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Suggest Treatment For Depression And Anxiety
Question: I have been treated for major depression since my dad died. I was taking 40 mg of Paxil, 1mg Clonazepam and 50 mg of trazadone. I took all this medication at night. The medications seemed to quit working. I tried Prozak for depression but it didn't work with my anxiety. Now my doctor has me taking Amytriptilene and Lamotrigine in addition to the Clonazepam and Trazadone. I still have anxiety that keeps me from working
Brief Answer:
Try venlafaxine rather than lamotrigine
Detailed Answer:
Hi
Thanks for using healthcare magic. I, Dr Abhishek Kapoor, would help you in this query.
In your case, i would suggest venlafaxine rather than lamotrigine. Lamotrigine is a mood stabilizer and help to control mood swings. If you do not have any history of manic episode, then it would not give you good result. Among antidepressant, venlafaxine is very effective in depressive and anxiety disorder. Being a different antidepressant's group i.e. SNRIs, it would show good result with paxil and trazodone. You can carry on with clonazepam with it. Rest, you can discuss with your psychiatrist.
In case, you need further help, you can ask.
Regards
Dr. Abhishek Kapoor
Psychiatrist
Try venlafaxine rather than lamotrigine
Detailed Answer:
Hi
Thanks for using healthcare magic. I, Dr Abhishek Kapoor, would help you in this query.
In your case, i would suggest venlafaxine rather than lamotrigine. Lamotrigine is a mood stabilizer and help to control mood swings. If you do not have any history of manic episode, then it would not give you good result. Among antidepressant, venlafaxine is very effective in depressive and anxiety disorder. Being a different antidepressant's group i.e. SNRIs, it would show good result with paxil and trazodone. You can carry on with clonazepam with it. Rest, you can discuss with your psychiatrist.
In case, you need further help, you can ask.
Regards
Dr. Abhishek Kapoor
Psychiatrist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
If you were treating a patient with major depression disorder. If you didn't know my history what would you prescribe? The paxil, clonazepam and traxadone were working fine for several years. All of a sudden I started having a lot of anxiety keeping me from working. A doctor put me on Prozak. So I was taking Prozak, Clonazepam and traxadone and I was still anxious while working. Then we tried a beta blocker for anxiety. It did help the anxiety but not the depression. Then my doctor gave me the elavil and the lamotrigine along with the clonazepam and traxadone. I will just be honest. The medicine I take at night makes me so drowsy and I have been taking phenteramine in the morning. Only 18 mg.
I seriously need some help here. My doctor wanted me to take the lamotrigine 3 times a day; building up to 100 mg. That would be two in the morning, two at night, and two in the evening. After my noon dose my lips and mouth would get all swollen like it was an allergic reaction. I am really scared; I am afraid I will lose my job. My psychiatrist is 100 miles away and I need help now. Please this is have here at my house. And I am not overmedicating myself. For depression would you take Elivil or Prozac. For anxiety and sleep; is allright to take the clonazepam and traxadone? The beta blocker really helps with the anxiety. I can't be nervous at my job because they push us to be faster, faster, faster. I took the Prozac for about 2 weeks. And I have been on the Elavil for exactly one week. Please give me an answer today because I have missed too much work already.
I seriously need some help here. My doctor wanted me to take the lamotrigine 3 times a day; building up to 100 mg. That would be two in the morning, two at night, and two in the evening. After my noon dose my lips and mouth would get all swollen like it was an allergic reaction. I am really scared; I am afraid I will lose my job. My psychiatrist is 100 miles away and I need help now. Please this is have here at my house. And I am not overmedicating myself. For depression would you take Elivil or Prozac. For anxiety and sleep; is allright to take the clonazepam and traxadone? The beta blocker really helps with the anxiety. I can't be nervous at my job because they push us to be faster, faster, faster. I took the Prozac for about 2 weeks. And I have been on the Elavil for exactly one week. Please give me an answer today because I have missed too much work already.
Also I would like to add that while taking the elavil and lamotrigine I started having major confusion. I did look up on the internet that elavil and traxadone may have bad side effects. I really do appreciate you answering my questions. Do to the stigma about mental illness I can't visit my local doctors. I go to one about 100 miles away. When I started getting the mental confusion I called him and he never got back to me. Once again I am not abusing my medicine. I just want to feel normal like the paxil, clonazepam and traxadone use to make me feel. Also if I watch the caffeine at night I can get by with 1/2 traxadone which is 50 mg. The beta blocker really stops the anxiety but should it cause mental confusion? Either way I can't miss anymore work. I can't take clonazepam in the day because it makes me sleepy. Just wanted to let you know I can't take venlafaxine. I had a bad reaction to it before. I'm just wondering if in an anti deppresant; do I need to stick with the same class of drugs. At this point if I keep taking the clonazepam, traxadone, beta blockers; should I take the elavil or prozak, since I used to take Paxil. I am just trying to get by this week so I don't have to miss anymore work. Please help me
Brief Answer:
You can avoid lamotrigine
Detailed Answer:
Hi
If you can not take venlafaxine, then i can try to maintain you with same drug combination. If you were my patient, you could have come under my follow up, i would have preferred this combination:
In antidepressant, you can take paxil, elavil and trazodone. Take paxil 40mg in divided doses, elavil 25mg with trazodone at night. It would help you to avoid or decrease night dose of clonazepam due to sedative effect of elavil and trazodone. In morning and afternoon, you can take low dose beta blocker and clonazepam. That would help to control underline anxiety. You can also try relaxation exercise like JPMR or deep breathing exercise, that would keep you calm.
I mean to say tablet Paxil 20mg BD, Tab Trazodone 50mg HS, Tab Elavil 25mg HS, Tab Propranalol 10 mg one at morning time and one at afternoon, Tab Clonazepam 0.5mg sos. You can also do JPMR
In your case, i would not suggest lamotrigine. It has serious dermatological side effects. Better to reduce the dose 12.5mg per week. Rest, you can discuss with your psychiatrist.
In case, you need further help, you can ask.
Regards
Dr. Abhishek Kapoor
Psychiatrist
You can avoid lamotrigine
Detailed Answer:
Hi
If you can not take venlafaxine, then i can try to maintain you with same drug combination. If you were my patient, you could have come under my follow up, i would have preferred this combination:
In antidepressant, you can take paxil, elavil and trazodone. Take paxil 40mg in divided doses, elavil 25mg with trazodone at night. It would help you to avoid or decrease night dose of clonazepam due to sedative effect of elavil and trazodone. In morning and afternoon, you can take low dose beta blocker and clonazepam. That would help to control underline anxiety. You can also try relaxation exercise like JPMR or deep breathing exercise, that would keep you calm.
I mean to say tablet Paxil 20mg BD, Tab Trazodone 50mg HS, Tab Elavil 25mg HS, Tab Propranalol 10 mg one at morning time and one at afternoon, Tab Clonazepam 0.5mg sos. You can also do JPMR
In your case, i would not suggest lamotrigine. It has serious dermatological side effects. Better to reduce the dose 12.5mg per week. Rest, you can discuss with your psychiatrist.
In case, you need further help, you can ask.
Regards
Dr. Abhishek Kapoor
Psychiatrist
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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