Suggest Treatment For Delirium And Acute Confusional State
Most likely the symptoms are not due to delirium or side effect of pacitane
Detailed Answer:
Hello thanks for asking from HCM
I have read your query and I can understand your concern. Coming straight to your doubts.
Your new psychiatrist found that you have anxiety and depression and you should not have been prescribed Sulpitac and Pacitane. Yes, these drugs are usually not the commonly used drugs for anxiety and depression.
Pacitane is an anticholinergic drug and the drug can cause delirium as side effects but that side effect is seen in very high doses or in critically ill patients. It may cause drowsiness, confusion, dizziness, nervousness etc side effects but these side effects are usually short lived and usually reverse after stopping the medicine. You have already stopped taking medicine so I don't think the symptoms of confusion and delirium (?) are occurring due to pacitane.
Then why these are occurring. Anxiety and depression could be possible explanation for these symptoms. In severe anxiety individuals may find it very difficult to focus, inability to concentrate, feels like disoriented and confused. So most probably poorly controlled anxiety is the reason for your symptoms.
These symptoms are probably not delirium because delirium is an emergency and it doesn't runs a long course. These symptoms of confusion are not permanent and will improve with improvement of your anxiety.
You have been prescribed Dapsol (Imipramine) and Clonazepam and these drugs will help in reduction of anxiety. With these drugs you will see improvement in your symptoms and will feel better. No need to worry wait for these drugs to control your symptoms.
Thanks, hope this helps you. Don't hesitate to ask again if you have more doubts.
And also I forgot to mention in the previous thing that pacitane has changed my attitude towards everything, the way I used to treat things, the way I used to think, the way I used to respond to others also changed. Now I have improved a little, but I got used to living like that, as I just said in the previous thing, so that's why I feel confused and delirious. Pacitane even gave me hallucinations and dilutions.
The symptoms of anxiety can be cured
Detailed Answer:
Hello again and thanks for asking a follow up
The abnormal thoughts, poor concentration, poor focus, feeling like sick, thoughts of committing suicide and other symptoms you have mentioned are not due to Pacitane, instead your mind has paired these symptoms of anxiety with pacitane. These are non-remitting symptoms of anxiety only and these symptoms will improve only on improvement of symptoms of anxiety only. As per my opinion Dapsol is a good drug for these symptoms but at high doses it has side effects and there are more efficacious and safe medicines like SSRIs are available. Once your exams are over you can discuss with your doctor to change your drugs to some SSRI medicine which would result in better treatment relief. These symptoms are not permanent.
The feeling that your brain is empty, difficulty in studying, thinking again and again about this etc are due to anxiety. Yes these symptoms can be cured. With proper treatment you will see improvement in these symptoms. Please try to concentrate on your exams right now and consult your doctor for change in prescription after exams.
Thanks
I also keep thinking about my past that I took pacitane and I'm not happy
All this is occurring due to anxiety only
Detailed Answer:
Hello again
Please don't think that Pacitane has made your life worse. You are very young and this would result in development of anxiety only. To some extent you have developed that anxiety. This could be a possibility that at time of prescribing the Sulpitac the doctors have assumed some symptoms of anxiety as psychosis. A lot of symptoms of psychosis and severe anxiety overlap.
You felt better after taking Dapsol and Clonotril because Clonotril helps in reducing anxiety and its symptoms which is the drug that resulted in improvement. Wait for some more time to see effect of Dapsol and you will feel better.
Try to build confidence in you and try relaxation exercises which will keep you healthy and away from anxiety. Everything is in your head, try to improve your focus.
Thanks, hope this helps you. Please ask again for more doubts.
And even when I used to listen to music before starting despol and clonotril, I felt nothing was going into my head because I can't listen properly. I thought it was a problem with my ears, so I got my ears checked, the ear doctor prescribed ear drops but that also didn't help. I still felt my brain was empty while listening to music and that's why I used to hate listening to music. But after starting despol and clonotril, my brain stopped feeling empty, and now I can listen to music properly and I've started enjoying it. It still feels empty once in a while but it's much better than before. So does this mean that I couldn't listen to music properly due to anxiety and depression only? If yes, will it get even better? If no, then what could be the other reasons?
And 1 more doubt... Before I started despol and clonotril I couldn't be myself. I used to try and live other peoples lives. I felt I don't have a life of my own and I used to keep thinking of myself as someone else. Even while studying, I used to think of myself as someone else and I used to feel that I have his brain. Why did that used to happen? After starting despol and clonotril it has improved so does that mean that it was due to anxiety and depression only? If yes, will it get even better? If no, what could be the other reasons?
