
Good Evening Doctor - I Have Made Amitryn 310 From

duolextine 60, betacap tr 40 in the morning
what tweaking in my medicine will help me to sleep better. And how long should i be on 310 amitryn before further increasing it. Pls help

duolextine 60, betacap tr 40 in the morning
what tweaking in my medicine will help me to sleep better. And how long should i be on 310 amitryn before further increasing it. Pls help
Quetiapine can be increased
Detailed Answer:
Hello again
Please don’t increase the dose of Amitriptyline now. This could increase the side effects and will not add to therapeutic benefit.
For improvement of sleep one option that can be tried is to increase the dose of Quetiapine to 150 mg in SR form. This will help in maintaining the sleep and will prevent night time awakening.
High dose of Amitriptyline could be resulting in anti-cholinergic side effects which could be resulting in urinary hesitancy.
Drink plenty of water to stay hydrated and this will also help you in improving urine stream.
Thanks

Quetiapine can be increased
Detailed Answer:
Hello again
Please don’t increase the dose of Amitriptyline now. This could increase the side effects and will not add to therapeutic benefit.
For improvement of sleep one option that can be tried is to increase the dose of Quetiapine to 150 mg in SR form. This will help in maintaining the sleep and will prevent night time awakening.
High dose of Amitriptyline could be resulting in anti-cholinergic side effects which could be resulting in urinary hesitancy.
Drink plenty of water to stay hydrated and this will also help you in improving urine stream.
Thanks



Mirtazapine in low dose helps in sleep.
Detailed Answer:
Hello again
Yes we discussed about this earlier too. Mirtazapine in lower doses helps in providing good sleep. Doses more than 30 mg doesn't help much in sleep. Dose of 15 mg is best for sleep.
If you are adding Quetiapine then you can add SR form which will help in refreshing long sleep.
Thanks.

Mirtazapine in low dose helps in sleep.
Detailed Answer:
Hello again
Yes we discussed about this earlier too. Mirtazapine in lower doses helps in providing good sleep. Doses more than 30 mg doesn't help much in sleep. Dose of 15 mg is best for sleep.
If you are adding Quetiapine then you can add SR form which will help in refreshing long sleep.
Thanks.


Also, in one of your advises earlier, you had mentioned that amitryn can be increased to 325 (am on 310), if residual anxiety is bothering me, do you think i can make it 325 to get over it? if yes, after how long?
Stopping quitipin 100 cold turkey and starting 150 sr, will have any withdrawal effects as 150 sr make take time to show effect? Also, do you think adding quitipin 25sr or 50 sr along with 100 plain can be a option? or else if have to switch to 150 sr from 100 plain, how do i do that?
My latest medication is as under :
Amitryn 310, quitipin 100, mirtaz 30+1/2 of 7.5 all in the night
Duolextine 60, betacap tr 20 all in the morning
Looking at my prescription and also keeping in my mind my residual anxiety, what would your revised prescription be?
I am also keen to consult you over the phone or may be through a video call, pls let me know how do i do that? Thank you

Also, in one of your advises earlier, you had mentioned that amitryn can be increased to 325 (am on 310), if residual anxiety is bothering me, do you think i can make it 325 to get over it? if yes, after how long?
Stopping quitipin 100 cold turkey and starting 150 sr, will have any withdrawal effects as 150 sr make take time to show effect? Also, do you think adding quitipin 25sr or 50 sr along with 100 plain can be a option? or else if have to switch to 150 sr from 100 plain, how do i do that?
My latest medication is as under :
Amitryn 310, quitipin 100, mirtaz 30+1/2 of 7.5 all in the night
Duolextine 60, betacap tr 20 all in the morning
Looking at my prescription and also keeping in my mind my residual anxiety, what would your revised prescription be?
I am also keen to consult you over the phone or may be through a video call, pls let me know how do i do that? Thank you
Mirtazapine can be reduced to 15-30
Detailed Answer:
Hello again
Try to make Mirtazapine in 15-30 mg dose. This will help in making sleep better without compromising its effects on anxiety and depression.
There are no significant drug interactions between Amitriptyline and Mirtazapine.
You can reach to 325 mg after a week but as mentioned earlier this might increase side effects like urinary retention or sexual side effects. This can have some effects on anxiety.
You can stop 100 mg plain cold turkey and can shift to 150 SR with no worries.
You can reduce Mirtaz to 15 in coming weeks, make Quetiapine to 150 mg and rest medicines should be same.
You can call HCM customer care for a call.
Thanks

