Need To Talk To Psychiatrist

Posted on Mon, 1 Apr 2019

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

Mon, 1 Apr 2019 Answered on

Last reviewed on

Question : Need to talk to psychiatrist

Follow up: Dr. Seikhoo Bishnoi (0 minute later)

Need to talk to psychiatrist

Answered by Dr. Seikhoo Bishnoi (43 minutes later)

Brief Answer:
Please provide me more details

Detailed Answer:
Hello thanks for using ask a doctor service

Please provide more details about the issues you want to discuss.

Thanks

Above answer was peer-reviewed by : Dr. Prasad

Answered by Dr. Seikhoo Bishnoi (0 minute later)

Brief Answer:
Please provide me more details

Detailed Answer:
Hello thanks for using ask a doctor service

Please provide more details about the issues you want to discuss.

Thanks

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Seikhoo Bishnoi (5 hours later)

Iam a physician and have a 26 yr old daughter
She has severe hypothyroidism and is being treated with 300 mcg Of thyroxine
Over the past 10 yrs she had been suffered greatly from severe depression and anxiety.
Only during the past few weeks she was feeling little little better with the following medicines:
Ecitalopram-20Mg
Aripiprazole injection 300mg every 15 days
And vyanese 40 mg twice a day
Right now her main problem
Is SEVERE MOTOR RETARDATION AND WEAKNESS
She does not feel like getting up from bed and doing things
She wants to get up and do things but cannot
She doesn’t have anxiety or depression during this phase.
But has like extreme laziness and weakness
What is the cause of this and how can we treat her ?

Thanks

Sent from my iPhone

Follow up: Dr. Seikhoo Bishnoi (0 minute later)

Answered by Dr. Seikhoo Bishnoi (5 hours later)

Brief Answer:
This might be due to persistent depression

Detailed Answer:
Hello thanks for providing details

The severe motar retardation might be due to persistent depression. PMR (psycho-motor retardation) is one of main symptoms of depression. She is on 20 mg Escitalopram and if her symptoms are persisting then there is need to add some other antidepressant. Sometimes for resistant depression augmentation with drugs like Bupropion or even Lithium becomes necessity. You can talk with her psychiatrist for this.

This should help to improve her PMR.

Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. Seikhoo Bishnoi (0 minute later)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (6 hours later)

She used almost all the drugs including bupropion for this
Lithium Iam afraid of using becAuse of hypothyroidism
She said she doesn’t have depression or anxiety during psychomotor retardation
Can it be still due to depression ?
Can that be due to drug side effects ?
Vyanese or aripiprazole?

Follow up: Dr. Seikhoo Bishnoi (0 minute later)

Answered by Dr. Seikhoo Bishnoi (15 hours later)

Brief Answer:
Aripiprazol might cause

Detailed Answer:
Hello again

Yes even if her mood is ok even then PMR could be due to depression. I don’t think Vyvanse can cause psychomotor retardation but yes she is on Aripiprazole and this can result in psychomotor retardation.

Thanks

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

Answered by Dr. Seikhoo Bishnoi (0 minute later)

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

Follow up: Dr. Seikhoo Bishnoi (3 days later)

Can u let us know what could be a substitute For aripiprazole?
And how to counter these effects esp when the patient is feeling better ?

Follow up: Dr. Seikhoo Bishnoi (0 minute later)

Can u let us know what could be a substitute For aripiprazole?
And how to counter these effects esp when the patient is feeling better ?

Answered by Dr. Seikhoo Bishnoi (11 hours later)

Brief Answer:
Lurasidone can substitute

Detailed Answer:
Hello again

Lurasidone can be kept in options. The drug is safe and has no metabolic side effects. The drug has great efficacy and can be substituted for Aripiprazole. Tye sedation and PMR should be less with Lurasidone.

Thanks

Above answer was peer-reviewed by : Dr. Kampana

Answered by Dr. Seikhoo Bishnoi (0 minute later)

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Seikhoo Bishnoi (14 hours later)

Let us know the dosage pl

Follow up: Dr. Seikhoo Bishnoi (0 minute later)

Let us know the dosage pl

Follow up: Dr. Seikhoo Bishnoi (32 hours later)

Can u answer our question
Don’t worry we are not taking this as your prescription
We are only suggesting this to our local psychiatrist

Follow up: Dr. Seikhoo Bishnoi (0 minute later)

Can u answer our question
Don’t worry we are not taking this as your prescription
We are only suggesting this to our local psychiatrist

Answered by Dr. Seikhoo Bishnoi (3 hours later)

Brief Answer:
Lurasidone dose is 20 mg starting and it can be increased to 40-80 mg

Detailed Answer:
Hello again

I am sorry I couldn't reply because I was travelling.

The dose of LURASIDONE is 20 mg starting dose and it can be increased to 40 mg after a week. The drug is safe if metabolic side effects are considered. Lurasidone will improve cognition too.

You can discuss this with her doctor.

Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. Seikhoo Bishnoi (0 minute later)