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Suggest Treatment For Depression And Anxiety
Question: I am a 48 yr old female who has suffers anxiety and depression from time to time. After 3 really good years I have been having major anxiety due to changes in my life over the last 6 wks. My G.p has prescribed citalopram and 5 weeks in iam still feeling nauseas and have little or no appetite. Is this side affects or just my anxiety? Am due to start a new job next week and am dreading feeling like this.
Brief Answer:
Depression is yet to be treated
Detailed Answer:
Hello,
Thanks for choosing health care magic for posting your query.
I have gone through your question in detail and I can understand what you are going through.
From what you have stated it is quite clear that you are having a depressive episode. Depression can occur with regular stress and it can also occur biologically without any stress as well. You need proper treatment for the same. There are various effective therapies for depression like fluoxetine, venlafaxine, bupropion, mirtazapine or escitalopram and they are all very effective and mostly safe. However its unfortunate that you are not able to tolerate citalopram. Nasuea and stomach upset is a side-effect of citalopram and this is due to the excessive serotonin in the body. Its would be wise to get shifted to venlafaxine or bupropion which may not cause depression. You may also require some benzodiazepines like clonazepam or lorazepam for a short period like 2-3 weeks to reduce the anxiety and help with your sleep.
If you are averse to the drug therapies then there is also an option of cognitive behavioural therapy. This therapy is taken by either a psychologist or a psychiatrist in which the therapist identifies impaired cognitions (Thoughts) and try to correct them. They are 15-20 min weekly session and there should be around 8-10 sessions to help you with your illness.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
In future if you wish to contact me directly, you can use the below mentioned link:
bit.ly/dr-srikanth-reddy
Wish you good health,
Kind regards
Dr. Srikanth Reddy M.D.
Depression is yet to be treated
Detailed Answer:
Hello,
Thanks for choosing health care magic for posting your query.
I have gone through your question in detail and I can understand what you are going through.
From what you have stated it is quite clear that you are having a depressive episode. Depression can occur with regular stress and it can also occur biologically without any stress as well. You need proper treatment for the same. There are various effective therapies for depression like fluoxetine, venlafaxine, bupropion, mirtazapine or escitalopram and they are all very effective and mostly safe. However its unfortunate that you are not able to tolerate citalopram. Nasuea and stomach upset is a side-effect of citalopram and this is due to the excessive serotonin in the body. Its would be wise to get shifted to venlafaxine or bupropion which may not cause depression. You may also require some benzodiazepines like clonazepam or lorazepam for a short period like 2-3 weeks to reduce the anxiety and help with your sleep.
If you are averse to the drug therapies then there is also an option of cognitive behavioural therapy. This therapy is taken by either a psychologist or a psychiatrist in which the therapist identifies impaired cognitions (Thoughts) and try to correct them. They are 15-20 min weekly session and there should be around 8-10 sessions to help you with your illness.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
In future if you wish to contact me directly, you can use the below mentioned link:
bit.ly/dr-srikanth-reddy
Wish you good health,
Kind regards
Dr. Srikanth Reddy M.D.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thankyou for your advice, is it ok to switch antidepressants? Would I have to be weaned off citalopram first? I have read that mirtazapine is effective for anxiety and may help with lack of appetite and nauseas anxious stomache?
Brief Answer:
Yes its a good drug
Detailed Answer:
Hello
Thanks for the additional query.
Yes you need to be weaned of citalopram and this can be done by cross titration with the new drug. The new drug like mirtazapine will have to be increased gradually and the citalopram will have to be reduced gradually. Its safe to switch antidepressants. Mirtazapine is a good drug for depression as well as anxiety.
Hope this helps,
Kind regards
Dr. Srikanth Reddy MD
Yes its a good drug
Detailed Answer:
Hello
Thanks for the additional query.
Yes you need to be weaned of citalopram and this can be done by cross titration with the new drug. The new drug like mirtazapine will have to be increased gradually and the citalopram will have to be reduced gradually. Its safe to switch antidepressants. Mirtazapine is a good drug for depression as well as anxiety.
Hope this helps,
Kind regards
Dr. Srikanth Reddy MD
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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