Brief Answer:
Yes it is safe to use Trend XR

Detailed Answer:
Hello thanks for choosing HEALTH CARE MAGIC for your health related queries

You are a healthy 31 years old female and have depression. You are on ESCITALOPRAM (Nexito) and ETIZOLAM for depression. Recently you are advised to take Trend XR 250.

Trend XR consist of Divalproate sodium. Valproate is one of common anti epileptic drug. Most of commonly anti-epileptic drugs are also used as mood stabilisers like Sodium Valproate, Carbamazepine, Oxcarbazine etc.

So there is no need to worry about that the drug is used for epilepsy. The drug is one of commonly used mood stabiliser drug used by Psychiatrists. The drug at 250 mg doses is safe and it will help in mood stabilisation and in improvement of your symptoms.

Yes it is safe to use the drug. It is free of serious side effects. During first few days of therapy you may feel nauseous but the nausea usually improve in about a week. Decrease in appetite due to nausea, slight sedation, dizziness can be other side effects at this dose. In very high doses in some susceptible individuals hepatic toxicity may be seen.

Over all the drug is safe and you can take it.

Thanks, hope this helps you. If you have more doubts then you can ask again in follow up question.

Take Care

Dr. Seikhoo Bishnoi

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Brief Answer:
Life style changes and good sleep hygiene will prevent recurrence

Detailed Answer:
Hello thanks for asking a follow up question

If we consider treatment response a number of individuals fails to respond to medicines or show poor response due to poor compliance to medicines and also due to some associated medical reasons. Depression recurrence can occur because of many reasons like-

- A lot of individuals with depression have low Vitamin B12 levels (especially in vegetarians). Even levels of Vitamin B12 less than 300 increase the risk of depressive symptoms. Poor response and recurrence of symptoms can occur because of this. I would advise you to start taking Vitamin B12 supplements. Also increase B12 sources in diet like curd, milk, animal foods etc.

- Second common reason for poor response to treatment and recurrence is associated hypothyroidism. I would advise you to get your Thyroid tests done to rule out hypothyroidism.

Once we rule out these conditions now I would advise you to follow some life style changes and methods to improve sleep hygiene to prevent recurrence of depression-

- Have diets rich in proteins and carbs and low in fats. This will increase tryptophan in brain and will improve depressive symptoms.

- Omega 3 Fatty Acids rich foods like hazelnuts, walnuts, flex seeds, soybeans, fishes like sardine or salmon etc help to improve symptoms.

- One of common reason for poor response and recurrence is stopping the medicines without consulting a psychiatrist. Continue to take medicines regularly as prescribed by your psychiatrist and your symptoms will improve.

- Exercise daily for mood elevation. Exercise results in release of endorphins and which improve the mood.

- Yoga and meditation helps in early recovery.

- Sleep hygiene

~ Have at least 7 hour of sleep, but also don't sleep till late in morning
~ Fix your time to go to bed
~ Don't use your bed for reading books or watching TV. Use bed for sleeping only
~ If you fails to get sleep with in 10-15 minutes on bed, get up and try to distract yourself
~ Avoid tea, coffee, chocolates in evening
~ Light exercise in evening followed by warm water bath will also help
~ Don't think about getting sleep again and again. Excessive worries about getting sleep further worsen the situation.

Improvement of sleep hygiene will improve your sleep. A good refreshing sleep will improve your day to day functioning and your symptoms should improve.


Thanks, hope this helps you. If you have still more doubts or want to clarify anything from my answer you can ask again.

Dr. Seikhoo Bishnoi

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