All these symptoms were due to anxiety and would reduce with time
Detailed Answer:
Hello thanks for asking a follow up question
Coming straight to your answer-
- The problems of jerk like feeling in eyes was most likely due to anxiety because nothing was found on EYE EXAMINATION by a doctor. I have come across a lot of patients who present with eye problems like twitch in eyes or jerks in eyes etc symptoms and they respond to anti-anxiety drugs.
- Yes the problem would reduce completely with your drug therapy. They are good drugs and you will see improvement with time. Try to distract yourself from that jerk like sensation in eyes. Try to reassure yourself again and again that nothing is wrong and all this is due to anxiety only.
- The sensation of emptiness in brain, not able to listen the music, feeling that you cant live life of own, feelings that you are not yourself etc were probably due to anxiety only. These symptoms would reduce with medicines and you will feel better. Just continue to take your drugs properly and visit your psychiatrist as advised.
Thanks, hope this helps. Take care
And 1 more doubt... My psychiatrist said that after my board exams get over, that is on 23rd March, I can stop despol and clonotril. But stopping these drugs will cause a relapse in the symptoms right? So won't I again start feeling that my brain is empty and depressed? Why don't I have to take them for 6 to 8 months, why do I have to only take it for a month till my exam is over?
These drugs are not neurotoxic so no need to worry.
Detailed Answer:
Hello again
Sulpitac is an antipsychotic drug and the drug is known to cause dopamine depletion in BASAL GANGLIA (one area of brain) which results in extra pyramidal side effects. Pacitane prevents these side effects.
The neurone don't die permanently, and no need to fear from that. Once side effects reduce this results in regaining of normal functioning. Intelligence areas are cortical areas and some limbic areas and there is no effects on that area due to that drugs. These drugs modulate the neurotransmitters and are not neurotoxic, so please no need to fear.
Your IQ came normal (instead more than normal) so this also reassures you that you are absolutely healthy.
Stopping the drugs would not result in relapse, reduce the doses of drugs gradually and under proper consultation of your doctor. Proper tapering would prevent any relapse of symptoms. Don't over think and over analyse your symptoms. Try to distract yourself from anxiety. Relax yourself by relaxation exercises. You are absolutely healthy.
It is possible that your symptoms are getting aggravated due to exams and this is the reason your psychiatrist want to reduce doses after exams. Anti anxiety drugs are usually not prescribed for prolonged periods in most cases especially benzodiazepines.
Thanks, hope this assures you.
And will the neuron death in the brain which sulpitac and pacitane caused shorten my lifespan? If no, will anything else happen which will give me trouble later in my life? Will the arrangement of neurons in the brain change, or will the neurons again start living or will they be dead permanently? And sulpitac was causing Parkinsonism. I had trouble walking on my heels, while sitting on a chair I could only sit by keeping my legs crossed, and if I tried to sit without my legs crossed, they would automatically get crossed again, and it was causing a mask like face with no emotions or expressions. All this has gone away now after stopping them so I won't get Parkinson's disease, right?
The effects of drugs are nor permanent.
Detailed Answer:
Hello again
I am not saying that effects of Depsol and Clonotril are permanent but once they are stopped then relapse of symptoms is not usually seen. Anxiety can occur in future also.
Sulpitac, Pacitane and Aripiprazole don't cause neuronal death. As mentioned earlier they cause changes at neurotransmitters levels and effect get reversed once drug is stooped. So no even a rare risk of neurotoxicity or neuronal death.
No these drugs has not caused even a single permanent effects on your brain.
No you won't get Parkinson's disease. The drugs cause Parkinsonian like side effects which improves on taking Pacitane or on stopping the drugs. The effects are not permanent.
Thanks, hope this reassure you. Still have more doubts please ask again.
This is occurring most likely due to aggravation of anxiety due to exams
Detailed Answer:
Hello again
I can understand your problem. The symptoms like dizziness, twitching in eyes and jerking in eyeballs occurring while reading are most likely due to anxiety. Trouble in brain, feeling emptiness, confused thinking etc are also because of anxiety. These are not because of the drugs.
Dapsol is Imipramine and as per my opinion 25 mg dose is not sufficient dose and it should be increased because it is probably not working. Alternatively I would advise you to wait for some more days till the drug start showing its full effects. The doses of the drug Clonotril is very high and increasing the dose of Dapsol or changing the drug would result in control of anxiety and this would also help to reduce the doses of Clonotril.
