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Suggest Treatment For Anxiety And Depression
Question: Dear Doctor,
My Wife is suffering from anxiety disorder for last 8 months (after her father's death).
Her problem is early wake up in morning around 3.0 a.m., feeling of crying (not crying actually), upset, increased sensation around neck and chest area. We could not understand the problem initially. The doctor identified these symptoms as depression. He prescribed Clonazepam 0.25 twice daily, nexito 10 mg at night. This resulted in excessive sedation and gastirc problems. However, when he added Amisulpiride 50 mg. her problem eliminated completely. later after two months her prolactin level increased. We left the medicine, as she was okay. and got treated from gyne doctor for prolactin. After 3 months , the symptoms appeared again. We again met doctor, she prescribed clonezapam 0.5 twice, nexito 10, again resulted in heavy sedation and gastro problems. For gastro problems doctror advised Pantocid -L containing Levosulpiride 75 mg and stopped Clonazepam and nexito for time being. She is OK with this new medicine for last one month. Now doctor wants to stop using Panoocid-L and start using Clonazepam and nexito. We are worried , we are not convinced with the treatment. please advise.
My Wife is suffering from anxiety disorder for last 8 months (after her father's death).
Her problem is early wake up in morning around 3.0 a.m., feeling of crying (not crying actually), upset, increased sensation around neck and chest area. We could not understand the problem initially. The doctor identified these symptoms as depression. He prescribed Clonazepam 0.25 twice daily, nexito 10 mg at night. This resulted in excessive sedation and gastirc problems. However, when he added Amisulpiride 50 mg. her problem eliminated completely. later after two months her prolactin level increased. We left the medicine, as she was okay. and got treated from gyne doctor for prolactin. After 3 months , the symptoms appeared again. We again met doctor, she prescribed clonezapam 0.5 twice, nexito 10, again resulted in heavy sedation and gastro problems. For gastro problems doctror advised Pantocid -L containing Levosulpiride 75 mg and stopped Clonazepam and nexito for time being. She is OK with this new medicine for last one month. Now doctor wants to stop using Panoocid-L and start using Clonazepam and nexito. We are worried , we are not convinced with the treatment. please advise.
Brief Answer:
modifications in drug treatment needed.
Detailed Answer:
Hello
Welcome to HCM.
I can understand your concerns for your wife.
I have gone through the details thoroughly.
Levosulpride can raise prolactin levels like amisulpride. I would also suggest to not continue this medication for long term.
I think she should use clonazepam on SOS basis (when there is disturbed sleep and intense anxiety) and not regularly. This will solve the problem of excessive sedation.
If you can please mention what kind of gastric problem she has developed after taking nexito, I would be able to guide you better.
Nexito is good anti-anxiety and anti-depressant drug. It usually does not cause sedation. It can cause diarrhea and gastritis sometimes.
If the gastric problem has started after taking nexito, I do not think levosulpride is the good choice.
The better option would be start with a lower dose of nexito or shift to another anti-depressant (paroxetine or sertraline).
Hope you find my suggestions helpful.
You can duscuss these points with your doctor and proceed accordingly.
Feel free to discuss further. I will be happy to help.
Take care.
Thanks.
modifications in drug treatment needed.
Detailed Answer:
Hello
Welcome to HCM.
I can understand your concerns for your wife.
I have gone through the details thoroughly.
Levosulpride can raise prolactin levels like amisulpride. I would also suggest to not continue this medication for long term.
I think she should use clonazepam on SOS basis (when there is disturbed sleep and intense anxiety) and not regularly. This will solve the problem of excessive sedation.
If you can please mention what kind of gastric problem she has developed after taking nexito, I would be able to guide you better.
Nexito is good anti-anxiety and anti-depressant drug. It usually does not cause sedation. It can cause diarrhea and gastritis sometimes.
If the gastric problem has started after taking nexito, I do not think levosulpride is the good choice.
The better option would be start with a lower dose of nexito or shift to another anti-depressant (paroxetine or sertraline).
Hope you find my suggestions helpful.
You can duscuss these points with your doctor and proceed accordingly.
Feel free to discuss further. I will be happy to help.
Take care.
Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr XXXXXXX
My wife took medicines clonzepam & Nexito for 2-3 days. The original symptoms of anxiety were still there. However, new symptoms of Gas, stomach pain, breathing difficulty & constipation started.
She does not want to take medicines considering their effects and want to treat naturally through changing life style, diet and meditation & exercise etc.
Is it possible to treat yourself naturally or medication is the only route.
Please advise.
Thanks & Regards
ratesh XXXXXXX singla
My wife took medicines clonzepam & Nexito for 2-3 days. The original symptoms of anxiety were still there. However, new symptoms of Gas, stomach pain, breathing difficulty & constipation started.
She does not want to take medicines considering their effects and want to treat naturally through changing life style, diet and meditation & exercise etc.
Is it possible to treat yourself naturally or medication is the only route.
Please advise.
Thanks & Regards
ratesh XXXXXXX singla
Brief Answer:
medications plus lifestyle modifications.
Detailed Answer:
Hello again Mr. XXXX.
Since your wife had relapsed after stopping the previous treatment, I think she should be given medical treatment.
In my opinion, dietary and lifestyle modifications should be a part of every treatment regime. This reduces the requirement of drugs.
If she is having gastric upset and other problems with nexito, I would suggest the use of another antidepressant. Every individual responds differently to each drug.
[I personally prefer to use sertraline (prescription drug) in low doses in such cases. Its just my clinical instinct].
In addition to this, dietary modification like restricting fatty and spicy food intake, eating green leafy vegetables (these are natural mood elevators) must be considered.
Also, meditation and yogic breathing are excellent anxiety controlling methods.
As the anxiety and depression goes away, the drugs can be gradually reduced and meditation and yoga be continued.
Hope this helps.
Feel free to discuss further.
Take care.
Thanks.
medications plus lifestyle modifications.
Detailed Answer:
Hello again Mr. XXXX.
Since your wife had relapsed after stopping the previous treatment, I think she should be given medical treatment.
In my opinion, dietary and lifestyle modifications should be a part of every treatment regime. This reduces the requirement of drugs.
If she is having gastric upset and other problems with nexito, I would suggest the use of another antidepressant. Every individual responds differently to each drug.
[I personally prefer to use sertraline (prescription drug) in low doses in such cases. Its just my clinical instinct].
In addition to this, dietary modification like restricting fatty and spicy food intake, eating green leafy vegetables (these are natural mood elevators) must be considered.
Also, meditation and yogic breathing are excellent anxiety controlling methods.
As the anxiety and depression goes away, the drugs can be gradually reduced and meditation and yoga be continued.
Hope this helps.
Feel free to discuss further.
Take care.
Thanks.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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