not be shortened.
It is recommended to adjust the medication "Lexapro" and take it daily for it to be effective.
These medications are only effective while being taken, so why do doctors say that taking them for just six months will suffice? Will the therapeutic effects not disappear? A: Because each person's condition is different, you should ask your doctor why they recommend taking it for only six months.
During the medication process, if you feel drowsy and fatigued and reduce the dosage, but the condition remains the same, even after completely stopping the medication, you still feel drowsy.
How long do the side effects of these medications linger in the body? A: Medications are almost completely metabolized within 24 hours, so these symptoms are not related to the side effects of the medication.
Why do I still feel drowsy after stopping the medication for a while? Currently, due to gastroesophageal reflux, I am still taking 50 mg of Sucralfate twice a day; does this increase the likelihood of feeling drowsy? Will I not feel drowsy after stopping the medication, or are there other reasons for feeling fatigued? A: As mentioned, it should not be related to the medication.
There are many reasons for feeling drowsy, including poor health, low energy, or feelings of depression and anxiety.
Dr.
Wu Enliang

Reply Date: 2024/03/09

More Info

Understanding the efficacy and side effects of anxiety medications is crucial for anyone undergoing treatment for anxiety disorders. In your case, you mentioned taking several medications, including Lexapro (Escitalopram), Buspirone, and possibly others, for about a year, albeit inconsistently. Let's break down your concerns regarding the efficacy, side effects, and the lingering effects of these medications.

Efficacy of Anxiety Medications
Anxiety medications, particularly selective serotonin reuptake inhibitors (SSRIs) like Lexapro, are designed to help manage symptoms of anxiety and depression. These medications typically take several weeks to show their full effects, and consistent use is essential for achieving the desired therapeutic outcomes. When taken as prescribed, SSRIs can help improve mood, reduce anxiety, and enhance overall functioning.

However, if medications are taken inconsistently, as you mentioned, their effectiveness may be compromised. While some benefits may persist after discontinuation, particularly if the medications were taken for an extended period, the full therapeutic effects are generally not retained without ongoing use. This is because the brain's neurochemical balance can revert to its previous state without the medication's influence.

Duration of Treatment and Residual Effects
Regarding your question about whether the treatment effects would last after stopping the medication, it's important to note that while some individuals may experience residual benefits after discontinuation, this is not universally applicable. The duration of treatment recommended by your doctor (six months) is often based on clinical guidelines that suggest a minimum duration to achieve and maintain symptom relief. However, individual responses can vary significantly.

If you return to treatment after a break, your doctor may reassess your situation and potentially adjust the treatment plan based on your current symptoms and any changes in your condition. The duration of the new treatment may or may not be shorter, depending on how well you respond to the medications this time around.

Side Effects and Their Duration
You expressed concerns about feeling excessively sleepy and lacking energy, which are common side effects of many anxiety medications, including SSRIs and anxiolytics. These side effects can occur during treatment and may persist for some time after discontinuation, depending on the specific medication and individual metabolism.
For instance, medications like Buspirone can cause drowsiness, especially when starting treatment or when the dosage is increased. If you are currently taking Buspirone for anxiety and experiencing increased sleepiness, it may be contributing to your symptoms. Additionally, if you are also dealing with gastroesophageal reflux disease (GERD) and taking medications for that condition, it could further complicate your symptoms of fatigue and sleepiness.

Other Factors Contributing to Fatigue
It's also essential to consider other factors that could be contributing to your feelings of fatigue and lack of energy. These can include:
1. Sleep Quality: Anxiety can significantly impact sleep quality, leading to feelings of tiredness during the day.

2. Diet and Nutrition: Poor nutrition can affect energy levels and overall well-being.

3. Physical Health: Other medical conditions, including thyroid issues or chronic fatigue syndrome, can also lead to persistent fatigue.

4. Mental Health: Ongoing anxiety or depression can manifest as fatigue and low energy.

Conclusion
In summary, while anxiety medications can be effective in managing symptoms, their efficacy is highly dependent on consistent use. If you have concerns about side effects or the duration of treatment, it is crucial to communicate openly with your healthcare provider. They can help you navigate your treatment options, adjust dosages, or consider alternative therapies if necessary. Remember that mental health treatment is often a journey, and finding the right balance may take time and patience.

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