Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Depression And Strange Mood Swings
Question: Hi,
One of my siblings is struggling with depression and strange mood swings. She ran into these around 6-7 years back. I consulted a psychiatrist and he recommended amixide tablet on a regular basis. Now the problem is she took it for quite a long time and now after many years, it seems like she is addicted to it. Whenever she is trying to stop it, it causes severe nausea and vomiting to her. Also now a days it seems like she is still under depression and heavy mood swings, with very uncontrollable anger (she even gets ready to hit others, abuse and bad language is common), on very small things. So now another visit to a different doctor and he recommended Oleanz 2.5 that she started only 2 days back. Please help me in making her get rid of this addiction and live a normal life without these bad behaviours.
One of my siblings is struggling with depression and strange mood swings. She ran into these around 6-7 years back. I consulted a psychiatrist and he recommended amixide tablet on a regular basis. Now the problem is she took it for quite a long time and now after many years, it seems like she is addicted to it. Whenever she is trying to stop it, it causes severe nausea and vomiting to her. Also now a days it seems like she is still under depression and heavy mood swings, with very uncontrollable anger (she even gets ready to hit others, abuse and bad language is common), on very small things. So now another visit to a different doctor and he recommended Oleanz 2.5 that she started only 2 days back. Please help me in making her get rid of this addiction and live a normal life without these bad behaviours.
Brief Answer:
Her proper evalution is needed for treatment
Detailed Answer:
Hello XXXXXXX
I can understand your concern for your sister.
Amixide contains amitryptiline and chlordiazepoxide. Chlordiazepoxide is a benzodiazepine . 6 years long use of benzo can cause physical dependence to it.Sudden stopping of this drug may cause withdrawal and she is mostly suffering from that.
In this case she should stop this drug gradually under doctor's advice(by tapering off) or this medicine can be replaced with other medicine to stop withdrawal.
Amixide is generally used for headache and sleep disturbance. It is not much useful in depression specifically.And for mood swings not at all useful.
Her symptoms of anger can be part of many psychiatric conditions. From your history I can say that she may have following conditions (first is with higher possibility and the last with the least possibility)
-Bipolar disorder
-Major Depression
-Intermittent explosive disorder
-Schizophrenia
For confirmation of diagnosis, her proper detail history from her as well as from close relatives and mental status examination are needed. That is to be done by a Psychiatrist.After diagnosis treatment can be done in that direction.
Oleanz 2.5 mg may help her in controlling anger.But in my opinion it is not enough dose. Severity of her symptoms suggest she may need 10 mg dose.
Discuss above aspects with her treating psychiatrist and change treatment accordingly after diagnosis.
I can throw some more light about her diagnosis if you can provide more detail
- symptoms with duration,frequency and seveirty and how do they affect her as well others with examples
- her education,marital history and onset of illness
- Any other information you think important for her diagnosis.
Hope I have answered your query, I will be happy to answer again.
Regards,
Dr.Chintan Solanki.
Her proper evalution is needed for treatment
Detailed Answer:
Hello XXXXXXX
I can understand your concern for your sister.
Amixide contains amitryptiline and chlordiazepoxide. Chlordiazepoxide is a benzodiazepine . 6 years long use of benzo can cause physical dependence to it.Sudden stopping of this drug may cause withdrawal and she is mostly suffering from that.
In this case she should stop this drug gradually under doctor's advice(by tapering off) or this medicine can be replaced with other medicine to stop withdrawal.
Amixide is generally used for headache and sleep disturbance. It is not much useful in depression specifically.And for mood swings not at all useful.
Her symptoms of anger can be part of many psychiatric conditions. From your history I can say that she may have following conditions (first is with higher possibility and the last with the least possibility)
-Bipolar disorder
-Major Depression
-Intermittent explosive disorder
-Schizophrenia
For confirmation of diagnosis, her proper detail history from her as well as from close relatives and mental status examination are needed. That is to be done by a Psychiatrist.After diagnosis treatment can be done in that direction.
Oleanz 2.5 mg may help her in controlling anger.But in my opinion it is not enough dose. Severity of her symptoms suggest she may need 10 mg dose.
Discuss above aspects with her treating psychiatrist and change treatment accordingly after diagnosis.
I can throw some more light about her diagnosis if you can provide more detail
- symptoms with duration,frequency and seveirty and how do they affect her as well others with examples
- her education,marital history and onset of illness
- Any other information you think important for her diagnosis.
Hope I have answered your query, I will be happy to answer again.
Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I am assuming all this information that I provided will be kept confidential.
