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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How To Treat Sleeplessness And Anxiety?

Good morning Doctors am asking for my mom She is now 42 years old, 5.2 feet 45 kg she has been suffering from anxiety , so less sleep and she is taking medicine(stalopalm plus) for last 18 months for the same we are now looking for another good Doctor . please help us
Wed, 30 Jul 2014
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Psychiatrist 's  Response
Hi,

I appreciate your concern for your mother. Her medicine stalopam plus contains escitalopram (an anti-depressant) and clonazepam (a sedative). It is used to treat anxiety. However, if there is no response with the treatment over such a long duration, further increase in dose of the anti-depressant is warranted.

I would recommend that you should seek a psychiatric consultation for your mother so that she is re-evaluated and diagnosis affirmed. Had I been your psychiatrist, I would have increased the dose of escitalopram to 20 mg/day and assessed response over next one month. If still there is no improvement, change to another agent like venlafaxine would be recommended. In addition, conditions that lead to anxiety like nutritional deficiencies and thyroid dysfunction needs to be ruled out. Clonazepam must be tapered and stopped once she shows response to the anti-depressant medication as long term intake will only lead to dependence. The ant-depressant medication on which she shows response must be continued for a long period of time even after improvement.

I do hope that you found the information helpful. Best wishes.
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How To Treat Sleeplessness And Anxiety?

Hi, I appreciate your concern for your mother. Her medicine stalopam plus contains escitalopram (an anti-depressant) and clonazepam (a sedative). It is used to treat anxiety. However, if there is no response with the treatment over such a long duration, further increase in dose of the anti-depressant is warranted. I would recommend that you should seek a psychiatric consultation for your mother so that she is re-evaluated and diagnosis affirmed. Had I been your psychiatrist, I would have increased the dose of escitalopram to 20 mg/day and assessed response over next one month. If still there is no improvement, change to another agent like venlafaxine would be recommended. In addition, conditions that lead to anxiety like nutritional deficiencies and thyroid dysfunction needs to be ruled out. Clonazepam must be tapered and stopped once she shows response to the anti-depressant medication as long term intake will only lead to dependence. The ant-depressant medication on which she shows response must be continued for a long period of time even after improvement. I do hope that you found the information helpful. Best wishes.