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Hello Dr, Brief History: I Am 35 Year Male Identified
Question: Hello Dr,
Brief History:
I am 35 year male identified with Generalized Anxiety Disorder and Depression and am on medicines for that since April 2016 i.e. around 3 years now.
My Dr also analyzed I am suffering Bi-Polar. I am not sure of it and due to this he started with a Lamosyn and now dosage has reached to 37 Mg.
Since past 6 months I have been on following medications:
1. Fluvoxin 50 mg - OD
2. Frisium 2.5 mg - OD, revised to 5 Mg since 7th March 2019
3. Lamosyn 37 Mg
4. Prestiq 100Mg , discontinued and replaced with Lamosyn
Before 6 moths I was on Nexito with dosage ranging to 25Mg for about 2.5 Years with Clonotril .25MG SOS to counter Panic attacks.
Thoughts:
1. What I am doing in life
2. What I am doing now, kind of rechecking my actions
3. What should I do next
4. I don't know what to do
5. What is life
5. What is difference between Day and Night
I was and am suffering still suffering from below thoughts but realize with present medication there has been little reduction in their intensity.
Feeling:
1. Fear of death
2. Fear of loosing control over self
3. High anxiety nearing to panic attack
4. Fast heart beats assuming it to be heart attack
5. Dizziness
6. Lack of concentration
7. Continued focus on chest area - tightening, uneasiness and breathlessness
8. Irritation in tongue like its shaking - I drink water hoping it is due to "thirst"
9. Feel sleepy
There has been little or no improvement on these, however I try to convince myself that these are must symptoms of of High Anxiety.
Impact on Life:
1. Unable to spend quality time with family and I office.
2. Life full of worries where am unable to plan for future, career, life, finances,
3. Not able to enjoy life
4. Always worried about my health that I may die
5. Limited my travel and official assignments due to fear of death or loosing control
Attachments:
1. Present medical Prescription
2. Annual health report, Dec 2018
Questions:
1. Am I on right medication? As Frisium is unable to control anxiety episodes and I think my anxiety continues thought day until I get distracted in some work like gardening i.e. different from my official work.
2. I read and understand that medicines which I am having also induce the "Feeling" i listed above. Are there other medicines available which just help reduce the symptoms and don't contribute to it?
3. Recommendations to improve my life and come out of this illness strong?
4. Enjoy my life normally like others, i.e. without fear of death or anxiety?
Brief History:
I am 35 year male identified with Generalized Anxiety Disorder and Depression and am on medicines for that since April 2016 i.e. around 3 years now.
My Dr also analyzed I am suffering Bi-Polar. I am not sure of it and due to this he started with a Lamosyn and now dosage has reached to 37 Mg.
Since past 6 months I have been on following medications:
1. Fluvoxin 50 mg - OD
2. Frisium 2.5 mg - OD, revised to 5 Mg since 7th March 2019
3. Lamosyn 37 Mg
4. Prestiq 100Mg , discontinued and replaced with Lamosyn
Before 6 moths I was on Nexito with dosage ranging to 25Mg for about 2.5 Years with Clonotril .25MG SOS to counter Panic attacks.
Thoughts:
1. What I am doing in life
2. What I am doing now, kind of rechecking my actions
3. What should I do next
4. I don't know what to do
5. What is life
5. What is difference between Day and Night
I was and am suffering still suffering from below thoughts but realize with present medication there has been little reduction in their intensity.
Feeling:
1. Fear of death
2. Fear of loosing control over self
3. High anxiety nearing to panic attack
4. Fast heart beats assuming it to be heart attack
5. Dizziness
6. Lack of concentration
7. Continued focus on chest area - tightening, uneasiness and breathlessness
8. Irritation in tongue like its shaking - I drink water hoping it is due to "thirst"
9. Feel sleepy
There has been little or no improvement on these, however I try to convince myself that these are must symptoms of of High Anxiety.
Impact on Life:
1. Unable to spend quality time with family and I office.
2. Life full of worries where am unable to plan for future, career, life, finances,
3. Not able to enjoy life
4. Always worried about my health that I may die
5. Limited my travel and official assignments due to fear of death or loosing control
Attachments:
1. Present medical Prescription
2. Annual health report, Dec 2018
Questions:
1. Am I on right medication? As Frisium is unable to control anxiety episodes and I think my anxiety continues thought day until I get distracted in some work like gardening i.e. different from my official work.
2. I read and understand that medicines which I am having also induce the "Feeling" i listed above. Are there other medicines available which just help reduce the symptoms and don't contribute to it?
3. Recommendations to improve my life and come out of this illness strong?
4. Enjoy my life normally like others, i.e. without fear of death or anxiety?
Brief Answer:
Lamotrigine helps in resistant depression.
Detailed Answer:
Hello thanks for using ask a doctor service
You are on right medicines and no need to get worried. The doctor has already advised you to increase Lamotrigine in coming days to 50 mg. The drug will supplement the actions of the Fluvoxamine too. The drug is commonly used in Bipolar depression and also in resistant depression.
Frisium is Clobazam and you are on 2.5 mg dose. This is a low dose. Secondly there are better benzodiazepine drugs available like Clonazepam or Alprazolam. Alprazolam is rapidly acting and has great efficacy in controlling anxiety attacks.