Family history has been painful, we lost one of our sister and mother also. She has done MBA but didn't get a job yet (even after 4-5 years). All this while she has this tendency to find someone to depend on. Multiple relationships but none actually worked out well, in short multiple guys left her alone in between. Every time her reactions were worse and very very aggressive, and whole family struggled to control the situation, just to run into next similar situation. Now she is engaged but again fights over very small things with this guy have lead to similar almost breakup situation. Last 1-2 months it has been even worse due to this breakup sort situation, and there is no one she is listening to now. She tends to go literally mad over something and demands all the time back from this guy when he refuses to marry (due to these nasty fights they had), abused him, and I doubt may be slapped too during anger.
She is not doing anything as of now, stays alone in metro. She refuses to join any basic job like internship etc, refuses to join activities like music, meditation etc. She was to get married this month but due to these problems marriage is postponed indefinitely (or may be even stands cancelled, as the guy is refusing now).
- symptoms with duration,frequency and seveirty and how do they affect her as well others with examples
>> I think I provided some context. Now these severe anger attacks are very frequent, almost daily or once in two days. She will have someone or else to blame, sometime it will be her fiancee, at others dad, sister or even me for problems in her life.
- her education,marital history and onset of illness
>> It started during mostly her college days (MBA). When she got really out of home environment. However from her childhood she has been little rebel.
- Any other information you think important for her diagnosis.
>> Please help me out here, it sometime feels impossible to calm her down, some guidance for me also as how should we be behaving with her on day to day basis and during those anger attacks.
Family history has been painful, we lost one of our sister and mother also. She has done MBA but didn't get a job yet (even after 4-5 years). All this while she has this tendency to find someone to depend on. Multiple relationships but none actually worked out well, in short multiple guys left her alone in between. Every time her reactions were worse and very very aggressive, and whole family struggled to control the situation, just to run into next similar situation. Now she is engaged but again fights over very small things with this guy have lead to similar almost breakup situation. Last 1-2 months it has been even worse due to this breakup sort situation, and there is no one she is listening to now. She tends to go literally mad over something and demands all the time back from this guy when he refuses to marry (due to these nasty fights they had), abused him, and I doubt may be slapped too during anger.
She is not doing anything as of now, stays alone in metro. She refuses to join any basic job like internship etc, refuses to join activities like music, meditation etc. She was to get married this month but due to these problems marriage is postponed indefinitely (or may be even stands cancelled, as the guy is refusing now).
- symptoms with duration,frequency and seveirty and how do they affect her as well others with examples
>> I think I provided some context. Now these severe anger attacks are very frequent, almost daily or once in two days. She will have someone or else to blame, sometime it will be her fiancee, at others dad, sister or even me for problems in her life.
- her education,marital history and onset of illness
>> It started during mostly her college days (MBA). When she got really out of home environment. However from her childhood she has been little rebel.
- Any other information you think important for her diagnosis.
>> Please help me out here, it sometime feels impossible to calm her down, some guidance for me also as how should we be behaving with her on day to day basis and during those anger attacks.
Brief Answer:
She has borderline personality disorder likely, needs medicines
Detailed Answer:
Hello,
Thanks for detail useful information.
Yes your information will be kept totally confidential and even you can delete all after discussion is over if you wish with request.
From her long term history since she was studying MBA, frequent break ups, not able to maintain relationships, dependency, not able to work; I can say she has borderline personality disorder(BPD) likely. Confirmation of diagnosis is done through metal status examination of patient as I described previously.
In this disorder frequent episodes of depression and anger outburst are common if not treated well.
She needs anti depressant medicines, mood stabilizer medicines as well as psychotherapy.
The main part of her treatment is rapport with the therapist/psychiatrist.
DBT(Dialectic Behavior Therapy) is useful in BPD.
At present first need is to calm her down with medicines like SSRI(Anti depressant) and sodium vaolproate(mood stabilizer). Increase in dose of oleanz also can help. After that some psychotherapy can be started.
Important point is regular follow with psychiatrist.(I am little bit surprised that why she had not been evaluated for these much symptoms and no other medicines have been given)
If her condition is too much worsen, she can be admitted in hospital and with injections her anger can be controlled. If she is harmful to herself or to others, she can be admitted in hospital forcefully as per XXXXXXX laws in case she is not ready for the treatment.
Please discuss about each aspect, I mentioned, to her psychiatrist and start treatment soon.
You should just try to control your anger if she is verbally abusive. You need to accept that she is behaving like this because of her psychiatric problem not on her own. However if she is physically abusive to herself or anyone else, you can use your judgment and physical strength to prevent the harm/injury according to situation. The best way you can help her is make her consult psychiatrist regularly.
