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Suggest Treatment For Persistent Depression And Sleep Disorder
Question: Our son XXXX(age 40) has been taking the following medications for depression,and sleep disorder: Cymbolta (90mg) 1x daily, trileptal (300mg)2x daily, latuda (40mg) 1x daily, mirtazapine (30mg) 1x daily, lunesta (2mg) 1x daily. He is having many side effects (facial swelling and twitching, memory loss, anxiety, nervousness) throughout most of the day. In addition, he has been having anxiety attacks and difficulty breathing in the evening about one hour after taking the latuda. He is also just starting TMS treatments (one so far). His regular psychiatrist is on a leave for two weeks and does not have any on call Dr. available. His regular physicians office is closed today. My question is : can we stop taking any of these meds today until we can get him to a doctor hopefully tomorrow?
Brief Answer:
Consultation
Detailed Answer:
Hello, and thanks for your question.
Facial swelling/twitching, memory loss, and anxiety are not likely to be caused by any of the medications you list above. More likely these are symptoms of depression, with the exception of facial swelling which needs emergent medical attention. I would not stop any of these medications, because they cannot be suddenly stopped safety -- instead, you should take him to an ER to get evaluated for facial swelling.
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
Consultation
Detailed Answer:
Hello, and thanks for your question.
Facial swelling/twitching, memory loss, and anxiety are not likely to be caused by any of the medications you list above. More likely these are symptoms of depression, with the exception of facial swelling which needs emergent medical attention. I would not stop any of these medications, because they cannot be suddenly stopped safety -- instead, you should take him to an ER to get evaluated for facial swelling.
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
Above answer was peer-reviewed by :
Dr. Prasad
Thank you for a very generic answer. If you look up side effects of these drugs almost ALL of them include the possible side effects XXXX is experiencing. Did you miss the one about difficulty breathing???? Which occurs one hour after he takes a Latuda pill. You're telling me that's due to depression?????Really....I find your response basically is telling me..... "go to the ER room and let a doctor evaluate the situation". Nice..... and for this I paid a $15 dollar fee.
Brief Answer:
Followup
Detailed Answer:
If you Google the side effects of Tylenol, you will see liver failure listed. Just because a side effect is listed does not mean it is likely. I did not say difficulty breathing was due to depression -- cognitive impairment is. Anxiety is related to depression and often causes the sensation of choking or difficulty breathing -- these are classic symptoms of anxiety and panic. Anxiety can be worsened after taking a medication because the person is anticipating its effects.
If your son is experiencing facial swelling, this could be angioedema or an allergic reaction and needs EMERGENT evaluation in the ER. This cannot wait until tomorrow.
I advised that none of these medications can be stopped safely. This is not a generic answer -- this is based on years of experience I have with these medications and the terrible withdrawal effects people suffer when they stop these medications suddenly.
My recommendation remains the same -- do not stop any of these medications, but go directly to an ER for evaluation of swelling, which could be life-threatening.
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:
If you Google the side effects of Tylenol, you will see liver failure listed. Just because a side effect is listed does not mean it is likely. I did not say difficulty breathing was due to depression -- cognitive impairment is. Anxiety is related to depression and often causes the sensation of choking or difficulty breathing -- these are classic symptoms of anxiety and panic. Anxiety can be worsened after taking a medication because the person is anticipating its effects.
If your son is experiencing facial swelling, this could be angioedema or an allergic reaction and needs EMERGENT evaluation in the ER. This cannot wait until tomorrow.
I advised that none of these medications can be stopped safely. This is not a generic answer -- this is based on years of experience I have with these medications and the terrible withdrawal effects people suffer when they stop these medications suddenly.
My recommendation remains the same -- do not stop any of these medications, but go directly to an ER for evaluation of swelling, which could be life-threatening.
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 guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Prasad
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