Anxiety Medications: Risks, Side Effects, and Usage Tips

Q: Anxiety Medications: Risks, Side Effects, and Usage Tips

Hello： These medications, when taken according to the dosage and frequency prescribed by your physician, are not likely to lead to addiction. <br>Therefore, it is strongly advised that you follow your doctor's instructions; otherwise, not only is there a risk of developing depend

I urgently request assistance in consulting about the interactions of these psychiatric medications?

Dear TH,
Thank you for taking the time to answer my questions amidst your busy schedule.
I have been on anxiety medication for a year and have also undergone psychological counseling for a year.
The names and dosages of my medications are as follows:
1.
Litalopram (Escitalopram) - one tablet before breakfast and one before lunch
2.
Clonazepam (Klonopin) - one soft gel capsule at bedtime
3.
Duloxetine (Cymbalta) - 1.5 tablets at bedtime
4.
Quetiapine (Seroquel) - two tablets at bedtime
5.
Lamotrigine (Lamictal) - 0.5 tablets at bedtime
I would like to know if the above medications can lead to dependence or cause drug interactions with prolonged use.
Recently, I have noticed that if I miss a dose of Litalopram, I experience significant drowsiness, and I feel an urge to continue taking it.
However, my psychiatrist has advised me not to become overly reliant on these medications.
I often feel that if the medications are not effective, I want to take the entire week's supply prescribed by my doctor in one go, but I keep reminding myself that this approach is not correct.
Am I on the verge of developing a medication dependence? What should I do? Additionally, could you explain the purpose of these medications and what I should be cautious about? How long should I expect to be on these medications? I have a natural tendency to have hand tremors, which seem to be worsening; could this be related to the medications? Sometimes, I experience palpitations—what could be causing this?
Recently, friends around me have urged me to stop taking these medications, claiming that the more I take, the worse it gets, and that high doses could lead to severe consequences.
This has made me quite anxious.

Could you please patiently explain the purpose, precautions, and side effects of each medication? Are there any specific things I should avoid while taking these medications? Thank you for your time in addressing my concerns.
Also, I have been experiencing dizziness when I tilt my head back; could this be related to the medications? I fear that I might rely on them for the rest of my life.
Thank you.

leoo len, 20~29 year old female. Ask Date: 2007/06/02

Dr. Duan Yongzhang reply Psychiatry

Hello: These medications, when taken according to the dosage and frequency prescribed by your physician, are not likely to lead to addiction.
Therefore, it is strongly advised that you follow your doctor's instructions; otherwise, not only is there a risk of developing dependence, but excessive use can also result in toxicity.
It is also recommended that you directly ask your treating physician about the effects and side effects of these medications, as this is your right during the consultation and will help you better understand the considerations behind your doctor's prescription of these medications.

Reply Date: 2007/06/02

More Info

Dear Ema,
Thank you for reaching out with your concerns regarding the medications you have been prescribed for anxiety. It’s understandable to feel overwhelmed when dealing with multiple medications, especially when you are not fully informed about their purposes and potential side effects. Let’s break down the medications you mentioned, their uses, and what you should be aware of regarding their long-term use.

1. Mirtazapine (利他蒙錠): This is an antidepressant that is often used to treat anxiety and depression. It works by increasing the levels of certain neurotransmitters in the brain, which can help improve mood and reduce anxiety. Common side effects include drowsiness, increased appetite, and weight gain. Long-term use can lead to dependence, but it is generally considered safe when monitored by a healthcare provider.

2. Clonazepam (康癲能): This medication is a benzodiazepine, which is commonly prescribed for anxiety and panic disorders. It works by depressing the central nervous system, leading to a calming effect. While effective for short-term relief, long-term use can lead to tolerance, dependence, and withdrawal symptoms if discontinued abruptly. Side effects may include drowsiness, dizziness, and cognitive impairment.

3. Estazolam (悠樂丁): Another benzodiazepine, Estazolam is primarily used for short-term treatment of insomnia and anxiety. Similar to Clonazepam, it can cause dependence and withdrawal symptoms. Side effects may include drowsiness, dizziness, and potential memory issues.

4. Lorazepam (無禦寧膜依錠): This is also a benzodiazepine used for anxiety relief. It has a rapid onset of action, making it effective for acute anxiety episodes. Long-term use can lead to dependence, and side effects include sedation, dizziness, and potential cognitive impairment.

5. Midazolam (導美睡): Typically used for sedation before medical procedures, it can also be prescribed for anxiety. Its effects are short-lived, and like other benzodiazepines, it carries a risk of dependence and withdrawal symptoms.

