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Suggest Treatment For Continuous Negative Thoughts, Fear, Hopelessness And Depression
Posted on
Thu, 3 Sep 2015
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Thu, 3 Sep 2015
Answered on
Thu, 24 Sep 2015
Last reviewed on
Question : Sir,i am suffering from continuous negative thoughts and fear about my life ahead,hopelessness,not able to concentrate,loss of interest in everything,moodless( very high in morning time),life seems like without purpose and so thinking of leaving job but worried about family responsibilities that i have on me.so i am not able to figure out what to do.always feel like i should sleep to avoid all this happening in mind.getting enough sleep also.get up automatically in the morning 7 am but cant get up from the bed as feel loke something happening in the stomach and conpletely energyless to get up. This is happening from a year now.have visited psychiatrist in jan-15 and felt well so stopped medication.again it started 3 months ago and visited the same doctor 10 days ago and he gave medicine amd told me not to stop and to complete 3 months course.i have been taking for 10 days now but not feeling as well as i felt for the first time i started medicine.what to do? I have been given your reference by vikramsinh rathod XXXXXXX is it a major depression?wili i ever feel good? Please suggest something.
Brief Answer:
symptoms highly suggestive of major depression.
Detailed Answer:
Hello
Welcome to HCM.
I have read your query and understand your concerns.
The symptoms which you have listed are strongly suggestive of major depression.
You took antidepressants earlier and responded well. Then you stopped the medication and your problem reappeared.
Most of the treatment guidelines recommend antidepressants for 6-9 months for first episode.
When there is relapse of depression, the treatment has to be continued for atleast 2 years.
I would advise you to not stop the drugs without your doctor's advice.
If you can mention your medicines in follow up, i can guide you about the choice of medicines as well.
Usually SSRIs (like escitalopram or sertraline etc) are the first choice drugs.
And, depression is treatable.
You will definitely get well soon.
Also, go for morning walk. Do practice yoga and meditation. Eat green vegetables and fruits. Drink plenty of water.
Hope to hear from you soon.
Take care.
Regards.
symptoms highly suggestive of major depression.
Detailed Answer:
Hello
Welcome to HCM.
I have read your query and understand your concerns.
The symptoms which you have listed are strongly suggestive of major depression.
You took antidepressants earlier and responded well. Then you stopped the medication and your problem reappeared.
Most of the treatment guidelines recommend antidepressants for 6-9 months for first episode.
When there is relapse of depression, the treatment has to be continued for atleast 2 years.
I would advise you to not stop the drugs without your doctor's advice.
If you can mention your medicines in follow up, i can guide you about the choice of medicines as well.
Usually SSRIs (like escitalopram or sertraline etc) are the first choice drugs.
And, depression is treatable.
You will definitely get well soon.
Also, go for morning walk. Do practice yoga and meditation. Eat green vegetables and fruits. Drink plenty of water.
Hope to hear from you soon.
Take care.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I am on the drugs as under
Tab.Pantaprazole sodium with domeperidone 1-0-0
Escitafol 1-0-0
Propranolol 10 mg 0-0-1
D-VENPAD XR -50 mg 0-0-1
Etizolam 0.5 mg 0-0-1
Tab.Pantaprazole sodium with domeperidone 1-0-0
Escitafol 1-0-0
Propranolol 10 mg 0-0-1
D-VENPAD XR -50 mg 0-0-1
Etizolam 0.5 mg 0-0-1
Brief Answer:
choice of drugs is appropriate.
Detailed Answer:
Thanks for the follow-up details dear.
You have taken these drugs for 10 days and still no response.
The choice of drugs is appropriate.
Escitafol and D-Venpad are both antidepressants. These belong to two different classes. As this is the case of relapse, so it is a good clinical choice to use drugs from different classes.
However, as you have minimal improvement with these drugs, I would recommend a dose increment of escitafol.
In my opinion, you should take two tablets of escitafol. 20mg is the maximum dose of escitalopram. Take this dose for another 2 weeks along with other drugs.
If there is still no improvement, then dose of D-Venpad should be increased.
This should be the further plan according to me.
Kindly discuss this with your doctor and proceed accordingly.
Hope this helps.
Feel free to ask further if you have more queries. Kindly Give your feedback and close the discussion if you are satisfied with my response.
I wish you well.
Regards.
Dr. Shubham, MD (Psychiatry).
choice of drugs is appropriate.
Detailed Answer:
Thanks for the follow-up details dear.
You have taken these drugs for 10 days and still no response.
The choice of drugs is appropriate.
Escitafol and D-Venpad are both antidepressants. These belong to two different classes. As this is the case of relapse, so it is a good clinical choice to use drugs from different classes.
However, as you have minimal improvement with these drugs, I would recommend a dose increment of escitafol.
