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Suggest Treatment For Homicidal Thoughts, Depression, And Insomnia

Posted on Tue, 29 Apr 2014

Question: When I was 16-17 I began seeing a psychiatrist for homicidal thoughts, depression, and insomnia. I was prescribed Celexa, Trazadone, and Risperdal. Little later he added Ambien for when Trazadone did't work. Shortly after I was 18 my insurance ran out. I am now 31 and I am thinking I need to go back to a Dr. For the most part, I didn't notice any effects from the medicine until after I stopped taking it. Risperdal helped me not think so much on bad thoughts. After stopped, seemed to seperate mind into 3 parts. Part I say, part that thinks, and part that has to stay quiet. I went to the hospital once. They seemed like they were surprised when I said why I was there. Made me think they couldn't do anything! What can I do to be happy and not feel like I'm just fighting a losing battle?

Answered by Dr. Jonas Sundarakumar (1 hour later)

Brief Answer: You need proper evaluation for a correct diagnosis Detailed Answer: Hello and welcome to Healthcare Magic. Thanks for your query. I understand that you are going through a very dificult battling with your psychological problems. The symptoms that you have described such as homicidal or bad thoughts and other disturbances can be due to a variety of causes - like obsessive disorder, psychotic disorder, etc. Regarding your medication, you seem to be on a combination of different medication: - Celexa (Citalopram) and Trazadone are anti-depressants which also have anti-anxiety and anti-obsessive properties. - Risperidal (Risperidone) is an anti-psychotic medication. So, I'm not sure what your initial diagnosis was and why you wre prescribed this particular combination of medication. But however, you say that they haven't seemed to help you much and that you are still going through a lot of suffering due to your symptoms. In such a situation, I think that the most important thing is to make a correct diagnosis. Only then the appropriate treatment can be given. Therefore, I would advise you to see a good psychiatrist to have a thorough evaluation and detailed psychological assessment in order to arrive at the correct diagnosis and for further treatment. Don't lose heart, there are many newer medication and therapies available nowadays, which can help you overcome your problems. Wish you all the best. Regards, Dr. Jonas Sundarakumar Consultant Psychiatrist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Jonas Sundarakumar (19 hours later)

When my insurance ran out, the Dr. said he would eat the cost of my visits and give samples meds to allow me to keep taking. Felt like he was concerned about me not being able to take meds. I'm now 31 so, been about 11-13 years since stopped seeing Dr. Was trying to say that I didn't notice much effect from medicine except, I think the Risperdal helped me to control the bad thoughts, and after stopping taking it seemed to divide my mind. I'm very in control but, I really think I need to get back to a Dr. to help me feel well! I've been searching for my old Dr. but, I can't find him anywhere! I have insurance through my work but, searching for psychiatrist on website only gives 1 that's 70+ miles away! I am having trouble finding a Dr. to go see! I know the Drs. have different specialties and I don't want to go into a new Dr. and start from scratch just to feel like they can't help me and have to go somewhere else to do it all again! I'm also concerned that, I first went to a Dr. for depression and sleep aid meds, and they had to call psychiatrist for recommendations on what meds to give me because of other conditions. I don't feel like it would be wise to go in to Dr. without them knowing what they were dealing with! Only thing the Dr. told me about diagnosis was, that based on test, I was near a nervous breakdown. I wound up checking myself in to hospital 3 weeks later.

Answered by Dr. Jonas Sundarakumar (35 hours later)

Brief Answer: I agree that you need an expert evaluation... Detailed Answer: Hello again, I would agree with you that it is important that the doctor is competent and experienced enough to conduct a proper evaluation and arrive at the correct diagnosis. Otherwise treatment efforts may only be futile. In my opinion, since your case requires an in-depth evaluation, it is better to see a specialist (psychiatrist) for this. Otherwise, like you mentioned, it is quite possible that a GP or family doctor may only end up referring you to someone else. As I had mentioned earlier, the most important part of management is an accurate diagnosis. So, even if you consult a specialist once to get a proper evaluation and diagnosis from a specialist, further treatment and follow-up can be continued with your local doctor. Best wishes, Dr. Jonas Sundarakumar Consultant Psychiatrist

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar