Brief Answer:
diazepam is not banned by government, quetiapine causes constipation

Detailed Answer:
Hello,

Thanks for writing again.

Diazepam is benzodiazepine drug and it is time tested drug. There is no major side effect. It may cause sedation and one must not use before driving a vehicle or using heavy machinery. In long run (after use of 150 to 20 years) it may cause some cognitive impairment. Constipation is not a side effect of it rather it is very common side effect of quetiapine.

Diazepam is rather an essential drug and available at most of the government hospitals so it cannot be banned. But yes it is a strict prescription drug and it must be used as per doctor's prescription (preferably psychiatrist's prescription)and advise to prevent abuse.

Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.

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Brief Answer:
quetiapine 300 mg per day is fine

Detailed Answer:
Hi,

Thanks for questions.

Lorazepam and clonazepam more or less same from effectiveness point of view. main difference is half life. Lorazepam has short half-life and clonazepam has long. 1 mg lorazepam is equivalent to 0.25 mg clonazepam. If you want less frequent dosing and good anti-anxiety effect without sedation clonazepam is better option in long run.

Maximum recommended dose of quetiapine is 800 mg. SR preparation helps to maintain constant drug level in body and avoid side effects of sedation and dizziness otherwise effectiveness of plain and SR preparations are same. Weight gain can be prevented by proper eating habits and exercise. If you are feeling better with 300 mg, you should continue in same dose.

Feel free to discuss further.

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Brief Answer:
yes you got it right

Detailed Answer:
Hello,

Yes you got it absolutely right. If you are stable on these doses you should continue the same for 6 months and later on diazepam can be reduced.

In future if you wish you can contact me directly on this site with following link:
http://bit.ly/drchintansolanki

by clicking on 'Ask me a question' on same page with three follow up questions.

All the best and take care.

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Brief Answer:
lamotrigine will not help in sleep

Detailed Answer:
XXXX,

Thanks for follow up.

Plain preparation will release the drug in blood instantly so there will be peak level of drug faster and drug will cause more sedation. In SR preparation drug is released slowly in blood slow there will be no acute peak level and drug will not cause sedation. So if someone wants sedation plain preparation of quetiapine is useful and when sedation is to be avoided SR preparation is used. That is why in your case plain preparation is useful for good sleep.
Lamotrigine can help as mood stabilizer but it will not give sedation so it is better to take quetiapine.


Regards,

Dr.Chintan Solanki.

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Brief Answer:
for diagnosis detail history and mental status examination are needed

Detailed Answer:
Hello Sir,

Thanks for asking your doubts.

First of all I want to mentioned that to clarify your diagnosis I need detail history form you as well as from close relatives and mental status examination personally.

Depression can be part of bipolar disorder. However, anxiety and sleep problem can be disorder itself or symptoms of bipolar disorder. Quetiapine is used in all mentioned disorder so it is difficult to say from that also that which disorder you have.

All disorders you mentioned has nothing to do with intelligence. However considering your achievements you should have bipolar disorder type 2.

Common side effects of your medicines:(with % of the patients usually suffer from)

Quetiapine:

Dizziness (1-18%)

Fatigue (3-14%)

Extrapyramidal symptoms (1-13%)

Increased diastolic blood pressure (41%)

Increased triglycerides (8-22%)

Increased total cholesterol (7-18%)

Increased appetite (2-12%)

Constipation (6-11%)

Dry mouth (9-44%)

Headache (7-21)

Somnolence (18-57%)


Clonazepam and diazepam:

Abnormal coordination (5-10%)

Ataxia (5-10%)

Depression (5-10%)

Dizziness (5-10%)

Fatigue (5-10%)

Memory impairment (5-10%)

Upper respiratory infection (5-10%)

Confusion (1-5%)

Dysarthria (1-5%)

Rhinitis (1-5%)

Coughing (1-5%)

Urinary frequency (1-5%)

Impotence (1-5%)

Decreased libido (1-5%).

Clonazepam and diazepam more or less are the same type of drug.

You might have developed tolerance to clonazepam but switching to other drug or reducing the dose may help to fight the tolerance.

Feel free to discuss further.

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Brief Answer:
no need of rozucor according to me

Detailed Answer:
Hello,

Sorry for delayed response.

You are physically absolutely fit and seems fit mentally also. You are living healthy lifestyles and considering all parameters there is no need of taking rozucor.

You can increase dose of quetiapine to 400 mg and add zolpidem to stop diazepam and clonazepam. However first of all you should try to reduce dose of clonazepam 0.25 mg every week and after stopping it try to reduce diazepam 2.5 mg every week.

Simultaneously try to follow some measures called 'sleep hygiene' which would help in sleep. You can find the same in below link.

sleepfoundation.org/ask-the-expert/sleep-hygiene

Drinking a cup of warm milk before going to bed helps in 30-40% of patients and they do not need medicines as per my clinical experience.

While reducing dose of benzodiazepine if you feel sleep disturbance you can increase the dose of quetiapine and later on can add zolpidem.

If you can continue healthy lifestyle, you can take quetiapine without any problem.

Hope this answer will help.

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