The feelings you have are bad thinkings, negative thoughts and also some intrusive thoughts. Poor focus, poor concentration, loss of energy, sleepiness, mild dizziness etc are part of persisting depression. This is the probable reason your doctor has advised you to take Lamotrigine. These are not due to medicines. I don't think any medicine you are taking are contributing to this feeling.
You should change your lifestyle in order to stay healthy and to improve your life. To reduce the symptoms medicinal treatment should be taken along with life style modifications.
Diet should be modified. The diet should be taken with high proteins and high complex carbohydrates and low in fats and refined carbs. Diet should have high amounts of foods rich in vitamin b12 like animal foods milk, curd, cheese, eggs, meat etc. Foods rich in Omega fatty acids like Salmon or Sardine fish, flex seeds, nuts like walnuts or XXXXXXX nuts etc. This will help to keep your mood better.
Exercise too has important roles in mood. Exercise daily for at least half to one hour daily. This should be mixture of cardio and weight training. Exercise results in release of endorphins which lift the mood.
Improve your sleep habits. Avoid waking up late, early to bed and early rise is best for any person.
You should avoid alcohol or tobacco totally.
Continue to take your medicines regularly and make these life style changed. With time you will see improvement. The intrusive negative thoughts will be controlled too.
Thanks and Take care
Please let me know if you have more doubts.
Lamotrigine helps in resistant depression.
Detailed Answer:
Hello thanks for using ask a doctor service
You are on right medicines and no need to get worried. The doctor has already advised you to increase Lamotrigine in coming days to 50 mg. The drug will supplement the actions of the Fluvoxamine too. The drug is commonly used in Bipolar depression and also in resistant depression.
Frisium is Clobazam and you are on 2.5 mg dose. This is a low dose. Secondly there are better benzodiazepine drugs available like Clonazepam or Alprazolam. Alprazolam is rapidly acting and has great efficacy in controlling anxiety attacks.
The feelings you have are bad thinkings, negative thoughts and also some intrusive thoughts. Poor focus, poor concentration, loss of energy, sleepiness, mild dizziness etc are part of persisting depression. This is the probable reason your doctor has advised you to take Lamotrigine. These are not due to medicines. I don't think any medicine you are taking are contributing to this feeling.
You should change your lifestyle in order to stay healthy and to improve your life. To reduce the symptoms medicinal treatment should be taken along with life style modifications.
Diet should be modified. The diet should be taken with high proteins and high complex carbohydrates and low in fats and refined carbs. Diet should have high amounts of foods rich in vitamin b12 like animal foods milk, curd, cheese, eggs, meat etc. Foods rich in Omega fatty acids like Salmon or Sardine fish, flex seeds, nuts like walnuts or XXXXXXX nuts etc. This will help to keep your mood better.
Exercise too has important roles in mood. Exercise daily for at least half to one hour daily. This should be mixture of cardio and weight training. Exercise results in release of endorphins which lift the mood.
Improve your sleep habits. Avoid waking up late, early to bed and early rise is best for any person.
You should avoid alcohol or tobacco totally.
Continue to take your medicines regularly and make these life style changed. With time you will see improvement. The intrusive negative thoughts will be controlled too.
Thanks and Take care
Please let me know if you have more doubts.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr, thanks for your reply There is a sense of depresonalization and constamt rechecking. Like, what I am doing right now? Am I doing right thing? Can you please help me with reason for these behaviours or doubts and what should i do to improve this.
Brief Answer:
These are part of depression and obsessive anxiety.
Detailed Answer:
Hello again
Its normal to have sense of depersonalisation in depression. The intrusive negative thoughts like what I am doing right now, am I doing right thing etc are most likely due to anxiety associated with depression. This could be obsessive anxiety. Over analysis, over thinking, multiple negative thoughts are seen commonly in depression.
But with proper medicines and life style changes you will come out of these symptoms. You should not be worried for that.
Thanks.
These are part of depression and obsessive anxiety.
Detailed Answer:
Hello again
Its normal to have sense of depersonalisation in depression. The intrusive negative thoughts like what I am doing right now, am I doing right thing etc are most likely due to anxiety associated with depression. This could be obsessive anxiety. Over analysis, over thinking, multiple negative thoughts are seen commonly in depression.
But with proper medicines and life style changes you will come out of these symptoms. You should not be worried for that.
Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks Dr, What should I do at the time when this depersonalization and these thoughts are occuring? Please guide with a trick to handle this situation. Thanks, Ankit
Brief Answer:
Follow the life style changes and exercise daily to stay healthy
Detailed Answer:
Hello thanks for asking again
The depersonalisation like feelings or thoughts are part of anxiety and depression. You can consider taking Alprazolam or Clonazepam in low dose at that time. This will help to reduce the thoughts immediately. With time your medicines will work and you will be alright.
Follow the life style changes I've mentioned and you will be alright.
Thanks.
Follow the life style changes and exercise daily to stay healthy
Detailed Answer:
Hello thanks for asking again
The depersonalisation like feelings or thoughts are part of anxiety and depression. You can consider taking Alprazolam or Clonazepam in low dose at that time. This will help to reduce the thoughts immediately. With time your medicines will work and you will be alright.
Follow the life style changes I've mentioned and you will be alright.
Thanks.
Above answer was peer-reviewed by :
Dr. Kampana
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