6. Propranolol (心悸): This medication is a beta-blocker that is often used to manage physical symptoms of anxiety, such as rapid heartbeat and tremors. It does not have the same dependence risks as benzodiazepines but can cause fatigue, dizziness, and gastrointestinal issues.

Understanding Risks and Side Effects
Given the medications you are taking, it is crucial to be aware of the potential for drug interactions and cumulative side effects, especially since several of these medications can cause sedation and cognitive impairment. Mixing benzodiazepines can increase the risk of respiratory depression, excessive sedation, and impaired motor function.

Concerns About Dependence
Your concern about becoming dependent on these medications is valid. Benzodiazepines, in particular, are known for their potential for dependence. It’s essential to follow your doctor’s guidance regarding dosage and duration of use. If you feel that your medications are not effective or are causing unwanted side effects, it’s important to communicate this with your healthcare provider. They may adjust your dosage or suggest alternative treatments.

Recommendations
1. Regular Communication: Keep an open line of communication with your psychiatrist. Discuss any side effects you experience, including the increased hand tremors and feelings of dizziness. This will help them make informed decisions about your treatment plan.

2. Avoid Abrupt Changes: Do not stop or change your medication regimen without consulting your doctor. Abrupt discontinuation can lead to withdrawal symptoms and a resurgence of anxiety.

3. Consider Therapy: In addition to medication, cognitive-behavioral therapy (CBT) can be highly effective for anxiety management. It can provide you with tools to cope with anxiety without relying solely on medication.

4. Lifestyle Modifications: Incorporate stress-reducing activities into your daily routine, such as exercise, mindfulness, and relaxation techniques. These can complement your medication and improve your overall well-being.

5. Monitor Symptoms: Keep track of your symptoms, including any new or worsening issues like dizziness or heart palpitations. This information can be valuable for your healthcare provider.

Conclusion
It’s understandable to feel anxious about your medication and its long-term effects. However, with proper management and communication with your healthcare provider, you can navigate your treatment effectively. Remember, you are not alone in this journey, and there are resources available to support you. Please take care of yourself, and don’t hesitate to reach out to your doctor with any concerns.

Best wishes for your health and well-being!

Similar Q&A

Understanding Anxiety Medications: Risks of Overuse and Alternatives

Dear Dr. Chen, I often experience anxiety and tension, and I frequently rely on my smoking habit to slightly alleviate my anxiety. After a consultation, my doctor prescribed a certain type of anxiolytic (a pink, round pill, though I am unsure of the exact name). The doctor advis...

Dr. Chen Wenke reply Psychiatry
Hello, Xiao K: Regarding the medication issue you mentioned, it's unclear from your description what medication you are using. It would be best to directly consult your attending physician. Regardless of the specific anti-anxiety medication, its primary function is to reduce...

Managing Panic and Anxiety: Can You Skip Medication for Self-Adjustment?

Doctor, I have been diagnosed with panic disorder and anxiety. The doctor prescribed me Cloene (clonazepam) and Mesyrel (trazodone) to take at bedtime, but I noticed that the side effects include drowsiness, dizziness, nervousness, and mental confusion. I'm concerned that th...

Dr. Chen Wenyu reply Psychiatry
Hello, Regarding the medications you are taking and the timing of their administration, these two drugs have sedative and antidepressant effects. Taking them before bedtime is intended to induce sleepiness. If you take a sedative or sleep medication and do not sleep, it is natu...

Managing Anxiety and Panic: Concerns for Heart Patients on Medications

I am a cardiovascular disease patient and had five coronary stents placed between 2008 and 2013. Two years ago, I began experiencing anxiety and panic, especially when traveling abroad or going far from home; I feel safer at home or near a hospital. Now, every day when I wake up,...

Dr. Qiu Junda reply Psychiatry
Hello: The medication mentioned in the text may be "Deanxit." If so, this drug is a combination medication that may be effective for treating anxiety, depending on whether it improves your condition after use. The side effects of the medication do not necessarily occur ...

Am I Addicted to My Medication? Understanding Anxiety Treatment Risks

As the doctor said, the medication controls my panic disorder very well. I take a fixed dosage every month. However, if I miss a dose, my panic symptoms become very severe, and I feel like I'm almost dying. I can't sleep all night, and my body feels like it's falli...

Dr. Ding Shuyan reply Psychiatry
Hello, the recurrence of symptoms without medication can be attributed to at least two reasons. First, the illness may not have fully resolved and is merely being managed by the medication. This is often seen in chronic conditions such as hypertension and diabetes, where missing ...