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Suggest Treatment For Weight Loss, Acute Anxiety And Sleeplessness After Increasing Lexapro Dosage
Question: have been on seroxat x 14 yrs maintained on 10mgs - relapses meds increased to 20 or even 30mgs & when stabilised decreased gradually to 10mgs. Last February had a relapse but when GP increased meds gradualy to 40mgs no improvement, fatigue, severe anxiety, etc. was referred to psychiatry team who gradually stopped seroxat & commenced on Mirap 7.5 then 15 & then 30mgs with increased anxiety, restlessness, pacing. when reported this to psychiatry they decided to change to Lexapro, commenced on Lexapro 5 x 1 month then increased to 10mgs x 1 month with terrible side effects, weight loss, acute anxiety, sleeplessness, reported same to psychiatry team who decided to try Mirap again 3.75 x 4 days then 7.5 x 8 days then 15mgs which I am due to start tomorrow, same side effects recurred on 7.5mgs - restlessness, burning sensation in legs/feet, jerking in sleep, pacing- reluctant to commence 15mgs & that this stage would happily go back to Seroxat (never thought I would say that), have tried CBT/Hypnosis but so agigated/exhausted did not get any improveme
nt with same. Have great support but am very frustrated that no improvement in symptoms in fact much worse,this episode of depression I feel was triggered by a bereavement over a year ago. At this stage have little faith in psychiatric team as up until this had been managed quite well by GP with relapses every 3/4 years. Would appreciate any advice you can offer - XXXXXXX
nt with same. Have great support but am very frustrated that no improvement in symptoms in fact much worse,this episode of depression I feel was triggered by a bereavement over a year ago. At this stage have little faith in psychiatric team as up until this had been managed quite well by GP with relapses every 3/4 years. Would appreciate any advice you can offer - XXXXXXX
Brief Answer:
Consultation
Detailed Answer:
Hello, and thanks for your question.
You have tried paroxetine, escitalopram, and mirtazapine, all with different problems or ineffectiveness. I would try a different class of antidepressant medication altogether -- a TCA such as nortriptyline. I'd ask your doctor about their thoughts about starting this. It is also important to keep in mind that complicated grief such as you are experiencing does not typically respond well to medications, but it does respond well to intensive 6 month or longer psychotherapy. Consider this as another option.
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers
Consultation
Detailed Answer:
Hello, and thanks for your question.
You have tried paroxetine, escitalopram, and mirtazapine, all with different problems or ineffectiveness. I would try a different class of antidepressant medication altogether -- a TCA such as nortriptyline. I'd ask your doctor about their thoughts about starting this. It is also important to keep in mind that complicated grief such as you are experiencing does not typically respond well to medications, but it does respond well to intensive 6 month or longer psychotherapy. Consider this as another option.
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers
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Above answer was peer-reviewed by :
Dr. Nagamani Ng
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