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Suggest Medication For Severe Anxiety
Question: I've got a meeting with a mental health nurse at my surgery on 2nd of XXXXXXX to discuss the possibility of changing my medication as I don't think it is working. I have been on it so long I think I've become immune to it. Knowing what you know about my mental health issues are you able to give me any idea what they might try with me?
I used to enjoy going out into my local town to have a wonder but I almost dread going out now. Ny anxiety is a daily constant challenge. If I manage to get out I have to do everything I need/want to do to first time. If I forget to do something I don't feel able to get out of the flat a second time to go into town. If its to see my best friend I can do it but that it.
I used to enjoy going out into my local town to have a wonder but I almost dread going out now. Ny anxiety is a daily constant challenge. If I manage to get out I have to do everything I need/want to do to first time. If I forget to do something I don't feel able to get out of the flat a second time to go into town. If its to see my best friend I can do it but that it.
Brief Answer:
Private Consultation
Detailed Answer:
Hello, and thanks so much for your direct question.
Can you please type out a complete list of all your current medications and their dosages? Then I might be able to predict what change they are likely to suggest.
Dr. Sheppe
Private Consultation
Detailed Answer:
Hello, and thanks so much for your direct question.
Can you please type out a complete list of all your current medications and their dosages? Then I might be able to predict what change they are likely to suggest.
Dr. Sheppe
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
As requested a list of all my medications and the doses:
Duloxetine 40mg
Ferrous fumarate 305mg
Mirabegron fomg
Promethaine 10mg
Propranolol 40mg
Ranitide 150mg
Mirtazapine 45mg. I hope this list helps. When I first started taking the 45 Mirtazapine I was taking it wrong for the first month I was on that dose. I was swallowing the tablet down. I called the surgery pharmacy who informed me at that dose it should be put in the mouth and let it dissolve slowly till gone. I have been doing it that way for a week now and I have been structuring to get off to sleep at night after taking it, but sleeping after my morning care about 0 till about 3 in the afternoon? Can I please have your opinion on this as well as the original/first question?
Duloxetine 40mg
Ferrous fumarate 305mg
Mirabegron fomg
Promethaine 10mg
Propranolol 40mg
Ranitide 150mg
Mirtazapine 45mg. I hope this list helps. When I first started taking the 45 Mirtazapine I was taking it wrong for the first month I was on that dose. I was swallowing the tablet down. I called the surgery pharmacy who informed me at that dose it should be put in the mouth and let it dissolve slowly till gone. I have been doing it that way for a week now and I have been structuring to get off to sleep at night after taking it, but sleeping after my morning care about 0 till about 3 in the afternoon? Can I please have your opinion on this as well as the original/first question?
Brief Answer:
Followup
Detailed Answer:
To target anxiety, I would increase the Cymbalta. This can be increased up to 120mg daily, so you are still on a relatively low dose. This would be the first thing I would do to help you.
Give the mirtazapine time to work. Take it an hour before you want to fall asleep, and do this for 1 week regularly. If it is still not helping you fall asleep, you should try something else, such as CBT-I (CBT for insomnia, such as the online program SHUTi).
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers
Followup
Detailed Answer:
To target anxiety, I would increase the Cymbalta. This can be increased up to 120mg daily, so you are still on a relatively low dose. This would be the first thing I would do to help you.
Give the mirtazapine time to work. Take it an hour before you want to fall asleep, and do this for 1 week regularly. If it is still not helping you fall asleep, you should try something else, such as CBT-I (CBT for insomnia, such as the online program SHUTi).
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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