More side effects than help for anxiety

C. writes in about the difficulty he has getting the right medicine to help his anxiety: 

I have tried 3 different meds for anxiety – effexor (37.5) , lexapro (10mg) and toprol all have given me severe headaches and I haven’t taken any meds in six weeks and I continue to have severe headaches and generalized weakness. Why do I get these headaches after taken these meds and why do I still have headaches and generalized weakness?

What you describe above is a limited trial of two SSRI’s (remember that low dose Effexor functions like an SSRI) and a trial of an anti-hypertensive (the Toprol).  The side effects that you describe are certainly possible with the antidepressants, but I would describe the lingering symptoms as unusual.  I’m not sure what the thought was behind the use of the Toprol.  It is possible that the headaches and weakness are from your anxiety (I assume that this continues) which can sap your energy and make you feel physically pretty lousy.  I would urge the following:

1. Routine bloodwork to make sure that there is nothing else going on that could be causing the described symptoms.  Labwork should include items such as a thyroid screen,  and a screen for Epstein-Barr/chronic fatigue,

2.  A visit to the neurologist.  If your family doc can’t figure out the headaches, you need a headache specialist (typically a neurologist).

3.  You should attend therapy to address stress management issues and relaxation techniques.  These, by themselves, can go a long way to addressing the above physical symptoms as well as your symptoms of anxiety.

4.  If the anxiety continues to be significant for you, your psychiatrist could evaluate you to see if use of a benzodiazepine is recommended and safe.  You can review the various blarticles on this page to educate yourself about them. 

If I can give you any word of encouragement it is for you to realize that you have received almost no treatment for your symptoms so far.  There are many other options available for you, both medicine and non-medication options.  Let me know how things turn out.

–Dan Hartman, MD

2 comments to More side effects than help for anxiety

  • Marcy

    Hello Dr. Hartman:
    Thank you for your site. Over the past 2.5 years I have been on and off 7 different antidepressants (5 SSRIs, one SNRI) but my doctor has not been satisfied that the benefits outweigh the risks/side effects. He says he is out of drug options and is looking to my psychologist to help me. For about the past year and a half I have consistently struggled with a heightened sensitivity to trauma, TV news, movies, sudden noises (jumpy) that significantly limit my lifestyle. I recall after one antidepressant telling my doctor I now know what anxiety is. Could antidepressants cause these problems – longterm? I have been off the last antidepressant (Trazodone) for about a month. Thank you.