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What Causes Lack Of Concentration, Irritability And Loss Of Interest In Daily Activities?

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Posted on Wed, 22 Jun 2016
Question: my wife is feeling very low and sad she is findin
g it difficult to concentrate and is very irritable aswell.she gets angry very fast.though she is a very lively and fun loving person.she is losing interest in day to day things.she was put on (amilin plus)amitriptyline hydrochloride 5 mg about 5 days back ,she is slightly better, is this the right medication for her and how can i get online cbt help for her.
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (2 hours later)
Brief Answer:
I think there is need to increase the dose

Detailed Answer:
Hello,
Thanks for using Healthcaremagic.

I read your query and understand your concerns.

From the available description it appear that she is having minor depressive disorder for which amitryptiline is right medication. Although the dose of amitryptiline for depression is 25 to 200 mg in adults but in minor depressive disorder the below 25 mg dose works well. Her good response at 5 mg indicates that she needs very low dose of it but I feel increasing dose to 10 mg per day will be enough to resolve her symptoms.

I do offer online CBT and you can contact me at https://www.icliniq.com/ashok.


I hope this helps you.
If you have more questions feel free to write back to me.
Thanks and regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ashok Kumar Choudhary (44 hours later)
Do you think cbt is possible over phone,what are the risks or what are the things i need to be careful about!plz also suggest me how should i convince her to try this?
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (24 minutes later)
Brief Answer:
I don't think phone is good option

Detailed Answer:
Hello,
Thanks for reverting back to me.

CBT over phone although practiced but have obvious limitations due to its non interactive at the level of non verbal communications.

Regarding convincing only patient can decide whether she needs CBT or medications. You just need to inform her that it is as effective as medications without any side effects. In addition the effect remains there even after discontinuation of CBT but that is not always true in regard to medications.

Regarding risks CBT is not that effective in severe depression. It is also not meant for someone unwilling to change.

I hope this clarifies further.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for my future patients.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ashok Kumar Choudhary (27 hours later)
Sir my wife spoke to her sister in law in the night whi told her that her brother has sold his factory and is keeping very low,he also talks about commiting sucide,then in the night my wife could not sleep and constantly kept waking up fearing she might go out and jump from the terrace she told me this in the morning when i asked if she slept well or not.she said she didnt get out of the bed fearing she might do that!hope these thoughts will be fine with the medicine she is taking or there is a change required?
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (4 hours later)
Brief Answer:
She required increased dose and more social support

Detailed Answer:
Hello,
Thanks for reverting back to me.

With information about fearfulness and ideas of self harm I feel we need to revise her diagnosis from Minor depressive disorder to Major depressive disorder.

As I suggested in my first answer we also need to increase her dose. This is right medication and will help her but I feel we need at least 25 mg of amitryptiline per day.

In addition she also needs social support from near and dear ones as it is stressful time for her. In addition to supporting her it is important to keep her constant observation and ensure somebody stays with her for atleast next one week.

I hope this assists you further.
Thanks and regards.

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

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr. Ashok Kumar Choudhary

Psychiatrist

Practicing since :2000

Answered : 3355 Questions

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What Causes Lack Of Concentration, Irritability And Loss Of Interest In Daily Activities?

Brief Answer: I think there is need to increase the dose Detailed Answer: Hello, Thanks for using Healthcaremagic. I read your query and understand your concerns. From the available description it appear that she is having minor depressive disorder for which amitryptiline is right medication. Although the dose of amitryptiline for depression is 25 to 200 mg in adults but in minor depressive disorder the below 25 mg dose works well. Her good response at 5 mg indicates that she needs very low dose of it but I feel increasing dose to 10 mg per day will be enough to resolve her symptoms. I do offer online CBT and you can contact me at https://www.icliniq.com/ashok. I hope this helps you. If you have more questions feel free to write back to me. Thanks and regards.