Mirtazapine can be reduced to 15-30
Detailed Answer:
Hello again
Try to make Mirtazapine in 15-30 mg dose. This will help in making sleep better without compromising its effects on anxiety and depression.
There are no significant drug interactions between Amitriptyline and Mirtazapine.
You can reach to 325 mg after a week but as mentioned earlier this might increase side effects like urinary retention or sexual side effects. This can have some effects on anxiety.
You can stop 100 mg plain cold turkey and can shift to 150 SR with no worries.
You can reduce Mirtaz to 15 in coming weeks, make Quetiapine to 150 mg and rest medicines should be same.
You can call HCM customer care for a call.
Thanks


I made mirtaz 30+(1/2) 7.5 on 16th XXXXXXX along with other medicines remaining the same i.e. amitryn 310, quitipin 100 in the night and duolextine 60 and betacap tr 40 in the morning.
After making this change, i am feeling better (yesterday and today) in terms of anxiety. is it that reduced dose of mirtaz along with other night medicines (especially amitryn) is helping me or you think amiyrn 310 from 300 is helping me? I am little confused, as i dont know whether to reduce mirtaz further or to increase amitryn further for me to completely feel better?

I made mirtaz 30+(1/2) 7.5 on 16th XXXXXXX along with other medicines remaining the same i.e. amitryn 310, quitipin 100 in the night and duolextine 60 and betacap tr 40 in the morning.
After making this change, i am feeling better (yesterday and today) in terms of anxiety. is it that reduced dose of mirtaz along with other night medicines (especially amitryn) is helping me or you think amiyrn 310 from 300 is helping me? I am little confused, as i dont know whether to reduce mirtaz further or to increase amitryn further for me to completely feel better?
Please reduce the dose of Mirtazapine
Detailed Answer:
Hello again
Most likely slight reduction of dose of Mirtazapine resulted in somewhat better sleep and this resulted in improvement of anxiety.
You should further reduce the dose of Mirtazapine and this will help you. As of now don’t increase the dose of Amitriptyline. This will help to reduce residual anxiety.
Thanks

Please reduce the dose of Mirtazapine
Detailed Answer:
Hello again
Most likely slight reduction of dose of Mirtazapine resulted in somewhat better sleep and this resulted in improvement of anxiety.
You should further reduce the dose of Mirtazapine and this will help you. As of now don’t increase the dose of Amitriptyline. This will help to reduce residual anxiety.
Thanks


Made following changes : mirtaz 30 from 30+1/2 of 7.5, amitryn 310, quitipin 100 plain and 50 sr...in the night
Duolextine 60, betacap tr 20... in the morning
Still woke up in between but sleep was sound and felt better in the morning, anxiety is also better. Just that after waking up, there were still nagging thoughts about the meeting on Monday. Do you think is there any other tweaking I should do to get over these morning nagging thoughts? But overall, feeling much better.
Any change you suggest for today or I should stick to this combo of medicines for sometime.
Also, can I request that i routinely would like to consult you apart from HCM and icliniq as I am more comfortable with you? Pls advise

Made following changes : mirtaz 30 from 30+1/2 of 7.5, amitryn 310, quitipin 100 plain and 50 sr...in the night
Duolextine 60, betacap tr 20... in the morning
Still woke up in between but sleep was sound and felt better in the morning, anxiety is also better. Just that after waking up, there were still nagging thoughts about the meeting on Monday. Do you think is there any other tweaking I should do to get over these morning nagging thoughts? But overall, feeling much better.
Any change you suggest for today or I should stick to this combo of medicines for sometime.
Also, can I request that i routinely would like to consult you apart from HCM and icliniq as I am more comfortable with you? Pls advise
You should stick with same prescription for a couple of days.
Detailed Answer:
Hello again
No need to make any changes for today. Wait till Wednesday and then you should reduce the Mirtazapine by 7.5 mg that is 22.5 mg in night. Rest of prescription should be same.
You can take Betacap TR 40 and low dose Clonazepam on SOS basis. These medicines will keep the anxiety under control during meetings if needed.
Thanks.

