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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Mood Swings, Restlessness And Memory Loss

sir,

Good morning. I have been taking psychiatric medicine (i.e Escitalopram oxalate , milnacipran, desvenlafaxine & some multivitamin( mentat, neurofit, vimintaforte)) for last 3 years . There is some improvement in my mental problem but not totally cured .Problems like mood swing, feeligs of hopelessness, restlessmind , sevre concentration & memory problem still persists and affecting in my job. I m confused & waiting for your valuable advice.

My age is 26 . Height-5 ft 6", Wt-65 kg
Wed, 30 Jul 2014
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Psychiatrist 's  Response
Hello,
You are on three antidperessant drugs along with three multivitamins...so many meds are usually not required.
You havent mentioned the dosage of antidepressants here and presently you are not completely fine.

Ideally, escitalopram can be taken upto 30mg and still if there is no response- better stop it and shift to another drug.

Milnacepram is usually not given with other drugs..so, if you want to continue it better take it to appropriate dosage strength or stop it.

Desvenalafaxine dosage can be upto 100mg- if it is less than this and still you have symptoms- then it should be increased or stopped. It is not useful beyond 100mg.

There is no point in taking three meds for one purpose and that too in inadequate doses.

One of the reasons behind your not getting well is so many drugs..With several drugs we dont come to know what is helping and what is not..this also increases mood swings.

Get TSH and B12 levels as they are frequently disturbed in mood disorder patients and show good improvement when treated.

I would have helped in drug changes if you had provided me the dosage you are taking.

Discuss the above points with your doctor, get the recommended tests.

Hope this will help you.
Dr. Manisha Gopal
MD Neuropsychiatry
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Suggest Treatment For Mood Swings, Restlessness And Memory Loss

Hello, You are on three antidperessant drugs along with three multivitamins...so many meds are usually not required. You havent mentioned the dosage of antidepressants here and presently you are not completely fine. Ideally, escitalopram can be taken upto 30mg and still if there is no response- better stop it and shift to another drug. Milnacepram is usually not given with other drugs..so, if you want to continue it better take it to appropriate dosage strength or stop it. Desvenalafaxine dosage can be upto 100mg- if it is less than this and still you have symptoms- then it should be increased or stopped. It is not useful beyond 100mg. There is no point in taking three meds for one purpose and that too in inadequate doses. One of the reasons behind your not getting well is so many drugs..With several drugs we dont come to know what is helping and what is not..this also increases mood swings. Get TSH and B12 levels as they are frequently disturbed in mood disorder patients and show good improvement when treated. I would have helped in drug changes if you had provided me the dosage you are taking. Discuss the above points with your doctor, get the recommended tests. Hope this will help you. Dr. Manisha Gopal MD Neuropsychiatry