Anxiety relief and sleeping pills

Currently, the drugs that are regularly used in clinical practice and have the effect of relieving anxiety and improving sleep mainly include non-benzodiazepine sedative-hypnotics, sedative anti-anxiety/antidepressants, and proprietary Chinese medicines used for syndrome differentiation. There is no "magic pill". All drugs need to be evaluated by a professional doctor and prescribed for use. It is absolutely not recommended to purchase drugs by yourself.

To be honest, I have been working in a psychology pharmacy for almost 6 years, and I have seen too many patients who search records on their mobile phones to prescribe medicines. Last week, I met a young girl who works in Internet operations. She lay up until 3 a.m. for 24 days in a row and opened her eyes to read sleep aid posts. She blindly bought imported melatonin and soothing gummies and ate them for more than half a month. Not only did she not fall asleep, but she was so confused at work during the day that she even wrote the wrong plan. As soon as she entered the door, she asked, "Is there any medicine that can make you sleep, does not affect work the next day, and is not addictive?" ”

In fact, there have always been different clinical usage trends regarding the selection of this type of medicine. For example, the older generation of psychiatrists would occasionally prescribe traditional benzodiazepines such as alprazolam and clonazepam when they encounter patients who have acute anxiety attacks and cannot close their eyes for three or four days in a row. They have quick effects and can stabilize the panic in ten minutes. Drowsiness follows, but the controversial point is also obvious: this kind of medicine has a long half-life, and it is easy to feel dizzy like a hangover the next day. If you take it continuously for more than 2 weeks, you may develop drug resistance. Many old patients cannot sleep after taking 3 tablets at a time, and they always forget things. Nowadays, more young doctors will give priority to prescribing non-benzodiazepine drugs such as eszopiclone and zolpidem. They have a half-life of only 5-6 hours, are metabolized quickly, and are basically not dizzy the next day. The addictiveness is much lower than traditional sleeping pills. However, individual differences are a bit obvious. Almost one-third of people will have a bitter taste in their mouth after taking them. The most exaggerated patients I have seen said that drinking soy milk the next day after taking them will be bitter. If you can't bear it, just change medicines.

Many people are confused when they get the medicine and see that it is an antidepressant: "I just can't sleep well, how can I be prescribed to treat depression?" ”In fact, drugs like trazodone and mirtazapine are not used to fight depression when used in small doses. They use their sedative effect to improve anxiety and sleep at the same time. They are especially suitable for patients with anxiety-type insomnia who can’t help but review their work while lying in bed and become more energetic the more they think about it. I used to have a class teacher at a key middle school who suffered from anxiety and insomnia for almost half a year. He could fall asleep taking eszopiclone alone, but he still felt flustered during class and his palms were sweaty. Later, he added half a tablet of trazodone. After taking it for two weeks, he came back for a follow-up consultation. He said that not only could he fall asleep after lying down for 20 minutes, but the irritability he felt while staring at students taking exams had mostly disappeared. Of course, some doctors are very cautious about the use of this kind of medicine. After all, a small number of people will have side effects such as increased appetite and weight gain. Whether to use it and how much dosage to use all depends on the individual's tolerance. There is no unified standard.

There are also many patients who say they are afraid of side effects of Western medicine and only want to take Chinese patent medicines. I have to be honest about this. Chinese patent medicines are useful, but they must be taken based on syndrome differentiation. Not everyone can sleep well after taking jujube seed paste and Wuling capsules. For example, if you usually get angry easily, suffer from dry mouth and bitter taste, and cannot calm down even after lying down and tossing and turning for half an hour, taking Bailemian and Shugan Jieyu Capsules will treat the symptoms. ； If you always feel tired, flustered, and have poor memory, then taking some jujube seeds and Guipi Pills will be helpful. Nearly half of the patients with mild anxiety and insomnia I have come into contact with take the right Chinese patent medicines and can see improvements in 2 to 3 weeks. If you have been having trouble sleeping for more than a month and are anxious during the day to the point that it affects your normal work, don't just take Chinese medicines. You should make adjustments in conjunction with Western medicines.

Oh, by the way, let me mention the most common pitfalls: melatonin is not a medicine, but a health product. It is only suitable for people suffering from jet lag or those over 60 years old who have insufficient melatonin secretion. Long-term use by young people will inhibit their own melatonin secretion, and the more they take it, the more they cannot sleep. Those sleep-aid gummies and lavender sleep-aid tea that boast of being amazing are basically a placebo effect. At most, they can make you relax psychologically. If you really have sleep problems, don't rely on it.

When I give medicines to patients, I always say that these medicines are just a crutch to help you get your disordered work and rest back on track, not a bed that can last you a lifetime. Last week, the little girl finally prescribed a 10-day supply of eszopiclone, along with a week of Shugan Jieyu capsules, and asked her to put her mobile phone in the living room an hour before going to bed. This week, when she came for a follow-up visit, she said that she could fall asleep in 20 minutes without any bitterness in her mouth. When she left, she asked if she could prescribe more, but I didn't give it to her. I said to her, "You can walk well on your own now, why are you always carrying a cane?" ”

By the way, one last thing, pregnant women, lactating women, and people with abnormal liver and kidney function, don’t take medicine randomly even if your insomnia is severe. You must consult a doctor for evaluation before using it. Don’t gamble with your body.