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Suggest Medication For Extreme Depression And Anxiety
Question: I have extreme depression and anxiety,I can't stay focused at all and i'm alwsys on the go. i'm on zoloft and im getting worse i heard i may be adhd please help. i dont eat sleep and always crying. i also have a cyst on my platuriyory gland
Brief Answer:
can you tell the duration of illness &dose of zoloft you are taking
Detailed Answer:
Hello,
Welcome to health care magic!
I have read your query and can understand your situation. I will try my best to help you .
Regarding your diagnosis-
1. You have said that you have depression and anxiety and are being treated with zoloft which is not helping adequately.
I would like to tell you that it is a right drug for this illness and may be on increasing the dosage of zoloft you feel better.
2. If I have such a case in my clinic I would ask about the duration of illness and the dosage which he is presently taking.
In cases where there has not been any response with zoloft- I prefer changing the molecule. This is usually enough to get relief.
3. In cases of anxiety many a times there is a differential of adhd that needs to be ruled out. The most important point here is - adhd is from the begening ( since birth). The features are: hyperactivity, impulsivity; the patient, appears as if dosent rest and continues to do one thing or the other. Since childhood....he has difficulty in sitting still. If someone was not such a child then adhd is almost ruled out; & it is just anxiety.
You have also mentioned paxil in treatment section- but in query there is no mention of it. Can you please tell clearly if you are on both zoloft and paxil and the dosage.
Anxiety and depression are most common mental helath problems and highly treatable. Dont worry, you will surely get well, its just a matter of time the right drug clicks you.
I also ask my patients of anxiety to avoid tea, coffee and other stimulants.
Its good if you eat more green veggies and take enough water / liquids.
Please answer the above questions so that I can help you properly.
Wish you good health!
Dr. Manisha Gopal
MD Neuropsychiatry
can you tell the duration of illness &dose of zoloft you are taking
Detailed Answer:
Hello,
Welcome to health care magic!
I have read your query and can understand your situation. I will try my best to help you .
Regarding your diagnosis-
1. You have said that you have depression and anxiety and are being treated with zoloft which is not helping adequately.
I would like to tell you that it is a right drug for this illness and may be on increasing the dosage of zoloft you feel better.
2. If I have such a case in my clinic I would ask about the duration of illness and the dosage which he is presently taking.
In cases where there has not been any response with zoloft- I prefer changing the molecule. This is usually enough to get relief.
3. In cases of anxiety many a times there is a differential of adhd that needs to be ruled out. The most important point here is - adhd is from the begening ( since birth). The features are: hyperactivity, impulsivity; the patient, appears as if dosent rest and continues to do one thing or the other. Since childhood....he has difficulty in sitting still. If someone was not such a child then adhd is almost ruled out; & it is just anxiety.
You have also mentioned paxil in treatment section- but in query there is no mention of it. Can you please tell clearly if you are on both zoloft and paxil and the dosage.
Anxiety and depression are most common mental helath problems and highly treatable. Dont worry, you will surely get well, its just a matter of time the right drug clicks you.
I also ask my patients of anxiety to avoid tea, coffee and other stimulants.
Its good if you eat more green veggies and take enough water / liquids.
Please answer the above questions so that I can help you properly.
Wish you good health!
Dr. Manisha Gopal
MD Neuropsychiatry
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
paxil I ended at 50mg 2twd now zoloft is @ 200mg 2twd ive always been a hyper active child but played a lot of sports did poorly in school my son just got diagnosed with adhd and my parents made the comment im eith bi polar, runs in family or adhd my dr isnt the greatest and my insurance wont cover alot of things like changing dr.and she says I cant offered the diagnose i just want to be normal again no more high low crying laughing low again
Brief Answer:
please see if you have manic symptoms as mentioned in detail answer by me
Detailed Answer:
Hello,
Thanks for writing back!
Your reply suggests the possibility of adhd in you ..as there is history of being good or more interested in sports and have focussing issues in studies ( which is a common reason behind these kids to fair poorly in academics).
