[23M] Experiencing anxiety with substance use and mental health history

Patient Description

A 23-year-old male has been experiencing anxiety for the past three days, potentially exacerbated by Adderall use. Relief is found with Xanax, though the patient acknowledges it may not be a healthy long-term solution. No additional symptoms related to anxiety are reported. The patient has been using substances including Oxycodone, Adderall, marijuana, and Xanax, leading to issues such as lack of sleep and withdrawal symptoms. The patient's medical history includes bipolar disorder, schizophrenia, generalized anxiety disorder, ADHD, and high blood pressure, diagnosed from age 13 onwards. Current medications include Adderall (30 mg XR, 4 times daily), Xanax (2 mg, 4 times daily), Percocet (2 tablets of 10 mg), Haldol (5 mg nightly), Remeron (30 mg), propranolol (40 mg), lisinopril (10 mg), and Zoloft (200 mg). Additionally, the patient takes melatonin (15 mg once nightly). There are no known allergies to medications.

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Arora's Assessment

What might be happening

Your anxiety and sleep issues could be related to several factors:

  • Medication Interaction: The combination of Adderall, Xanax, and other substances like Oxycodone and marijuana can increase anxiety and disrupt sleep. Adderall, a stimulant, can particularly contribute to anxiety and insomnia.

  • Substance Use: Using multiple substances can lead to withdrawal symptoms and increased anxiety when the effects wear off.

  • Underlying Conditions: Your bipolar disorder, schizophrenia, and generalized anxiety disorder can also contribute to these symptoms.

Typical treatments might include adjusting medications, therapy, and addressing substance use.

What you can do

Anxiety and Sleep Issues:

  • Consult Your Doctor: It's important to discuss your current medication regimen and substance use with your healthcare provider. They can help adjust your medications safely.
  • Avoid Substance Use: Try to reduce or eliminate the use of substances like marijuana and Oxycodone, as they can worsen anxiety and sleep problems.
  • Relaxation Techniques: Practice deep breathing, meditation, or yoga to help manage anxiety.

Substance Use:

  • Seek Support: Consider reaching out to a counselor or support group for help with substance use.
  • Track Symptoms: Use MDandMe to journal your symptoms and track any changes. This can help your healthcare provider make informed decisions.

What you should look out for

  • Worsening Symptoms: If you experience increased anxiety, mood changes, or any new symptoms, seek medical attention.
  • Withdrawal Symptoms: Be aware of signs like agitation, sweating, or tremors, and contact a healthcare provider if they occur.
  • Emergency Situations: If you have thoughts of self-harm or experience severe side effects, seek immediate medical help.

Remember, it's important to work closely with your healthcare provider to manage your conditions and medications safely.

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2 mo ago

People Also Ask

How can Adderall use affect anxiety and sleep?

Adderall is a stimulant that can increase anxiety and cause insomnia, especially if taken in high doses or late in the day. It can exacerbate anxiety symptoms and disrupt normal sleep patterns.

What are the risks of using multiple substances like Adderall, Xanax, and Oxycodone together?

Using multiple substances can lead to complex interactions, increasing the risk of side effects like heightened anxiety, sleep disturbances, and withdrawal symptoms. It can also complicate the management of mental health conditions.

What are some non-medication strategies to manage anxiety?

Non-medication strategies for managing anxiety include practicing relaxation techniques such as deep breathing, meditation, yoga, and maintaining a regular sleep schedule. Engaging in regular physical activity and seeking therapy can also be beneficial.

How can underlying conditions like bipolar disorder and schizophrenia impact anxiety levels?

Bipolar disorder and schizophrenia can contribute to anxiety due to mood fluctuations and psychotic symptoms. Managing these conditions effectively with appropriate treatment can help reduce anxiety levels.

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