Finding the Right Medication for Mental Health: A Patient's Journey

Hello, could you please tell me what medication I should take?

Hello, I have been taking Anxiolytic 5mg in the morning and Risperidone 1mg in the evening for almost two years.
However, I feel that over the past year, the effectiveness of these medications has diminished.
Due to work stress and emotional issues, along with ongoing dental problems, my condition has worsened, and I fear that I may lose control.
Previously, I took Anxiolytic alone for a year and Lurasidone for four months, but I experienced a similar decrease in effectiveness.
I am wondering if there are any treatments or medications, or even psychological therapies, that could help me feel more stable, regain my cognitive function, and not experience diminishing returns from the medications.
Additionally, I would like to know if Quetiapine would be a good option.
I appreciate your assistance in addressing these concerns.
Thank you.
I am not looking to be exceptionally outstanding; I just want to live well and improve a little bit.

Jaremy, 20~29 year old female. Ask Date: 2024/04/20

Dr. Li Guanying reply Psychiatry

From your letter, it is clear that you are experiencing discomfort and distress due to the pressure of taking medication.

1.
Facing an uncertain future, psychosomatic disorders are common in modern society.
This is a chronic condition that requires long-term treatment for recovery.

2.
Psychosomatic disorders are chronic illnesses that have periods of exacerbation, remission, recovery, and relapse.
More than half of patients may experience a recurrence even after symptom relief.
Due to individual differences in constitution, it is necessary to confirm whether your situation requires medical attention.

3.
Regarding medication treatment, each primary medication requires 4 to 6 weeks to assess its efficacy.
It is advisable to note the duration and frequency of any discomfort symptoms you experience.

4.
In addition to medication and psychotherapy, repetitive transcranial magnetic stimulation (rTMS) is a non-invasive, anesthesia-free, highly safe treatment option that does not require hospitalization and can improve anxiety and depressive mood issues.

Please discuss whether to take medication or which medications to consider during your follow-up appointment with your physician.
Our clinic is open for consultations from Monday to Friday, both in the morning and afternoon.
We recommend that you consider visiting the clinic for a personal assessment of your symptoms, so that together with your doctor, you can make the best decision for your health.

Wishing you mental and physical well-being.

Reply Date: 2024/04/20

More Info

Finding the right medication for mental health can be a challenging journey, especially when dealing with the complexities of mental health conditions and the side effects of medications. Your experience with medications like Anxiolytics (安立復) and Risperidone (理思必妥) over the past two years, and your feeling that they are becoming less effective, is not uncommon among patients with mental health issues.
Firstly, it’s important to understand that the effectiveness of psychiatric medications can change over time. This phenomenon is sometimes referred to as "tachyphylaxis," where the body becomes accustomed to a medication, leading to reduced efficacy. This can be particularly frustrating, especially when you are also dealing with external stressors such as work pressure and physical health issues like dental problems. These factors can significantly impact your mental health, making it feel like the medications are no longer working.

In your case, it might be beneficial to have an open and honest discussion with your psychiatrist about your current medication regimen. They can assess whether the dosages need to be adjusted or if a different medication might be more effective. There are many classes of medications available for treating anxiety and mood disorders, including SSRIs (Selective Serotonin Reuptake Inhibitors), SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors), and atypical antipsychotics. Each class has its own profile of efficacy and side effects, and finding the right combination can take time and patience.

In addition to medication, incorporating psychotherapy into your treatment plan can be incredibly beneficial. Cognitive Behavioral Therapy (CBT) is particularly effective for anxiety and depression. It helps you identify and change negative thought patterns and behaviors that contribute to your emotional distress. Engaging in therapy can provide you with coping strategies to manage stress and improve your emotional well-being.

Moreover, lifestyle changes can also play a significant role in managing mental health. Regular physical activity, a balanced diet, and adequate sleep are crucial for maintaining mental health. Mindfulness practices, such as meditation or yoga, can help reduce anxiety and improve your overall mood. Finding hobbies or activities that you enjoy can also provide a much-needed distraction from stressors and improve your quality of life.

Regarding your inquiry about the medication "Risperidone" (銳思定), it is an atypical antipsychotic that can be effective for certain conditions, including schizophrenia and bipolar disorder. However, it is essential to discuss with your doctor whether it is appropriate for your specific situation, as it may have side effects that could impact your daily life.

In summary, finding the right medication and treatment plan for mental health is often a process of trial and error. It is crucial to maintain open communication with your healthcare provider, explore the possibility of combining medication with psychotherapy, and consider lifestyle changes that can support your mental health. Remember, seeking help is a sign of strength, and taking steps towards improving your mental health is a commendable journey. You deserve to feel better and to live a fulfilling life.

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