Managing Panic Disorder: Addressing Sleepiness from Seronil and Xanax Use

Q: Managing Panic Disorder: Addressing Sleepiness from Seronil and Xanax Use

Dear Friend： Your physician has prescribed you SERONIL 20MG QD and XANAX：XR 0.5mg BID, which are effective for panic attacks. <br>However, some individuals may experience drowsiness as a side effect of the latter (XANAX：XR 0.5mg), although this usually improves after a period of

Diagnosed by a doctor with panic disorder?

I was diagnosed with panic disorder by my doctor.
The doctor prescribed SERONIL 20 mg once daily and XANAX XR 0.5 mg twice daily.
However, after taking the medication in the morning, I feel drowsy for the entire day, and only feel a bit more alert in the evening.
I would like to know if one of these medications could be causing the drowsiness.
Would it be possible to take SERONIL 20 mg at bedtime instead? Would this help improve the drowsiness? Thank you for your response.

zankson, 30~39 year old female. Ask Date: 2004/10/27

Dr. Tang Xinbei reply Psychiatry

Dear Friend: Your physician has prescribed you SERONIL 20MG QD and XANAX:XR 0.5mg BID, which are effective for panic attacks.
However, some individuals may experience drowsiness as a side effect of the latter (XANAX:XR 0.5mg), although this usually improves after a period of use.
As for the former (SERONIL 20MG), a small number of patients have reported feelings of dizziness, fatigue, or drowsiness after taking it, but most also find that these symptoms improve over time.
I do not recommend that you adjust the medication on your own, as there are also some patients who complain that taking SERONIL 20MG before bedtime can negatively affect sleep quality.
It is advisable to discuss this with your prescribing physician, who can evaluate and make adjustments to minimize side effects.
Wishing you peace and joy!

Reply Date: 2004/10/27

More Info

Managing panic disorder can be challenging, especially when medications like Seronil (Sertraline) and Xanax (Alprazolam) cause side effects such as excessive sleepiness. Both medications are commonly prescribed for anxiety and panic disorders, but they can have different effects on individuals.

Understanding the Medications:
1. Seronil (Sertraline): This is a selective serotonin reuptake inhibitor (SSRI) used primarily to treat depression and anxiety disorders, including panic disorder. While SSRIs are generally well-tolerated, some individuals may experience side effects such as fatigue, dizziness, or sleep disturbances, especially when starting the medication or adjusting the dosage. These side effects often diminish over time as the body adjusts to the medication.

2. Xanax (Alprazolam): This medication belongs to the benzodiazepine class and is effective for short-term relief of anxiety symptoms. However, it can cause sedation and drowsiness, particularly in the initial stages of treatment or when the dosage is increased. The extended-release formulation (XR) is designed to provide a longer duration of action, which may contribute to prolonged sedation in some patients.

Addressing Sleepiness:
Given your experience of excessive sleepiness after taking these medications, it is essential to consider a few strategies:
- Timing of Doses: You mentioned the possibility of taking Seronil at night instead of in the morning. While some patients find that taking SSRIs at night helps mitigate daytime drowsiness, this change should be discussed with your prescribing physician. They can provide guidance based on your specific situation and monitor any changes in your symptoms.

- Adjusting Dosages: If the sleepiness persists, your doctor may consider adjusting the dosages of either medication. Sometimes, a lower dose of Xanax or a gradual tapering off can help reduce sedation while still managing anxiety effectively.

- Medication Review: It may be beneficial to review all medications you are currently taking, including any over-the-counter drugs or supplements, as these can also contribute to drowsiness. Your doctor can help identify any potential interactions or side effects.

- Lifestyle Modifications: Incorporating lifestyle changes such as regular exercise, a balanced diet, and good sleep hygiene can also help improve your overall energy levels and reduce feelings of sleepiness. Engaging in activities that promote alertness during the day, such as taking short walks or practicing mindfulness, may also be beneficial.

- Monitoring and Follow-Up: Regular follow-up appointments with your healthcare provider are crucial. They can assess your response to the medications, monitor for side effects, and make necessary adjustments to your treatment plan. Keeping a journal of your symptoms, including when you take your medications and how you feel throughout the day, can provide valuable information for your doctor.

Conclusion:
In summary, while both Seronil and Xanax can effectively manage panic disorder, they may cause excessive sleepiness in some individuals. Adjusting the timing of Seronil, discussing dosage changes, and implementing lifestyle modifications can help manage this side effect. It is essential to maintain open communication with your healthcare provider to find the most effective treatment plan tailored to your needs. Remember, managing panic disorder is a process, and finding the right balance of medications and lifestyle changes can lead to improved well-being.

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