Hello,

Thanks for your query.

It is nice to see such a nice and precise description of problem in spite of having so many problems.

Important points of your query:
•     Long duration symptoms: 6-8 month
•     Symptoms precipitated by emotional stress
•     Symptoms: Decrease interest in study, decrease concentration
•     Currently on Daxid 50mg (Sertaline) per day for 10 days and partial improvement with treatment

With your symptoms following things come in my mind:

•     Adjustment disorder with prominent Depressive symptoms
•     Mild Depression
•     Anxiety disorder

I am not aware about severity of emotional stress in your perspective, but relationship conflict usually gives rise to chronic stress which can lead to adjustment problem. If the symptoms are severe or prolonged and associated with other symptoms like decrease sleep/appetite, ideas of guilt/worthlessness/hopelessness/self harm and decrease activity then its raise suspicion of Depression. But final diagnosis is possible on personal interview only.

Points in favour of Depression in your case:
•     Long duration of symptoms
•     Symptom precipitated by stress 8 month back and continuation of symptom in current situation
•     Symptoms affecting personal, social or occupational life

I would consider anxiety as least possibility as you did not mention about anxiety in your primary complaints and mild anxiety symptoms common in depression.

But whatever is diagnosis you are on right track regarding treatment as Daxid is helpful in all these disorders.

Following steps will be helpful in your case:

•     Do not worry and focus on exam preparation. Satisfaction with study is biggest stress reliever for medicos.
•     Continue Daxid in same doses for at least 9 month
•     Take psychiatrist consultation.
•     Try to maintain personal and social life in your usual self.
•     Do aerobics, meditation and yoga
•     Take milk and multivitamins capsule as vitamins deficiency can lead to decrease concentration

Hope this answers your query. In case of any doubt, I will be available for follow ups.

Wishing you good health.

Regards,

---

Hello again,

50 mg Daxid is minimum effective dose of sertaline and you have shown improvement with that. So there is no need to increase dose.

Before starting treatment you must visit psychiatrist to assess current need of treatment and future plan of management.

Do not worry about weight much but monitor it weekly. In my practice I have not seen much side effects with only 50 mg dose of Seratline.

Final Words: do not worry, seek treatment and concurrently prepare for PG preparation.

Best of Luck,

Regards,

---