Experiencing Severe Side Effects on Day One of Taking Lorazepam

I felt very uncomfortable on the first day after taking Lofepramine?

Recently, I experienced a panic episode and went to the emergency room.
I have a history of arrhythmia and gastrointestinal issues (gastroesophageal reflux disease and duodenal ulcer), but all test results came back normal, so I was referred to a psychiatrist.
The doctor later diagnosed me with panic disorder and anxiety disorder, prescribing Lorazepam (one tablet after dinner daily) and Alprazolam (one tablet as needed), with a one-week supply.
Before starting the medication, my daily activities and physical condition were normal aside from the episodes; I could go out to shop and take showers.
However, after taking the first dose of Lorazepam, the next day I experienced chills, tremors, muscle tingling, and an increased heart rate.
My condition was actually worse than before taking the medication, and I could only lie in bed without any ability to care for myself.
Should I see the doctor again, or is this a normal reaction?

CJ, 20~29 year old female. Ask Date: 2016/01/10

Dr. Zhong Mingxun reply Psychiatry

Lofepramine is an antidepressant that can enhance serotonin and norepinephrine levels in the brain.
This medication can alleviate depression and reduce anxiety; however, it may still have some side effects.
Individual responses to the medication can vary due to differences in body chemistry, so a small percentage of people may experience significant side effects.
It is advisable to consult with the prescribing physician early on.
Generally, there are many types of antidepressants available, and if a patient does not tolerate a specific medication, they can try another class of drugs.
It is recommended to start with a low dose when attempting a new medication.

Reply Date: 2016/01/10

More Info

It sounds like you are experiencing some significant side effects after starting your medication regimen, particularly with the use of Lorazepam (also known as Ativan) and possibly the other medication, which appears to be an antidepressant. It's important to address your concerns regarding these side effects and the overall management of your anxiety and panic symptoms.

First, it's crucial to understand that medications like Lorazepam are benzodiazepines, which are commonly prescribed for anxiety and panic disorders. They work by enhancing the effects of a neurotransmitter called gamma-aminobutyric acid (GABA), which has a calming effect on the brain. While they can be very effective in managing acute anxiety symptoms, they can also lead to side effects, especially when starting treatment or adjusting dosages.

The symptoms you described—shivering, muscle tingling, and increased heart rate—are not uncommon when beginning a new medication, particularly one that affects the central nervous system. Some individuals may experience heightened anxiety or paradoxical reactions, where the medication seems to exacerbate symptoms rather than alleviate them. This can be particularly true for those with pre-existing conditions such as heart arrhythmias or gastrointestinal issues, as these can complicate the body's response to new medications.

Given your history of panic attacks and the fact that you have underlying health conditions (like arrhythmia and gastrointestinal disorders), it's essential to communicate these side effects to your prescribing physician as soon as possible. While some side effects may diminish over time as your body adjusts to the medication, severe or debilitating symptoms warrant immediate medical attention. Your doctor may need to reassess your treatment plan, which could include adjusting the dosage, switching medications, or adding supportive therapies.

In addition to medication management, consider incorporating non-pharmacological strategies to help manage your anxiety. Techniques such as cognitive-behavioral therapy (CBT), mindfulness, and relaxation exercises can be beneficial. These approaches can provide you with tools to cope with anxiety and panic symptoms, potentially reducing your reliance on medication.

Lastly, if you ever feel that your symptoms are overwhelming or if you experience any new or worsening symptoms, do not hesitate to seek medical help. Your health and safety are the top priority, and your healthcare provider is there to support you through this process. Always remember that medication management is a collaborative effort, and your feedback is invaluable in finding the most effective treatment for your needs.

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