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Suggest Treatment For Anxiety, Sleeplessness And Poor Concentration

Posted on Sat, 4 Jul 2015

Question: Having long term problem with concentration, anxiety and sleep

Answered by Dr. Vipul Prajapati (8 hours later)

Brief Answer:
Need to take treatment.

Detailed Answer:
Hi dear,

Thank you for your query.

difficulty in concentrating, anxiety and sleep is suggest that you might have depressive or anxiety disorder.
If above symptoms affects your personal, social and functional level than definitely it needs to be corrected by proper treatment.

First of all detail evaluation of your mental status is necessary.
In your case selective serotonin inhibitor drugs like escitalopram, sertraline, paroxetine may help also other drugs like SNRI also helps you.

With above treatment you need to take benzodiazepins on SOS basis.

Consult local psychiatrist and discuss.

Thank you

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Vipul Prajapati (14 minutes later)

Thanks Dr for your replay.

Based on the details message I sent and attached photos, What is my diagnosis ? Is it a sleep disorder or depression or what ?

How do I make this detail evaluation of your mental status ?

Can we follow up together online for a new treatment journey ?

Answered by Dr. Vipul Prajapati (8 minutes later)

Brief Answer:
it is a major depressive disorder

Detailed Answer:
Hi dear,

Thanks you for your reply.

Based on your reports and your photos i would like to tell you you ave major depressive disorder rather than sleep disorder.

For mental status examination it is necessary to have face to face consultation.

Yes we can start your treatment again.

with your reports and your symptoms i would definitely say that you will benefit by SNRI drugs like desvenlaflexine, venlaflexine but you have to wait for minimum 15 days to see effect.

If you are my patient then i would start tab zyven OD plus 50 mg every night with mirtazepine 15 mg at night and wait for 15 days.

Thank youu

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Vipul Prajapati (10 hours later)

So some questions based on your replay

1- Why previous meds did not work if it was a depression ?
2- I've been on the current valdoxan for over 2 years now. Shouldn't be cured by now ? what's the difference between the medications i took and the last 2 meds mentioned.
3- If I decided to go for the meds mentioened, should I stop valdoxan and buspar ?
By the way, this medications are not available in Turkey. Try this site for other alternatives available https://www.eczanesiparis.com/ or https://www.eczanem.com.tr

4- Is there any chance to get cured without medications at all ?

Answered by Dr. Vipul Prajapati (14 hours later)

Brief Answer:
Yes there is chance without medicines also

Detailed Answer:
HI dear,

Thank you for your reply.

Sometimes medicines not work as every individual are different. so one can try with other medicine which helps one.

Valdoxan is a agomelatine which may help but it is not much effective in depression.
it is particularly used to maintain circadian sleep.

The medicines which i described is serotonin and nor epinephrine inhibitor which is mainstay treatment for depression.

If you want to start the medicines which i described you should stop the medicines which you are using gradually.

yes there is chance of getting cured without medicines in case of mild to moderate depression by exercise, meditation, yoga etc.. but with this methods improvement occurs after a long time.
Thank you

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Yogesh D