“Ab theek ho gaye toh dawai lena chhod doon?”
Anxiety Medicine Adherence in India
Medical adherence is a big problem in India. Family duties, work ka pressure, bachchon ka rona, upcoming deadlines, subah subah bhaag-daud - dawai bhool jaana bohot easy hai.
40-50% of psychiatric patients in India do not take their anxiety medicines properly. There are a lot of reasons to miss doses, whether it’s cost, or that you simply got too busy and forgot, or that you’re worried about the anxiety medicine itself and subconsciously don’t want to take it. Yeh sab toh hota hi hai.
“I have a lot of patients who abruptly discontinue their prescription, and they even stop going to doctors for follow-ups. People think - I’ve already taken this medicine for 4 months or 6 months, I don’t need it anymore, I’m feeling strong, I think I can manage on my own” -Madhulika Agarwal
But anxiety meds regularly lena zaruri kyu hai? Because most of them need to be taken daily, consistently, and timely, to do their work. Skipping a day or two affects your progress and can show negative effects.
Jab hum khudse self medicate karke “need-based” Restyl lete hai, it helps in the moment, but in the long run, it can lead to dependence.
Prescribed and monitored anxiety medication, taken as per your doctor’s instructions, is the best way to treat your anxiety effectively.
Agar aapko theek lag raha ho to dawai lena band mat karo. Agar sab theek lag raha hai, toh iska matlab yeh hai ki dawai apna kaam kar rahi hai. If you stop the medicine now, who bhi doctor se consult kiye bina, you are only increasing your chance of relapsing. The only way to stop this yo-yo of feeling fine and not fine is to stick to your plan and make changes only under your doctor’s guidance. Even if the decision is to taper and slowly stop medication, it needs to be made together.
Hum kaafi Baar sochte hai "Yeh dawai (alprazolam/Restyl/ any neend or tension ka dawai) se mujhe araam mil jaata hai, toh mujhe aaj, kal, jabhi bhi zarurat pade, I’ll just take this” but using these need-based, one-off medicines regularly increases the risk of dependence on such medication, especially when self-medicating.
Side-effects ka matlab yeh nahi hai ki dawai uses samay rokni padegi. Some mild side effects are common when you start taking medication. A lot of them are manageable, too. Dawai rokne se baadmein aur problem hogi. Isse better, just speak to your doctor and let them know what’s going on and make a collective and informed decision. You can adjust your dose or find something that can help relieve a specific side-effect, eg, taking your dose with food may reduce nausea.
Aaj dawai miss hogayi toh kal double lene se much nahi hota. Bina apne doctor ko consult kare, eating double the amount of medicine you should, will only do you harm. If you miss a dose, take it when you remember, if it is close to the next one, then skip the missed dose and make a note of this.
Another roadblock that can stand in the way of medication adherence is cost. A very valid concern. Informing your doctor and choosing generic medicines over brand-name medicines, which are just as good, can help manage this to a certain extent. The Jan Aushadhi (PMBJP) scheme offers generic meds at a low cost that are quality assured.
Small changes can help remember taking medicine - phone pe alarm laga lo, pillboxes khareed lo, SMS reminders set karlo. Agar yeh kaam na kare, try tying your medicine to another daily task, like always having your medicine with your morning chai or right after brushing or as soon as you sit at your desk. Carry backup strips of medicine on the go; keep one in your daily purse or your office bag. You can even appoint your friend, partner, parent or child as your personal reminder. Of course, this is tied to other things, but if everyone is aware, perhaps they will be more comfortable and help you feel more comfortable, too?
India is moving to more structured counselling, simplification and scheduled follow-ups through DMHP and Tele MANAS. People are working on reminder systems, pharmacist partnerships and easier access to psychiatric medicine. Joining this wave or not is completely up to you. But if you are taking medication for anxiety, it’s important to do it in a safe and respectful environment, work alongside your doctor and psychologist, and ensure that you make the best decisions for yourself.
To know more about Medication Nonadherence in India, Tele MANAS, Rule for taking medication, The Jan Aushadi PMBJP Scheme or The District Mental Health Program (DMHP), follow the links below:
● Medication nonadherence in psychiatric patients in India