Home » Expert Q & A » Anxiety Disorders » Anxiety: Jill Edwards


  • eb81882200 Asks ...

    oh me again my medication was increased first venlafaxine from 180 to 225mg and sulpiride 200 to 600 but i went back down to 400 because i just didnt have any energy.not sure if this is making me feel scared in the morning

  • Jill Edwards Says ...
    Jill Edwards

    I have spoken in the previous answer about letting your doctor know about the change in medication and the need for some talking therapy around the intrusive thoughts.

    This might however be useful to think about: It is from one of the UK NHS Trusts

    Handy Guide – coming off medicines

    Very few people actually want to have to have to take medicines every day, but many people do e.g. for

    diabetes, high blood pressure, low thyroid, epilepsy, arthritis, Parkinson’s Disease and heart problems.

    They take them to help control symptoms or problems that then help them get on with their life. You need

    to decide what are the pros and cons of taking a medicine and the risks of becoming unwell again.

    This is not a definitive guide and it's not even really very scientific. These are ideas gathered together over

    many years, but should help you have a meaningful discussion with your health professional.

    Why might you want or need to stop taking a medicine?

     Side effects

     Concern about long-term side effects

     Fear of addiction or dependence

     Not then being able to take something else that interacts with it e.g. pain killers

     The medicine is no longer needed – your life may have changed

     Other illness affecting the medicine

     Doesn’t help or work

     You’re too unwell to remember to take a medicine regularly or reliably

     The medicine might be making things worse

     You need to prioritise another medicine

     You’re taking too many medicines already

     You’re pregnant or breast-feeding

     Cost (e.g. the prescription tax in England)

     The medicine has been withdrawn, not available in UK or no one will prescribe it for you

     Don’t like the pain of an injection or having to go somewhere for a regular injection.

    What are the advantages of stopping a medicine?

     No side effects (short-term or long-term)

     No need to collect medicines

     No stress of trying to remember to take medicines every day

     Being able to drive (e.g. if the medicine is making you feel sleepy)

     Relationships might improve

     Less stigma

     Feeling better in yourself because you’re managing without medicines

     You can find out whether it was working or not – if you get ill again at least you’ll know it was working

     Saves the cost of the prescriptions.

    What are the disadvantages of stopping a medicine?

     Risk of becoming ill again and what might then happen e.g.:

    o Effects on your relationships – family and friends

    o Effects on your work (either getting or keeping a job)

    o Effects on you e.g. the distress of getting unwell again, the need to start treatment again. This

    might actually end up with you needing more medicines than you would have had if you’d carried


     Possibility of going into hospital or see the crisis team again

     Annoying your GP if you get ill again

     Getting some withdrawal or discontinuation effects

    www.nsft.nhs.uk and click "Learn more about medication". Medicine

    helplines 01603-421212(Nfk), 01473-329141(Sfk)

    How can you work out how to make a decision?

    Have a look at this table and tick the boxes for the nearest answer for you:

    Stability (how stable you have been recently)

    I have been: □

    Stable for many

    years with no


    Stable for a couple

    of years or just had

    a few wobbles

    Stable for about a


    □ Unwell in the last year

    How often I

    have been


    I’ve only been ill

    once before

    I’ve been ill a few

    times before □

    I’ve been ill quite

    a few times

    and/or had quite a

    few wobbles

    I’ve been ill lots before

    and/or they may be

    getting closer together

    Severity (how badly ill you have been)

    In the past

    when I’ve been


    I’ve been managed

    and supported by

    my GP

    I’ve been managed

    as an out-patient □

    I’ve been an inpatient or seen

    the crisis team

    I’ve nearly been

    sectioned or have

    been sectioned

    Support (from family, friends, carers)

    I have: □

    Good family/carer

    support □


    family/carer support □

    Some family/carer

    support □

    Very little or no

    family/carer support

    Relapses (getting unwell again)

    If I start to get

    unwell again a

    relapse seems

    to come on:

    slowly over several

    months □

    gradually over

    several weeks □

    quickly over a

    week or so □

    quickly over a few


    If I start to get

    unwell again: □ I notice early on □

    I notice but often

    not how badly □

    I don’t really

    notice until it’s got

    quite bad

    I don’t notice until too


    If I start to get

    unwell again: □

    Other people notice

    early on and say so □

    Other people notice

    and don’t say but

    would if I asked

    Other people don’t

    really notice or

    wouldn’t say

    Other people don’t

    notice at all

    If I start to get

    unwell again: □

    I listen to and

    believe other

    people and will

    seek help early on

    I hear other people

    and might be willing

    seek help early on

    I don’t listen to

    what other people


    I don’t listen to what

    other people think and

    wouldn’t want any

    help anyway

    Medicines (the one(s) you are taking for the mental health problem)

    Long-term side

    effects: □

    I get side effects

    and find them hard

    to cope with

    I get some side

    effects which I can

    just about cope with

    I get some side

    effects but I can

    cope with them

    I don’t seem to get

    any side effects at all

    Do medicines

    help? □

    Very sure

    medicines don’t

    help me

    Not sure if

    medicines help me □

    I’m fairly sure I

    started to get

    better within a

    month or so of the

    medicines starting

    I started to get better

    within a month or so

    of when the medicines


    If I restart

    medicines: □

    I get better in a

    few weeks □

    I get better in a few

    months □

    it takes many

    months to start to

    feel better

    it might take many

    months or longer to

    start to get better

    Consequences (what would happen if you became unwell again)

    If I get ill

    again: □

    my GP should be

    able to help me □

    I’ll probably end up

    as an out-patient □

    I’ll probably end

    up with the crisis


    I’ll probably end up as

    an in-patient

    If I get ill again

    it would: □

    really only affect

    me □

    affect me and my

    family □

    affect me, my

    family and lots of


    Be a disaster for me

    and my family, friends

    and/or work

    Risk factors (see the list on the C website for the symptoms you are taking medicines for)

    I’ve looked at

    the list and: □

    I haven’t got any

    extra risk factors □

    I have a few minor

    risk factors □

    I have a few risk

    factors □

    I’ve got lots of extra

    risk factors

    Number of ticks

    Multiply by 1 2 3 4

    Scores a b c d

    Your relapse risk score is: a + b + c + d =

    www.nsft.nhs.uk and click "Learn more about medication". Medicine

    helplines 01603-421212(Nfk), 01473-329141(Sfk)

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