The problem which now remains --is making a diagnosis if you are anxious depressed or a bipolar. It is important to diagnose correctly as a depressed anxious will be treated differently from a bipolar.
A bipolar patient will have had a manic episode ( may or may not have a depressive episode ever). Manic episode is characterised by- hyperactivity ( more than normal self), increased flow of thoughts, increased energy, increased appetite or loss of appetite, reduced sleep, patient might feel over confident, become over social, spendthrift, boastful, over planning ( can even plan to make a city or think himself a superman or even God), emotionally labile , etc.
Such symptoms should be significnat enough and last for a week or more.
So, please think and tell if you have manic symptoms or just anxiety ( in which patient is restless, anxious, unhappy feeling of being disturbed and have palpitation and have difficulting in concentrating).
I hope the above reply helps you to have a clear view of your situation.
P.S. Your dose of paxil was enough and zoloft is also sufficient but still there is no response. This gives us a doubt of comorbidity..or you being a bipolar. So,please reply accordingly.
Both are very treatable illnesses so there is no need to worry.
wish you good luck and speedy recovery!
Dr. Manisha Gopal
MD Neuropsychiatry
please see if you have manic symptoms as mentioned in detail answer by me
Detailed Answer:
Hello,
Thanks for writing back!
Your reply suggests the possibility of adhd in you ..as there is history of being good or more interested in sports and have focussing issues in studies ( which is a common reason behind these kids to fair poorly in academics).
The problem which now remains --is making a diagnosis if you are anxious depressed or a bipolar. It is important to diagnose correctly as a depressed anxious will be treated differently from a bipolar.
A bipolar patient will have had a manic episode ( may or may not have a depressive episode ever). Manic episode is characterised by- hyperactivity ( more than normal self), increased flow of thoughts, increased energy, increased appetite or loss of appetite, reduced sleep, patient might feel over confident, become over social, spendthrift, boastful, over planning ( can even plan to make a city or think himself a superman or even God), emotionally labile , etc.
Such symptoms should be significnat enough and last for a week or more.
So, please think and tell if you have manic symptoms or just anxiety ( in which patient is restless, anxious, unhappy feeling of being disturbed and have palpitation and have difficulting in concentrating).
I hope the above reply helps you to have a clear view of your situation.
P.S. Your dose of paxil was enough and zoloft is also sufficient but still there is no response. This gives us a doubt of comorbidity..or you being a bipolar. So,please reply accordingly.
Both are very treatable illnesses so there is no need to worry.
wish you good luck and speedy recovery!
Dr. Manisha Gopal
MD Neuropsychiatry
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
i just know that im emotionally unbalanced i can switch like a light switch, i'm alway run around the house like a nervous reck as my boyfriend states and when i get to overwhejmed well lets just say the time bomb goes off. i used to go out but the last 6 months ive left the house mabey 6 times.I forget where i put things and i am ALWAYS doing 10 plus things at a time, the cyst has grown in my XXXXXXX about .33 and i'm losing my hair and ive lost a lot of weight and my eyesight has gotten a lot worse. I want to be normal again, ive been so wound up and mad and emotional and soook tired but always on the go
Brief Answer:
its almost like adhd. atomoxerine or clonidine helps. neurologist for cyst
Detailed Answer:
Hello,
Your reply is more in favour of adhd rather than anything else. In such case zoloft or paxil or rather anykind of antidepressant is useless.
When I have a similar case in my clinic I prefer to use atomoxetine . The starting dose can be 10-18mg once a day. You should reduce and stop zoloft gradually like- 25 mg every week or ten days. I thing that even on reducing the zoloft your some symptoms might get relieved.
One can start atomoxetine at the same time of reducing zoloft.
I also think that you are not exactly bipolar as the history is more suggestive of adhd.
So, according to me the best approach would be to start with one drug at a time and see the response. If needed we can think of adding another drug later.