In my opinion, you should take two tablets of escitafol. 20mg is the maximum dose of escitalopram. Take this dose for another 2 weeks along with other drugs.
If there is still no improvement, then dose of D-Venpad should be increased.
This should be the further plan according to me.
Kindly discuss this with your doctor and proceed accordingly.
Hope this helps.
Feel free to ask further if you have more queries. Kindly Give your feedback and close the discussion if you are satisfied with my response.
I wish you well.
Regards.
Dr. Shubham, MD (Psychiatry).
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much sir.
I will follow your advice.hope it helps.but,I dont feel like i have enough strength to do any exercise.no will power.its like i am totally changed person now.will i ever become the same person I used to be?
I have constipation from the day i started these drugs.what should be done on this?
What all are the other major side effects of this medicines that may harm me later?
Worried...
I will follow your advice.hope it helps.but,I dont feel like i have enough strength to do any exercise.no will power.its like i am totally changed person now.will i ever become the same person I used to be?
I have constipation from the day i started these drugs.what should be done on this?
What all are the other major side effects of this medicines that may harm me later?
Worried...
Brief Answer:
lifestyle modifications are must.
Detailed Answer:
You are most welcome.
Sorry for the late response.
Even if you do not feel power to do any exercises, try to keep motivating yourself for some workouts.
You will definitely become the same person as earlier. Drugs may take some time to show their effects but you will surely improve.
For constipation, you can take fibrous foods. Increase your water intake.
Isabgulha husk with water will also help to clear constipation.
These drugs can cause weight gain, raised Blood pressure in some cases.
You have to manage your lifestyle accordingly. Avoiding junk food, eating green vegetables, physical exercises should be done.
I wish you speedy recovery.
Take care.
Thanks.
lifestyle modifications are must.
Detailed Answer:
You are most welcome.
Sorry for the late response.
Even if you do not feel power to do any exercises, try to keep motivating yourself for some workouts.
You will definitely become the same person as earlier. Drugs may take some time to show their effects but you will surely improve.
For constipation, you can take fibrous foods. Increase your water intake.
Isabgulha husk with water will also help to clear constipation.
These drugs can cause weight gain, raised Blood pressure in some cases.
You have to manage your lifestyle accordingly. Avoiding junk food, eating green vegetables, physical exercises should be done.
I wish you speedy recovery.
Take care.
Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you sir.
I have started follwing you advice.
A last question i would like to ask it is about desvenlafaxine extended release 50 mg tablets.i take once daily as recommended.but, i read more about its side effects than benefits.please guide about what this drug actually is?
How long will it take to show its effect as an antidepressant in releving my depressive sympotms?
Thanks.
I have started follwing you advice.
A last question i would like to ask it is about desvenlafaxine extended release 50 mg tablets.i take once daily as recommended.but, i read more about its side effects than benefits.please guide about what this drug actually is?
How long will it take to show its effect as an antidepressant in releving my depressive sympotms?
Thanks.
Brief Answer:
Desenlafaxine acts on serotonin and norepinephrine both.
Detailed Answer:
Hi again.
Desvenlafaxine is an antidepressant with action on serotonin and norepinephrine neurohormones. It is a newer antidepressant drug.
It is different from escitalopram in that escitalopram has action only on serotonin.
Most of the literature about it mentions discontinuation syndrome as its major side effects. That is, when the drug is stopped after taking it for long term, there are symptoms like dizziness, irriatbility, mood swings etc.
But, in my opinion, the chances are less. You can safely take this drug.
However, I would prefer the increase in dose of escitafol first if there is no response after two weeks.
Like all other antidepressants, it also takes around 2 weeks to show any noticeable effects.
Just continue with your drugs as advised.
I hope you will get well soon.
All the best.
Feel free to ask further.
Kindly close the discussion if you have no more queries and give your valuable feedback.
Regards.
Desenlafaxine acts on serotonin and norepinephrine both.
Detailed Answer:
Hi again.
Desvenlafaxine is an antidepressant with action on serotonin and norepinephrine neurohormones. It is a newer antidepressant drug.
It is different from escitalopram in that escitalopram has action only on serotonin.
Most of the literature about it mentions discontinuation syndrome as its major side effects. That is, when the drug is stopped after taking it for long term, there are symptoms like dizziness, irriatbility, mood swings etc.
But, in my opinion, the chances are less. You can safely take this drug.
However, I would prefer the increase in dose of escitafol first if there is no response after two weeks.
Like all other antidepressants, it also takes around 2 weeks to show any noticeable effects.
Just continue with your drugs as advised.
I hope you will get well soon.
All the best.
Feel free to ask further.
Kindly close the discussion if you have no more queries and give your valuable feedback.
Regards.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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