One more thing, try to distract yourself and don't over thing and overanalyse. Try to concentrate on your exams and don't think about results. Most likely these symptoms occurred because of aggravation of anxiety because of exams and this is a common thing seen in most of students during exams. Try to relax yourself and don't let panic to control your mind. If possible exercise for some time and this will result in reduction of anxiety.
Try to relax yourself, there is nothing serious, you will improve in some time.
Thanks
Take small breaks in between studies
Detailed Answer:
Hello thanks for asking a follow up question
Yes 0.25 mg of dose of Clonazepam is not a high dose and this will help you to reduce anxiety and would not make you drowsy.
For studying I would advise you to to read according to topics and chapters. After finishing a chapter try to take a small break like 10-15 minutes, which can be utilised in listening a light music or playing some game in XXXXXXX This would distract the mind and will increase concentration once you resume your reading. This would also make learning rewarding because you will have a target to listen music or playing game or something like that at the end of chapter. This learning will give best results. Try not to think whether you are retaining or not, continue to read by free mind and after finishing a chapter try to recapitulate the reading. Don't force your brain to retain the things, continue to study without distracting your mind. Don't read continuously for more than a hour and try to take small breaks at regular intervals.
Have good meals, diets rich in proteins and complex carbs and low in fats. This would improve concentration in brain. Try to relax yourself, have a cup of coffee if you feel drowsy. Brain cant become full, this is your mind which is thinking that your brain is full. Try to change your thinking and don't think about this thing again and again.
There is nothing abnormal in your brain, just continue to do your work and you will get good results.
Thanks, hope this helps.
Earlier before that day in October I was feeling continuous of my life but now I feel I'm not.
Please don't overthink, try to concentrate on exams, this is anxiety only
Detailed Answer:
Hello again
I have read the history again and it appears that the symptoms you have mentioned like while reading you think that there are two ways of reading i.e. active and passive, similar thing in listening music points towards two main things as per my opinion one is our main diagnosis anxiety with some symptoms mimicking OC (Obsessive compulsive) symptoms and other is some Psychotic episode.
I want to know few things about the voices you were listening. If the passive and active listening were for any voice like when some one is talking to you or some one in real is talking to some one? or Were you hearing the voice when no one was there and other people could not listen those voices? Were these voices were abusing you or talking to you?
In heightened anxiety individuals may hear abnormal voices or may become sensitive to sounds also. As per my opinion the active passive things related to reading or listening, feelings that your life is not continuous as others are due to anxiety only. Try to relax your self and don't feel bad, with time your anxiety would reduce and you will feel better.
Thanks, hope this helps you. Take care
And I still feel that everyone else in the world has a much better life than mine, because my life is not continuous, and theirs is, and I feel that my end is any moment from now, and they don't feel like that. I still remember all those thoughts of committing suicide and all.
And everyone else was/is not on all these medications and I am.
And I keep thinking of myself as someone else, and when I do that, I feel that that person has a much better life than mine because his life is continuous, which makes me more anxious and depressed. And I keep thinking that before January 2014 I was fine and now I've become abnormal and I want to go back to that time and I don't feel like living only now.
These symptoms are occurring due to anxiety and depression
Detailed Answer:
Hello again, I apologise for late reply because of busy schedule
I have read the details you provided and I can say with more confidence that these symptoms are occurring due to anxiety and have resulted in development of depression. You had complaints of listening voices in abnormal manner which you used to think that you can hear in active and passive manner. The problems like some one is conspiring against you could be occurring due to psychosis but they can also occur in severe anxiety. Feelings that brain is empty which are not up to the levels of unshakable belief as in delusions are most likely the part of anxiety.
It could be occurring due to obsessions as these are repetitive thoughts in your mind which you know that they are purposeless still you cant get rid of these thoughts. Do you think that the thoughts of emptiness in brain are not right and still you cant control them? or You have strong belief that your mind is empty?
To some extent the thoughts that you are reading or listening in passive manner and active manner are also due to anxiety. Though detailed evaluation is needed to ascertain final diagnosis.
Feelings that others have good life as compared to you could be due to depressive symptoms, and this can occur due to anxiety. Aggravation of symptoms with exams or stress, presence of insight for illness also strengthens the diagnosis of anxiety. As we discussed earlier also that twitching of eyes, difficulty in reading etc symptoms were certain symptoms of anxiety only.