Kindly meet your doctor and discuss the above points. I remember that you mentioned your insurance wont cover many things but your condition needs to be treated.
If atomoxetine is not affordable in some cases then we even use -clonidine: for the management of adhd. It needs some monitoring of blood pressure and is not taken if BP falls below 90/60mm Hg.
Otherwise I have found it useful in this illness. It is started at a dosage of 0.1mg twice a day and can be raised to 0.1mg : 2-0-2.
You can even discuss the above molecule with your doctor.
Regardig your weight looss- this can be due to your psychological condition as you are always doing one thing and the other.
But the hair loss and vision issues might be related to cyst. It can cause some pressure in the nearby brain parenchyma and causing these symptoms. You must see a neurologist and get yourself examined for the same.
Wish you speedy recovery!
Please feel free to ask more queries for clarification.
Dr. Manisha Gopal.
MD Neuropsychiatry
its almost like adhd. atomoxerine or clonidine helps. neurologist for cyst
Detailed Answer:
Hello,
Your reply is more in favour of adhd rather than anything else. In such case zoloft or paxil or rather anykind of antidepressant is useless.
When I have a similar case in my clinic I prefer to use atomoxetine . The starting dose can be 10-18mg once a day. You should reduce and stop zoloft gradually like- 25 mg every week or ten days. I thing that even on reducing the zoloft your some symptoms might get relieved.
One can start atomoxetine at the same time of reducing zoloft.
I also think that you are not exactly bipolar as the history is more suggestive of adhd.
So, according to me the best approach would be to start with one drug at a time and see the response. If needed we can think of adding another drug later.
Kindly meet your doctor and discuss the above points. I remember that you mentioned your insurance wont cover many things but your condition needs to be treated.
If atomoxetine is not affordable in some cases then we even use -clonidine: for the management of adhd. It needs some monitoring of blood pressure and is not taken if BP falls below 90/60mm Hg.
Otherwise I have found it useful in this illness. It is started at a dosage of 0.1mg twice a day and can be raised to 0.1mg : 2-0-2.
You can even discuss the above molecule with your doctor.
Regardig your weight looss- this can be due to your psychological condition as you are always doing one thing and the other.
But the hair loss and vision issues might be related to cyst. It can cause some pressure in the nearby brain parenchyma and causing these symptoms. You must see a neurologist and get yourself examined for the same.
Wish you speedy recovery!
Please feel free to ask more queries for clarification.
Dr. Manisha Gopal.
MD Neuropsychiatry
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
IVE talked to my doctor last week and she bumped the zoloft up thats why I contacted you so how can I go about getting a script im sorry to ask
Brief Answer:
you can try it online after discussing with GP or your doctor
Detailed Answer:
Hello,
Your doctor has increased zoloft further but it is not helping you, neither did it help you before. I think you must talk about this with your treating team..even with the GP of your area. You can use the converstaion done here to explain this.
Regarding the prescrption- I think atomoxetine is not a scheduled drug like methylphenidate, so, you can get it online.
But best would be to take some one along with you (may be your boyfriend or your parents ) who can corraborate the history to the doctor. This information given by a reliable source is very helpful to convince the treating team for appropriate management.
I hope the reply helps you.
Wish you good health!
Dr. Manisha Gopal
MD Neuropsychiatry
you can try it online after discussing with GP or your doctor
Detailed Answer:
Hello,
Your doctor has increased zoloft further but it is not helping you, neither did it help you before. I think you must talk about this with your treating team..even with the GP of your area. You can use the converstaion done here to explain this.
Regarding the prescrption- I think atomoxetine is not a scheduled drug like methylphenidate, so, you can get it online.
But best would be to take some one along with you (may be your boyfriend or your parents ) who can corraborate the history to the doctor. This information given by a reliable source is very helpful to convince the treating team for appropriate management.
I hope the reply helps you.
Wish you good health!
Dr. Manisha Gopal
MD Neuropsychiatry
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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