
Suggest Treatment For Depression

She needs proper treatment
Detailed Answer:
Hi
Thanks for using healthcare magic. I, Dr Abhishek Kapoor, would help you in this query.
The way, you have explained her symptoms, definitely she is in depression. In that case, she needs antidepressant like escitalopram. I think, you should remember, patients do not become dependent upon antidepressant. These drugs help to control depressive symptoms, which happens due to serotonin imbalance. It is myth most of people say that they will become habitual to these drugs, but if they do not take drugs, then it could suffer. For sleep, she can take benzodiazepine on sos basis, that would avoid dependence tendency.
Same in your wife case. Right now, just consult a psychiatrist and get her antidepressant prescribed. With medicine, she would become fine and later
psychiatrist will taper down or stop medicine accordingly. In depression, treatment depends upon number of episodes. For first episode, duration of treatment is 6 to 9 months and it would increase if number of episodes increase. Better to give her medicine to avoid further episodes.
In case, you need further help, you can ask.
Regards
Dr. Abhishek Kapoor
Psychiatrist


Do not know any one in XXXXXXX
Detailed Answer:
HI
Sorry for that. I do not know anyone in Gorakhpur(UP).
In case, you have more query, you can ask.
Regards
Dr. Abhishek Kapoor


Escitalpram and clonazepam
Detailed Answer:
Hi
If she was my patient, then i would have preferred to give her tablet escitalopram 10mg with clonazepam 0.5mg. Medicine would take time to show response. Keep her on same dose for next few days and better to consult a psychiatrist for proper monitoring.
In case, you need my help, you can ask.
Regards
Dr. Abhishek Kapoor
Psychiatrist
0000 XXXXXXX


She will be better with medicine
Detailed Answer:
Hi
Low mood, decrease interest in household activity, not caring her baby, negative thoughts or excessive worries are part of depression. These symptoms would improve in few days with medications and her mood would become like before. Just give her medications regularly and wait for few days to get response.
In case, you need further help, you can ask.
Regards
Dr. Abhishek Kapoor
Psychiatrist


thnks for ur feedback in the morning.now i only want to confirm whether to stop all medicine which she used to take kabhi kabhi the medicine which was perscribed by her doctor the details of the medicine are- LITAB SR 400MG(LITHIUM CARBONATE EXTENDED RELEASE TABLET),TOLPAZ-MD(RX OLANZAPINE RAPDLY DISSOLVE TABLET),XS(FLUOXETINE CAPSULES IP 20 MG),AXITAN1(LORAZEPAM TABLET BP 1MG).PLS CONFIRM SIR SHOULD I STOP THESE TABLET AND GO ON WITH THE TABLETS PERSCRIBED BY U ESCITALOPRAM 10 MG AND clonazepam 05 MG.what doses i have to give her and any addition medicine reqired pls mention sir.
You can give her these drugs
Detailed Answer:
HI
If she does not have any history of mania, then you can stop these drugs. Mania means over-talkativeness, decrease need for sleep, grandiose ideas, easy irritability, increase religiosity or sexuality etc. If she does not have any episode with these symptoms, then stop all these drugs and start with escitalopram and clonazepam. In case, she feels problem in sleep, you can take two or three tablet at night.
If you have more query, you can ask.
Regards
Dr. Abhishek Kapoor
Psychiatrist


Give 1 mg clonazepam
Detailed Answer:
Hi
Right now, she is on olanzapine and it is a sedative antipsychotic. Better to start at dose of 1 mg at night and in case, she needs more, you can give her 0.5 mg again. Rest, tell me the response after giving medications.
Regards
Dr. Abhishek Kapoor
Psychiatrist


Give her clonazepam 0.5 mg
Detailed Answer:
HI
Olanzapine is a antipsychotic and there is no need to give her olanzapine for anxiety. In case of anxiety disorder or sleep, give her clonazepam rather than olanzapine. You can give her clonazepam 0.5 mg on sos basis on any time. She can also try relaxation exercise like deep breathing or life style modification in form of morning or evening walk.
Regards
Dr. Abhishek Kapoor


Just wait for few days.
Detailed Answer:
HI
Antidepressant takes at least 10 to 14 days to show response. Just keep her on escitalopram 10 mg once a day and give her clonazepam whenever she feels anxiety symptoms. With medicine, depressive and anxiety symptoms would subside and that would help to improve her appetite. Usually in first episode of depression, antidepressant stays for nine months and if episodes are more than two, then for 2 to 5 years or more. Same protocol would be for your wife case also. Just wait to get response with medications.
In case, you need further help, you can ask anytime.
Regards
Dr. Abhishek Kapoor
Psychiatrist


Give her liquid diet in that case
Detailed Answer:
HI
Low mood is part of depression. With time that symptoms will be improved. You can give her any appetizer or tell her to eat any thing after short interval. That would help to give the required energy content for a day. You can also try liquid diet for her like shake, juice etc that would also give her few energy.
Regards
Dr. Abhishek Kapoor


Give her mirtazapine
Detailed Answer:
HI
You can either give her appetizer Aptimust twice a day or antidepressant mirtazapine 7.5 mg at night. Both help to increase appetite. I would suggest you mirtazapine. It has dual effect antidepressant as well as appetizer. With this, there is no need to give clonazepam at night due to its sedative effect.
Regards
Dr. Abhishek Kapoor


Carry on with same drugs
Detailed Answer:
Hi
I have already told that you drugs would take two weeks to show response. In between, if she feels anxiety symptoms, you can give her clonazepam 0.5 mg on sos at any time. Antidepressant would control her anxiety symptoms. These symptoms are part of depression, so nothing to worry about it. With time along with depressive symptoms, anxiety symptoms will also decrease. There is no need to change drugs. Just be patient.
Regards
Dr. Abhishek Kapoor
Psychiatrist


as directed by u i m giving her the medicine as directed by u mirtazapine 7.5 mg, escitalopram 10 mg in the night and clonazepam 05 mg in the day time .but since one month has been completed but there is no improvement in her.so guide me whether to change the medicine or what to do.
Increase dose of escitalopram
Detailed Answer:
Hi
There is no need to change the drugs. What ever antidepressant she takes, it would take two weeks to show response. Better to increase the dose of escitalopram up to 20mg and then wait for another two weeks. Carry on with mirtazapine at same dose. Sometime, patient takes time to get improvement with drugs. Just be patient.
In case, you have more query, you can ask.
Regards
Dr. Abhishek Kapoor
Psychiatrist


You can give her drugs in divided doses
Detailed Answer:
Hi
She is in depression for last one year. Usually depressive episode stays for 6 to 9 months, but if a patient has depression more than nine months, that means he or she is towards chronic depression and needs longer treatment. In that case, patient should be on drugs and take time to get improvement. How long would she takes to get improvement, is difficult to tell. Better to give her drugs as i have advised. You can give her escitalopram in divided doses 10mg twice a day or 20 mg at night. In both way, she would get equal effect.
If you have more query, you can ask.
Regards
Dr. Abhishek Kapoor
Psychiatrist


Thanks
Detailed Answer:
Thanks. Its my pleasure to help you.
Regards
Dr. Abhishek Kapoor
Psychiatrist

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