Try to relax yourself and reassure yourself that this is anxiety only and nothing serious. Take your exams with confidence and then visit your psychiatrist again and get yourself evaluated again. As per my opinion as symptoms are persisting so there is need to increase the dose of Dapsol or to replace the drug with some SSRI drug like Fluoxetine which would control the symptoms of anxiety more effectively and you will feel better.
Thanks, hope this relaxes you to some extent. TAKE CARE
and those bullies were also telling me that I look very ugly, because I was very good looking, and was very healthy, and they were jealous of me, so I actually started thinking that I look ugly. And in February and March 2014 I started watching and doing inappropriate things on the internet, because that was the only way in which I could relieve my depression.
And those voices which I used to hear, were apparently from them and I felt that they were abusing me, although now I've stopped hearing them because of dispol and clonotril.
And I also used to feel that the world is going to come to an end, but now I get that feeling a little less.
And I thought that watching my favorite sport, going to the gym, listening to music, playing music would help me to study but it is not, and that twitching of eyeballs keeps happening because of that bullying, and I keep thinking about it.
And I've started thinking now that there are 2 ways of reading (not active and passive) - one without jerking of eyes while going to the next line, and the other way is with jerking of eyes while going to the next line, and I read in the second way, that is, with jerking of eyes while going to the next line. What do I do about this also? Are there 2 ways of reading? And I'm also trying to read aloud.
And I also feel that there are 2 ways of living, one way is by your life being continuous and not feeling that you're going to die any moment, and the other way is that by your life being not continuous, and feeling that your end is going to be any moment, and I feel I live the second way. I feel that my end is any moment from now, because I'm anxious, but I still feel that my life is not continuous.
All these thoughts are distracting you from studies
Detailed Answer:
Thanks for writing back and asking a follow up question
One thing I would like to know- Who were bullying you? Are those people belong to your school or some outside people or those were people you don't know? Whether you were hearing their voices when these people were not around? Whether you were aware of the thing that you are hearing voices were not real?
Currently the feeling you are having that you would not be happy after exams is probably due to heightened anxiety due to all these exams and stress. Once exams are over you will feel better and also complete.
Bullying during school times may affect some individuals but this doesnt mean that everyone develop personality issues. This doesnt mean that you have to live with depression through the life. If you want to read then check the details about depression, most of individuals with depressive symptoms and anxiety improve with time and they also lead normal life. Their life remain same as the life of others.
Don't think about future, your present aim should be to pass the exams and to get good marks. You are an intelligent person and don't loose your confidence. Try to remain calm and you will pass that bad phase of life.
Don't feel like helpless. Try to remain calm. The bad thoughts you are having will go and will not remain persistent. Don't think about those bullies, you are getting distracted because of significant stress of exam only. You will feel better after exams.
The feelings like two ways of living or two ways of hearing voices or two ways of reading etc appears due to heightened anxiety and obsessive thickenings. Visit your psychiatrist again for reevaluation after exams and ask for proper SSRI drugs for your treatment. Talk to your parents about any stressing thought that comes into your mind.
Thanks
And when I am studying, should I think that while I am reading I am gaining more knowledge and my mind is becoming fuller? Or I should think that I have to study to pass the exam? If nine of these, what should I think? And when I am talking to someone, or I am with someone else and not alone, or I think of someone, should I think that I have their life or try to put myself in their place and then think how they are feeling? If no, then what should I do?
Don't let these thoughts to control your mind
Detailed Answer:
Hello again
Try to avoid all these thinkings while talking to someone. Don't feel that you are inferior to someone. You have to come out of these bad feelings. There is nothing like that you are incomplete and others are complete. Distract your mind, exercise daily. After your exams take help of a Psychologist for Behaviour Therapy, which would teach you to stop these unwanted intrusive thoughts.
Some features you have mentioned denote psychotic symptoms like hearing voices when some one was not there, but presence of these voices while in fear and response to anti anxiety drugs make anxiety as more likely possibility. Still there is need for evaluation by a psychiatrist again to make the diagnosis confirmed.
You should not think that there are two different things. Try to think away from this, don't think about these things that there are complete and incomplete things.
Studies are different things and these answers are different.
No these answers will not make your mind full, free your mind and don't let these things control your mind. Don't think about control or not control, or complete or incomplete. Do nothing, just study hard and pass your exams.
Thanks