“The goal of medication is minimal side effects, and no allergic reactions.” – Bipolar: The Medication Journals

Side effects are the number one reason that people stopping taking their medication. To be honest the long list of side effects attached to psychiatric medications is miserable. However, it is important to note that if only 1 person in ten thousand experienced the side effect, it legally has to be listed. Responses to medication and side effects are individual.

Some common side effects: weight loss/weight gain, agitation/restlessness/anxiety, vision problems/dizziness/fainting/headache, seizures/tremors/uncontrollable muscle movement, dry mouth/increased saliva/nausea/increased appetite/decreased appetite, vomiting/diarrhea/constipation/stomach pain/heartburn, dry skin/rashes/skin discolouration/acne, hair loss/ brittle hair & nails, trouble falling asleep/ trouble staying asleep/drowsiness/increased dreaming, and increased sexual interest/decreased sexual interest/decreased sexual ability.

Another important note is that some side effects are short term and this is best clarified with your doctor. For example, my doctor has me wait a month after reaching the desired dosage of a medication to see if side effects level. Interestingly enough the really unpleasant side effects leveled out to tolerable or disappeared completely. On the other hand there are going to be side effects that don’t go away. Julie Fast & John Preston state, “It’s important to point out that it’s usually a trade-off between side effects and mood swing reduction” (p4).

So, can side effects be managed?

Honestly, I don’t know but I am trying. I have been making healthy life style changes to try and manage side effects that I struggle with. I have found it to be somewhat helpful. I have also found that each small change builds on the next one creating added benefits and encouragement to continue.

Life style changes are challenging, especially if there are lots of things that you would like to change at once. The key is to go slow and make one small change at a time. Be happy and comfortable with that change before making another. Be patient with yourself. Make sure that when it comes to your health and medication that you talk to your healthcare team about changes you want to make.

Let’s talk about how I am managing, or trying to manage, my side effects. Please note that I am not a doctor or a licensed practitioner. Things that I have implemented have been cleared for my health and medication by my healthcare team. Should you wish to try them you need to take your own health and medication into account and please speak to your healthcare team before adding vitamins or supplements or whatever.

Hair Loss

• After consulting with the pharmacist I now include a triple strength Omega-3 soft gel into my day. Omega-3 is one of the hardest things to naturally consume in our diets, and it can help with hair loss. (Natural sources include flaxseed, soy products, walnuts, and fish oils)
• Do not blow dry your hair (or do it as little as possible).
• Avoid chemical treatments on your hair (perms, colour…)
• Scalp massages are recommended
• There are shampoo/conditioners for hair loss. You can get these products specific for men and women. I am trying eprouvage progressive plant cells right now. It also has a restorative scalp serum.
• Try not to pull your hair back into tight ponytails…leaving it loose is better.

Note: Be mindful about your hair loss. I was taken off a medication because of the amount of hair loss was too great, I was actually having an allergic reaction. An allergic reaction is something different from a side effect.

Acne

• Facial masks that pull impurities from the skin. Find one that is right for you. I use Marcelle Purifying Clay Mask. I also use the Marcelle facial wash.
• Exfoliate your skin, gently. A soft cloth works best for your face. For the other areas of your body there are a number of exfoliating products available. Body Shoppe sells a rough rectangular cloth that works well for exfoliating your own back. There are also cloths, gloves, puffs and etcetera for this purpose. It is important to launder them regularly.
• Be mindful of soaps, creams, and other products that you are using on your skin. They may be oily or irritate the acne in some way.
• Don’t touch it. When my jaw line started to breakout I had a hard time keeping my fingers off of it. It was as if rubbing my fingers along my jaw every five minutes might allow me to discover that the bumps had suddenly disappeared. It made it worse.
• Change your pillow case more frequently, even if it is only one more time then you normally would.
• For those of you with long hair consider a loose braid at night.
• Be mindful of products that you use in your hair (gel, hairspray…). I find that they irritate acne along the hairline and face as well.
• Fresh air and sunlight are great for the skin. Sitting outside or going for a walk are helpful ideas.
• Drink lots of water. Make water your primary beverage.
• Limit sugary, greasy food.

The last 2 points also have benefits in the weight gain side effect department.

Weight Gain

• Exercise (I find this also helps with agitation and restlessness). Find something you enjoy and make it a regular part of your day. Walk when you can’t fit anything else into your schedule, and if you walk outside you get the added benefit of sun and fresh air. Dance, rollerblade, chase the kids, it doesn’t matter, just move. Join a group.
• Portion control and healthy choices that fill you up and last.
• Healthy snacks. My go to snacks are popcorn and frozen fruit (yes frozen). With increased appetite healthy snacks are key.
• Try not to night snack, nothing 3 hours before bed. I usually enjoy a herbal tea during this window of time (nothing added to it).
• Make sure there are no underlying issues causing the weight gain (thyroid, allergies…)
• Talk to your doctor as needed.

Vision/Headache

• I wear my glasses more frequently. I also visited the eye doctor and found that my prescription had changed.
• Eye drops
• Adequate amount of sleep

Sleep Disturbance

I suffered with this problem previous to starting medication so I had a routine already in place:

• No coffee after 12 noon, and try to limit it to 1 cup
• Limit or avoid other forms of caffeine
• Maintain a bedtime and a get up-time regardless of the day of the week
• Maintain a bedtime routine
• Try a sleep app
• Use a sleep tracker
• Very rarely will I use melatonin, but when I do it is never more than 3 nights in a row
• I have found that yoga helps, the classes that focus on quieting the mind (more restorative calming classes) because it is practice for stilling thoughts
• *Talk to your doctor about the best time to take your medication. Perhaps if it is keeping you awake a morning dose would work better or if it is drowsiness than before bed (this works well for nausea too). Confirm with your doctor.

Dry Mouth: This side effect was one of the effects that cleared off for me once I was past the initial 1 month hurdle, but the following tips are useful.

• Increase you water intake, sip regularly
• Limit caffeine intake
• Stop tobacco
• Chew sugar free gum or suck sugar free candies
• Don’t use mouth washes that contain alcohol, try one that is designed for dry mouth
• Breathe through your nose
• Use fluoride tooth paste.

Manage your best. Know your own limits, and keep an open line of communication with your healthcare team. If a side effect seems too much for you talk to your doctor about solutions. I have also found the pharmacist to be a great resource. Most of all remember to be patient with yourself and any changes that you decide to make to help with your side effects. The changes will need time to start showing you their benefits.

Stay positive and stay healthy.

By Shari Marshall – 2017