Brief Answer:
Further details required

Detailed Answer:
Hello,
Thanks for choosing health care magic for posting your query.
I have gone through your question in detail and I can understand what you are going through.
However I would like to know a few more details like what are your problems/symptoms and how are you feeling and thinking and behaving these days? Further let me know whether you are interested in routine tings in life and find pleasure in what you are doing? Any ideas of hopelessness/worthlessness? Any thoughts of self harm? Do you use any drugs of abuse?
And finally are you on any treatment?
Hope to hear from you at your convinience,
Kind regards
Dr. Srikanth Reddy MD
Psychiatrist

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Brief Answer:
Depression it is

Detailed Answer:
Hello,
Thanks for choosing health care magic for posting your query.
I have gone through your question in detail and I can understand what you are going through.
From what you have stated it is quite clear that you are having a depressive episode. Depression can occur with regular stress and it can also occur biologically without any stress as well. You need proper treatment for the same. There are various effective therapies for depression like fluoxetine, venlafaxine, bupropion, mirtazapine or escitalopram and they are all very effective and mostly safe. You may also require some benzodiazepines like clonazepam or lorazepam for a short period like 2-3 weeks to reduce the anxiety and help with your sleep.
If you are averse to the drug therapies then there is also an option of cognitive behavioural therapy. This therapy is taken by either a psychologist or a psychiatrist in which the therapist identifies impaired cognitions (Thoughts) and try to correct them. They are 15-20 min weekly session and there should be around 8-10 sessions to help you with your illness.

Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
bit.ly/dr-srikanth-reddy
                                                                                                                                                                                                                                                                                                                                               
Wish you good health,
Kind regards
Dr. Srikanth Reddy M.D.

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Brief Answer:
Yes effexor dose can be increased

Detailed Answer:
Hello
Thanks for the follow-up question.
The medicines which you are on are good medicines and you are being treated for bipolar depression (resistant). You are also right in believing that effexor dose can be increased. At present you are on 150 mg/day and the same can be increased to either 225mg/day - 300mg/day, depending on the response. Themaximum dose of effexor is 375mg/day.
Also it would be wise to evaluate for thyroid profile as hypothyroidism can present with resistant depression.
Hope this helps,
Wishing you a great health,
Kind regards
Dr. Srikanth Reddy MD

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Brief Answer:
Increase in venlafaxine dose will help

Detailed Answer:
Hello
Thanks for the follow-up.
Yes, increase in the dose of venlafaxine will help if its depression.
However the notes of the doctor suggest that there are bizzare thoughts, mood swings and poor array of thinking which mostly goes in the favour of psychosis. Along with venlafaxine it would be wise to start with olazapine or risperidone as well.
Kind regards
Dr. Srikanth Reddy MD

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Brief Answer:
Clarifications

Detailed Answer:
Hello
I am very sorry but I am not able to understand what you want to ask.
Especially I feel that the word "Tocefla Drugs" is a typographical error.
Would you mind re-writing your question and also try to rephrase it , so that I can understand it in the best manner.
Thanks
Dr. Srikanth Reddy

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Brief Answer:
Consult your treating doctor

Detailed Answer:
Hello,
Thanks for the follow up.
Health care magic being an online forum it may not be possible to prescribe you without physicallh examining you. Moreover online prescriptions are not considered valid in most of the countries. You will require a prescription from a local doctor.
Hope this helps..
Kind regards
Dr. Srikanth Reddy MD

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