I will be glad to answer more queries if there.
She has borderline personality disorder likely, needs medicines
Detailed Answer:
Hello,
Thanks for detail useful information.
Yes your information will be kept totally confidential and even you can delete all after discussion is over if you wish with request.
From her long term history since she was studying MBA, frequent break ups, not able to maintain relationships, dependency, not able to work; I can say she has borderline personality disorder(BPD) likely. Confirmation of diagnosis is done through metal status examination of patient as I described previously.
In this disorder frequent episodes of depression and anger outburst are common if not treated well.
She needs anti depressant medicines, mood stabilizer medicines as well as psychotherapy.
The main part of her treatment is rapport with the therapist/psychiatrist.
DBT(Dialectic Behavior Therapy) is useful in BPD.
At present first need is to calm her down with medicines like SSRI(Anti depressant) and sodium vaolproate(mood stabilizer). Increase in dose of oleanz also can help. After that some psychotherapy can be started.
Important point is regular follow with psychiatrist.(I am little bit surprised that why she had not been evaluated for these much symptoms and no other medicines have been given)
If her condition is too much worsen, she can be admitted in hospital and with injections her anger can be controlled. If she is harmful to herself or to others, she can be admitted in hospital forcefully as per XXXXXXX laws in case she is not ready for the treatment.
Please discuss about each aspect, I mentioned, to her psychiatrist and start treatment soon.
You should just try to control your anger if she is verbally abusive. You need to accept that she is behaving like this because of her psychiatric problem not on her own. However if she is physically abusive to herself or anyone else, you can use your judgment and physical strength to prevent the harm/injury according to situation. The best way you can help her is make her consult psychiatrist regularly.
I will be glad to answer more queries if there.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
On the advise of current doctor she started Oleanz 5 mg today and she feels this burning sensation in body and restlessness during sleep, are these side effects normal ? will these go away after some time ? Any other way to make these drugs easier on body.
Brief Answer:
Yes it will go away if it is side effect
Detailed Answer:
Hello,
Thanks for question.
Oleanz can cause restlessness and burning sensation. But this may be part of her stressful condition also. At 5 mg dose olanzapine is less likely causing such side effects.
If theses are side effects, they will decrease gradually in 2-3 days and stop or they will stop if medicines is stopped.
If this continues for more than 5 days or becomes more severe, stopping of medicines is needed. Even after stopping medicines this continues,it needs evaluation and medicines for the same should be started.
take care,
Hope I have answered your query. If still any query there, I will be happy to answer. If not, you can close the discussion and if feasible give your feedback so I can improve service. In future you can contact me directly if you wish with this link: http://bit.ly/drchintansolanki
Regards,
Dr.Chintan Solanki.
Yes it will go away if it is side effect
Detailed Answer:
Hello,
Thanks for question.
Oleanz can cause restlessness and burning sensation. But this may be part of her stressful condition also. At 5 mg dose olanzapine is less likely causing such side effects.
If theses are side effects, they will decrease gradually in 2-3 days and stop or they will stop if medicines is stopped.
If this continues for more than 5 days or becomes more severe, stopping of medicines is needed. Even after stopping medicines this continues,it needs evaluation and medicines for the same should be started.
take care,
Hope I have answered your query. If still any query there, I will be happy to answer. If not, you can close the discussion and if feasible give your feedback so I can improve service. In future you can contact me directly if you wish with this link: http://bit.ly/drchintansolanki
Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks a lot Dr. One more question, she is very thin, like really thin. So current psychiatrist says that it would be better if she can gain some mass, not only for physical aspect but also psychological too. He suggested to take some steroid injection for the same (1-2). What do you think about that ?
Brief Answer:
No. Steroid is not at all indicated in this
Detailed Answer:
Hello Dear,
There is not at all any indication of steroid for weight gain in my opinion. Even oleanz in long run (5-6 months) can cause weight gain.
If you want to know her ideal weight(what should be her weight at present)you can search on internet about BMI-body mass index or tell me her height and current weight.
Hope this answers your query.
If you need more help you can ask and I will be glad to answer.Or close the discussion and rate your feedback.
http://bit.ly/drchintansolanki
No. Steroid is not at all indicated in this
Detailed Answer:
Hello Dear,
There is not at all any indication of steroid for weight gain in my opinion. Even oleanz in long run (5-6 months) can cause weight gain.
If you want to know her ideal weight(what should be her weight at present)you can search on internet about BMI-body mass index or tell me her height and current weight.
Hope this answers your query.
If you need more help you can ask and I will be glad to answer.Or close the discussion and rate your feedback.
http://bit.ly/drchintansolanki
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