You should stick with same prescription for a couple of days.
Detailed Answer:
Hello again
No need to make any changes for today. Wait till Wednesday and then you should reduce the Mirtazapine by 7.5 mg that is 22.5 mg in night. Rest of prescription should be same.
You can take Betacap TR 40 and low dose Clonazepam on SOS basis. These medicines will keep the anxiety under control during meetings if needed.
Thanks.


Also, if i have to do a phone/video consultation with you, how can i do that directly with icliniq? pls suggest

Also, if i have to do a phone/video consultation with you, how can i do that directly with icliniq? pls suggest


Make SR 150 from today.
Detailed Answer:
Hello again
I am sorry for replying late I was traveling.
You can make 150 SR from today evening. This should help in long refreshing sleep.
Ativan works rapidly and has short duration of action. You can take this with Betacap SR 40 on sos basis without worries. You can take tablets around half hour before meeting.
You can take Zapiz 0.5 too but Ativan is better in such situations in my opinion.
Yes you can contact HCM customer care for this.
Thanks

Make SR 150 from today.
Detailed Answer:
Hello again
I am sorry for replying late I was traveling.
You can make 150 SR from today evening. This should help in long refreshing sleep.
Ativan works rapidly and has short duration of action. You can take this with Betacap SR 40 on sos basis without worries. You can take tablets around half hour before meeting.
You can take Zapiz 0.5 too but Ativan is better in such situations in my opinion.
Yes you can contact HCM customer care for this.
Thanks


And also every time I need to talk to you, I should go through icliniq or as a patient I can consult you directly after fixing up the timing in advance.

And also every time I need to talk to you, I should go through icliniq or as a patient I can consult you directly after fixing up the timing in advance.
You can take SR150 from today.
Detailed Answer:
Hello again
Yes you can take 150 SR from today only. This will help in improving the sleep quality and you will feel refreshed in morning. Don't anticipate about tomorrow's meeting. You will do good. No need to get worried for that.
Slight anxiety which you faced today was because of anticipation only. Stop anticipating about any futuristic things. Just keep one thing in mind that you have anxiety and you have to overcome this. Make your brain realise that this is just anxiety and most of individuals have anxiety.
You can take Betacap TR 40 and Lorazepam on SOS basis.
You can contact through HCM too.
Thanks.

You can take SR150 from today.
Detailed Answer:
Hello again
Yes you can take 150 SR from today only. This will help in improving the sleep quality and you will feel refreshed in morning. Don't anticipate about tomorrow's meeting. You will do good. No need to get worried for that.
Slight anxiety which you faced today was because of anticipation only. Stop anticipating about any futuristic things. Just keep one thing in mind that you have anxiety and you have to overcome this. Make your brain realise that this is just anxiety and most of individuals have anxiety.
You can take Betacap TR 40 and Lorazepam on SOS basis.
You can contact through HCM too.
Thanks.



I will let you know about schedule.
Detailed Answer:
Hello again
In that case you can contact me.
Right now I don't have plans for XXXXXXX on 15th-19th Feb. I am in XXXXXXX for few hours on 31st XXXXXXX and also on 3rd Feb. If there is any plan I will let you know.
Thanks

I will let you know about schedule.
Detailed Answer:
Hello again
In that case you can contact me.
Right now I don't have plans for XXXXXXX on 15th-19th Feb. I am in XXXXXXX for few hours on 31st XXXXXXX and also on 3rd Feb. If there is any plan I will let you know.
Thanks

Answered by

Get personalised answers from verified doctor in minutes across 80+ specialties
