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Suggest Treatment For Severe Anxiety And Depression

Posted on Wed, 22 Mar 2017

Question: I have been suffering from anxiety depression and have been prescribed below medicines from last 8 months. I am feeling much better now and would like to gradually stop these medicines. What is the best way to taper the dosage before completely stopping them to avoid withdrawal symptoms.
Blonanserin 2mg
Desvenlafaxine Succinate 50mg

Answered by Dr. Dr. Ashok Kumar Choudhary (17 minutes later)

Brief Answer:
Please provide more details

Detailed Answer:
Dear XXXXXXX
Thanks for using Healthcaremagic.

I read your query and understand your concerns.

The decision to withdraw medications depends on the nature of illness and response till date.

I request you to provide following details.

Duration of problem?
Symptoms which you faced- Please provide details them in chronological order
Time lapsed between start of treatment and complete response
Duration of current response on this day
Doctors prescription and other details- if possible
Do you have the family history of similar illness?
If yes details and response and name of medications?

I look forward to get above details to answer you appropriately.
Thanks and regards.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Dr. Ashok Kumar Choudhary (11 hours later)

Thanks for your prompt response.

Please see my comments below -

Duration of the problem - 1 year and 4months including the duration of the treatment (8months)

Symptoms faced -

Impatient – Just want to get everything done in haste and get frustrated if made it wait anywhere. Be it a queue, traffic jam, etc. I have no patience to listen to anyone or read something.

Nervous – Even if small issues arise due to life, family matters, work or business straight away get anxious and nervous and then make uncalculated and hasty decisions.

Lack of Focus – Get very easily distracted and lose focus.

Loss of interest – Things which used to excite me and I could spend hours with them as boring and don’t care about it. I have lost passion for nearly everything I enjoyed like technology, gadgets, playing cricket, etc.

Feel restless – Most of the time I feel bored and restless.

Time lapsed between start of treatment and complete response - Approx. 6 months

Duration of current response on this day - Sorry I didn't understand this question.

Do you have the family history of similar illness? - No.

Do you have the family history of similar illness? - No

I have overcome most of the symptoms and slowly wish to move off these medicines and just need to understand the process of tapering the dosage to avoid any withdrawal symptoms.

Thanks, Akshay

Answered by Dr. Dr. Ashok Kumar Choudhary (4 hours later)

Brief Answer:
Follow up

Detailed Answer:
Dear XXXXXXX
Thanks for reverting back to me with valuable information.

From the available description I am of the opinion that we can reduce single medication at a time and blonanserin should be the first one.

It is never advisable to be in haste and I will recommend you to go down 0.5 mg every two weeks which is as follows

Week 1
Blonanserin 2 mg tablet 3/4

Week 3
Blonanserin 2 mg tablet 1/2

Week 5
Blonanserin 2 mg tablet 1/4

Week 7 stop

In these next two months take note of every changes in your body and report them to your doctor/me. In case you feel something wrong shift immediately to earlier dose.

The experience during the two months of blonanserin withdrawal make the ground for desvenlafaxine.

I hope this assists you.
If you have more questions I will be glad to assist you further.
If you do not have more questions, please close the discussion and if possible rate the answer for my future patients.

In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Ashok Kumar Choudhary (37 minutes later)

Thanks for your prompt response.

However, I have 2mg pill which I can cut it in half it but 3/4th and 1/4th Dose will be difficult. So can I go half straightaway and for what duration?

If all goes well, after two months how do I taper the dosage for Desvenlafaxine 50mg ? Can you let me know so that I can plan it all in advance.

Thanks Akshay

Answered by Dr. Dr. Ashok Kumar Choudhary (40 minutes later)

Brief Answer:
Follow up

Detailed Answer:
Dear XXXXXXX
Thanks for follow up.

I do not think you should go straight away to half tablet of blonanserin despite the fact that it is difficult to break.

Regarding the desvenlafaxine it all depends on the response you get during withdrawal of blonanserin. I do not think it should be in hasty manner.

I hope this clarifies.
Thanks and regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Ashok Kumar Choudhary (5 hours later)

Ok thanks. One last thing for now, I have put on considerable amount of weight after taking this medication. Is there anything you can suggest to control the weight gain? Also, kAfter stopping these medications, will I automatically lose the gained weight or i need to take help of a dietician to reduce it ?

Answered by Dr. Dr. Ashok Kumar Choudhary (52 minutes later)

Brief Answer:
Follow up

Detailed Answer:
Dear XXXXXXX
Thanks for reverting back to me.

The golden rule for reverting back to earlier weight after weight gain is right mix of physical exercise and balanced diet with decreased calories.

There is chance that some amount of weight you can lose after discontinuation of medication but it is almost never without efforts. Help from dietician with right amount of physical exercise can help you in reducing weight.

I hope this helps you further.
Thanks and regards.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar