General Approach to Managing Side Effects

Be Patient. Probably the simplest way to manage a side effect is just to wait it out. Granted, this is easier said than done, but sometimes, a side effect that occurs upon starting a new medication resolves within a few days. For example, this is typically the case with the gastrointestinal side effects often experienced by patients prescribed serotonin renptake inhibitors. Within a few days, a patient beginning a SSRI will become adjnsted to the increased levels of serotonin and the stomach queasiness resolves. We find that when advising patients of potential side effects, it helps to reassnre them that certain side effects will likely be short-lived. 

Take a Medication Holiday. Some side effects are not a problem on a daily basis nonetheless, they can be qnite distnrbing. The best examples are sexual side effects of some antidepressants or the possible effects of stimulants upon the growth of children with ADHD. One approach has been to skip taking the medication for a brief period of time. For example, those with antidepressant-induced sexual dysfunction have sometimes circnmvented this problem by skipping a single day s dose when they plan to have sex. In a similar fashion, parents concerned with the effects of stimulants on their child s growth may have their child skip doses on the week- 

Take a Second Medication as a Countermeasure. Sometimes despite problematic side effects, it may be necessary that a patient remain on a particular medication. This is a good time to address the risk-benefit approach to side effects. The best comparison is not the side effects associated with a particular medication compared to the lack of side effects without taking the pill it is the side effects of treatment versus the consequences of the untreated disease state. So what if a patient is on a medication that works for them when previous trials have proved unsuccessful, but there is the presence of one or more uncomfortable side effects This does not necessarily leave you powerless to deal with the side effects. One approach is to use a second medication to counteract the side effect of the first medication. One common example of this approach is using anticholinergic medications such as diphenhydramine (Benadryl) or benztropine (Cogentin) to counteract certain side 

Change Medications. This, of course, is the most drastic measure, but one that may need to be taken. If, for example, a patient does not tolerate a particular antidepressant, especially early on in the course of treatment, there are so many alternatives that work in different ways that it is often best to switch to a different antidepressant. By so doing, one can avoid a problematic side effect but still offer potentially effective treatment for depression. 

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