
Suggest The Ideal Dosage For Duloxetine

Medications adjustment
Detailed Answer:
Good evening XXXXXXX
good to hear from you
When is the appointment scheduled?? Lot of time it takes there to schedule an appointment. Here in XXXXXXX you can meet 3 doctors in the same day.
Well for the duloxetine to take it s course, it takes usually around 3 weeks to 4 weeks. But we normally step up the dose after a week as 20 mg is slightly on the lower side. Maximum dose if 60 mg. But that will depend on your initial response to it and provided there are no side effects.
But if they feel increasing Ritalin will work, you can give it a try..Withint 3-4 weeks you can feel the difference in symptoms if they are working or not...Yeah you can go off the injections...I really dont think they are making much difference...
DO let me know for more queries
Regards
Dr Naval


Understandable
Detailed Answer:
Good evening Mr XXXXXXX
Well,this is something which I normally dont tell everyone...But, yes when you tell a patient he is gonna live like that , they lose any hopes of gaining any improvement. So that is something I dont do... There are a very few medications in medical field...But first and foremost is to give someone a hope that they will get better. And I am sure, if I am Able to motivate you to get better, half the job is done.. You will work on whatever is needed to get better...The medication I recommended is to help you get out of the situation, so you can feel better and work towards even more betterment.
But just try to beat the stress around your illness and wake up..as if you are gonna hit it back harder and come out of it. Like today is the day, I am gonna do it...It is still gonna tire you out and stuff, but keep progressing...
I hope it provides some motivation
Regards
Dr Naval


Which system is wrong
Detailed Answer:
Good evening
Well, I understand just talking is not the way out, but believe me, it is one of the first steps forward. I do feel you already are motivated enough to get back to your normal life style, but the fatigue is limiting you
Well, it is not your immune system...It is mostly from the central nervous system which is causing this problem. It doesnt affect the nerves or muscle...But more of a center located in the brain. And once triggered it doesnt rest and it becomes a vicious circle of fatigue/tiredness. ( Chronic Fatigue Syndrome)
Difficult problem with difficult solution. But I hope some different medicine works well in your case
Regards
DR Naval


Chronic Fatigue syndrome
Detailed Answer:
Good evening Mr XXXXXXX
Well, yeah I can understand the long waiting periods there with the appointment. I hope it works out for you next week and you get the desired medications..Something to make you feel better. It definitely aint testosterone deficiency.
Do let me know whatever they prescribe and counsel you further
REgards
Dr Naval


Dr. Mendiratta, I wrote you a letter a couple of days ago and have not gotten a response. If you did not receive it, I'll be happy to send it again. Just let me know. Thanks, XXXXXXX
Late Response
Detailed Answer:
Good evening Mr XXXXXXX
Really sorry for the late response. Was out of town and just got back in today evening
Well, it is good that he is at least into it and not just letting you go off without finding the actual cause. I thought he may just increase the medicines and ask you to follow up after 3 months again.
As for the Gene testing, I am not sure what genes he wants to test..But I doubt they will reveal anything significant here. Gene testing at your age, may have already been altered with all the enviromental changes. Maybe he has something different in mind which he wants to look at. Never the less, if it is something he can figure out we should let him proceed with it.
Repeat testosterone is of not much use i feel. If needed he should measure Sex horomone Binding Globulin as it will give us the correct picture whether free testosterone is low or high or normal. Total testosterone doesnt hold too much value especially since you have already been treated with it.
Do let me know if you come across the genes they are gonna check. I can do some research on it as well and see if it will give us the right direction
Regards
Dr Naval


Further course
Detailed Answer:
Good evening XXXXXXX
Well, really sorry to say. I still cant interpret what exactly he is planning to do here. I havent heard of such a test or how the medicines you are taking gonna be helpful. We normally do it for allergy but not for the other medicines. Maybe some advanced technology in US which is still not there in XXXXXXX
But never the less, do let me know the results once they are out. Will do some research on it and see how useful they have been or not. But if he s confident, within 2 weeks we should know the result and what exactly should be our next step.
Will wait for your result
REgards
Dr Naval

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