How Long Should Propranolol And Paroxetine Be Taken For Psychotic Disorder?

Posted on Fri, 12 Sep 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Fri, 12 Sep 2014 Answered on

Tue, 7 Oct 2014 Last reviewed on

Question : Sir , I don't know with what psychotic disorder I am going through or suffering with, as my doctor said you are suffering with mild panic attack cum anxiety and has prescribed me with Propranolol 40 Sustained Release in morning and Paroxetine 25 controlled released at night ....its been a year now for I have been taking these pills and I am completely fine but my Doctor is neither reducing dose nor finishing course even after my insistent.
My question to him (Doctor) and to YOU as well that for how long I have to keep continue taking these antipsychotic pills or it is treatment for lifetime??
And if I am feeling fine so there would cut down in doses of pills which am taking regularly or not?

Answered by Dr. Dr. Chintan Solanki (14 minutes later)

Brief Answer:
it can be decreased and stopped

Detailed Answer:
Hello,

Thanks for using healthcare magic.

Your diagnosis and medicines are matched and you are treated well that I can conclude from your narration.

If you are fine since more than 6 months and the situation or stressor which started this problem is not there, yes dose can be decreased.

One session of psychotherapy and drug counselling needed.When dose will be decreased , you may have some anxiety like features.But those will not due to your psychological problem but due to stopping/decreasing of medicines.They will go away on its own.

Either propranolol reduced to 20 mg first or paroxetine cr to12.5.
After 1 month propranolol can be stopped from 20 to 0 and paroxetine 25 to 12.5 ,if you have initially decrease propranolol.

IF you have initially decreased paroxetine , you can then reduce propranolol to 20.

So in both case after second month you will have to continue with paroxetine 12.5 and then 4th month it can be taken alternate day for 20 days and then stopped completely.

Do as above after consulting your doctor.

CBT(Cognitive Behavior therapy) can help surely to stop medicines.In my opinion at present, you do not have need to take medicines for lifetime.

I would be happy to help further.
All the best & regards,
Dr.Chinatn Solanki.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Chintan Solanki (2 hours later)

Hi, I have provided some attachments. Please review them.

Answered by Dr. Dr. Chintan Solanki (4 minutes later)

Brief Answer:
see below detail answer

Detailed Answer:
Hello,

I have seen your case papers.
Your doctor seems to be more pharmaco therapy oriented.He only writes same medicines though you are better since long without changing dose or noting points regarding counselling.

Ii want to know from you,"Have you asked about decreasing medicines to your doctor?, how much time your doctor does provide you in consultation?. Dis your doctor have explain about you psychotherapy or counselling for anxiety disorder?What your doctor has explained about your illness and did he tell until when you have to take medicine?"

If you can provide me above details, I can give more helpful guidance.

regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Dr. Chintan Solanki (23 hours later)

Hello sir, Thanks for your reply...on April 10 th 2014, I felt convulsions onto my cheeks then I was feeling uneasy drawing and analysing what are the options there who can help me in taking me to the nearby hospital or doctor...I was in the midst of analysing my current psychological panic attack then I went to my doctor who measured my BP which was 220 systolic and further was hospitalized for that day.... I was advised to go to Neuro surgeon who further referred me To the psychiatrist Dr XXXXXXX Shah as my CT scan And EEG report was normal.... Since that time I have been under treatment...initially doctor was giving me Propranol SR 40 and combination of Clonazepam and Paroxetine 40.....now for 3months hes cut the dose to Paroxetine CR only and removed clonazepam at night and that also when I insisted on every visit and with the fear and intention that he will not finish the treatment, so I pretend infront of him that I am fine.
Now the answers for questions you asked is :
1. I feel sorry to write about that my doctor XXXXXXX Shah is rude in treating me as on the first visit I raised my hand for Handshake but he did not turn up...he treated me like his subordinate... Never gives answer to my question and says" unless and untill you leave your habit of enquiring and surfing on internet fruit lessly, you will not become healthy
2. He gives me hardly 3 to 5 minutes of consultation even my mother is accompanying me for last two visit ...she also asked for how long XXXXXXX will be on medication or if he required less doses then also doctor replied sarcastically to my mother if you want to write the prescription you write yourself while passing the paper towards which I disliked the most even then ......
3. On every visit I asked him to finish the treatment or cut down the doses...but fruitlessly never make it through... He always ask me to do exercise and leave internet or inquisitiveness and never answer my question s and querry.
4. No he neither told me about any psychotherapy nor consultation on anxiety disorder..

Sir , I am putting on weight my stomach is bloating and sometimes I feel that I am not well and it's haltering my day to day activities as I am taking pills continuously and don't know the time when it comes to stop..please tell me what to do as I am going to UAE at the end of this month... what safety and suggestions which you like me to take in account and what should I do to SHUN or REMOVE this disorder from my life completely..I believe that if my Doctor was jolly by heart and would have said to me " XXXXXXX you are perfectly fine and you have no disorder and these drugs would be soon stopped then that would have done magically changed my psychology, behavior, health and life ....thats it sir....

Answered by Dr. Dr. Chintan Solanki (8 hours later)

Brief Answer:
Please visit some young doctor who can spare time

Detailed Answer:
Hi XXXXXXX

I can understand your pain and feelings.

I am sorry on behalf of my professional counterpart for not giving you time though I do not know him.
Your location is in XXXXXXX and I am not knowing personally anyone there.But yes, if you want to go to XXXXXXX ,I can recommend someone who can give you time.

Actually it is current scenario in many parts pf country where private doctors do not give sufficient time to listen the patient not only in psychiatry but in most of the branches.
Personally I believe listening patient carefully is half the treatment done.

From your last paragraph I can say you will surely be helped by counselling.

You can simply consult someone else if you feel to do so or you can reduce medicines as I mentioned above,if you are better since 6 months.
If you consult someone else find the doctor who can help you telephonic when you will be in UAE.

I can say you can be your doctor.You mentioned,"I believe that if my Doctor was jolly by heart and would have said to me " XXXXXXX you are perfectly fine and you have no disorder and these drugs would be soon stopped then that would have done magically changed my psychology, behavior, health and life ....thats it sir...."
If you believe so , just try to imagine that your doctor has already told that and implement that in your life and you can be cured.

All the best and wish you healthy happy future.

Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Raju A.T