Brief Answer:
Yes L thinning can be taken

Detailed Answer:

Hello,

First of all regarding L theanin I like to inform you that as per the available data no side effects has been observed till date. It is considered largely safe and without any risk.

I also like to make it clear that there are no recommendations about the dosage of L theanin in severe anxiety and depression but as per my experience people get good response below 300 mg per day (I never tried more than 300 mg per day for any of my patients).

The serious interaction with L Theanin are not known with any of the current medications including Lamictal, trazodone and Ativan.


Regarding Ativan it is safe to taper off slowly. As per that available data you can decrease by 15-20% every 7-10 days. By this way it takes 6-10 weeks to completely stop Ativan. I must inform you that if you still have symptoms of anxiety and depression it will be better to continue with assign as long as you are uncomfortable. Once the symptom remission is achieved you can take a call to discontinue Ativan.

I hope this answers you. Feel free to write back to me if you have more questions.
Thanks.
Regards



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Brief Answer:
Antidepressant should be considered as first line medication

Detailed Answer:

Hello,

Considering that you got a diagnosis of severe depression and anxiety, antidepressants should be the part of treatment as first line. In case there is no response or poor response after a trial of adequate dose and duration other kind of medications can be used which includes both Latuda and Lamictal (they are not exclusive for bipolar disorder or schizophrenia).

It is true that antipsychotics (Latuda) have more side effects in compare to antidepressants. Considering the family history of diabetes I feel SSRI group of medications (Prozac, Lexapro, Zoloft) should be tried as first line followed by SNRI (Effexor, Pristiq).

I hope this helps you further.
Thanks
Regards

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Brief Answer:
Follow up

Detailed Answer:

Hello,

Before you start Latuda it is recommend to get routine blood investigations done such as complete blood count, Lipid profile, Liver function test, renal function test and thyroid profile. At the same time some of these tests (depending on the patient parameters need to be repeated every three and six months).

Considering that you are suffering with recurrent depressive disorder with anxiety with drug resistance I feel you need to continue for a long time (say minimum five years or life long).

Considering your weight I feel bupropion or Fluoxetine or combination of both can be tried as they are effective in resistant depression and does not cause weight gain or dry mouth.

Considering the poor response to medications I feel maintenance ECT can be used for long term management of anxiety and depression. I understand that ECT is invasive procedure but it is one of the safest, least time consuming and efficient treatment modality for treatment of depression (drug resistant).

You need to communicate to your doctor about the fears and weight gain. I must assure you that he will do his best to cure/treat you while causing minimum side effects.

Hope I am able to answer your concerns. 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 me, so that I get a good feedback. Thanks.

Regards

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