Hello,

Can u please clarify the reason why you were started on these medication? And have you had any similar episodes in the past?

Regards,
Dr. Jonas Sundarakumar

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Hello Mr. XXXXXXX

Thanks for your clarifications.

From the analysis of your problems, you seem to be suffering from a depressive disorder (and anxiety symptoms very often co-exist with depression). The medication which you had been taking most recently are both anti-depressants. Xet CR (Paroxetine) is an SSRI anti-depressant and Bupron (Bupropion) is an NDRI anti-depressant. Bupropion, in addition to being an anti-depressant, is also used in the treatment of smoking addiction.

The prescription which you have attached also contains three other medication - Liofen XL (Baclofen), Ativan (Lorazepam) and Benfage Forte (Benfothiamine) - all of which are used in the treatment of alcohol dependence.

Now, the symptoms which you are currently experiencing i.e. after stopping the anti-depressant medication are most likely due to the withdrawal effects of the medication. If anti-depressants are abruptly stopped after taking them for a while, this can result in withdrawal symptoms like headache, sleep problems, nausea, vomiting, tremors, rebound anxiety and sometimes even rebound depression. Since you were on two anti-depressants and 300mg of Bupron was a high dose, this is the reason for the severe symptoms.

So, in this scenario, the best option would be to restart the medication. Even if a decision is made to stop the medication, this has to be done only after gradually reducing the dose over a period of 2 - 3 months.

I would also like to let you know that unfortunately, depression is a relapsing illness i.e. it can reccur again. You have mentioned in your past history that you have already suffered from multiple relapses.

If you are totally not in favour of taking any medication, then you can try psychological therapies. There are specific psychotherapies for depression, such as Cognitive Behavioural Therapy (CBT) which are found to be as effective as medication for mild to moderate depression.

Right now, if you are not able to get the same medication, then you can see a doctor and get some alternative medication which can help you tide over this phase. You can also take some over-the-counter medication like Pantoprazole for the stomach ache and gastric symptoms. I would also suggest that you drink plenty of fluids, take adequate rest and avoid physical and mental stress, as much as possible. And, it goes without saying, avoid alcohol and tobacco, as it can worsen your anxiety and depression.

Wish you all the best.

Regards,
Dr. Jonas Sundarakumar
Consultant Psychiatrist

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