Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties
195 Doctors Online

By proceeding, I accept the Terms and Conditions

Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

HCM Blog Instant Access to Doctors
HCM BlogQuestions Answered
HCM Blog Satisfaction

While taking stimulants for depressionannd anxiety how do we tackle

Answered by
Dr.
Dr. Ashok Kumar

Psychiatrist

Practicing since :2000

Answered : 3118 Questions

default
Posted on Wed, 6 Feb 2019 in Mental Health
Question: While taking stimulants for depressionannd anxiety how do we tackle the symptoms of crash ASAP
ex: extreme tachycardia, and rebound anxiety ?
Sometimes clonazepam helps but takes painfully long time to act
Taking methyl amphetamines and bi phentin
default
Follow up: Dr. Ashok Kumar 0 minute later
While taking stimulants for depressionannd anxiety how do we tackle the symptoms of crash ASAP
ex: extreme tachycardia, and rebound anxiety ?
Sometimes clonazepam helps but takes painfully long time to act
Taking methyl amphetamines and bi phentin
doctor
Answered by Dr. Ashok Kumar 4 hours later
Brief Answer:
Clonazepam mouth dissolving tablet can be helpful

Detailed Answer:
Dear XXXXXXX
Thanks for using Healthcaremagic.

I read your query and understand your concerns.

Symptoms of crash such as extreme tachycardia and rebound anxiety can be helped with use of Moth dissolving clonazepam better in compare to clonazepam as per say. This is because mouth dissolving tablets bypasses the stomach and readily becomes available for action.

The next best alternative is alprazolam as this gives early response in compare to clonazepam and similar medications.

I hope this helps you.
Feel free to write back to me if you have more questions.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ashok Kumar 0 minute later
Brief Answer:
Clonazepam mouth dissolving tablet can be helpful

Detailed Answer:
Dear XXXXXXX
Thanks for using Healthcaremagic.

I read your query and understand your concerns.

Symptoms of crash such as extreme tachycardia and rebound anxiety can be helped with use of Moth dissolving clonazepam better in compare to clonazepam as per say. This is because mouth dissolving tablets bypasses the stomach and readily becomes available for action.

The next best alternative is alprazolam as this gives early response in compare to clonazepam and similar medications.

I hope this helps you.
Feel free to write back to me if you have more questions.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Ashok Kumar 3 hours later
Can you please let us know
If the tachycardia is due to anxiety or a drug side effect
And let us know the doses of alprazolam and clonazepam
default
Follow up: Dr. Ashok Kumar 0 minute later
Can you please let us know
If the tachycardia is due to anxiety or a drug side effect
And let us know the doses of alprazolam and clonazepam
doctor
Answered by Dr. Ashok Kumar 4 hours later
Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for follow up.

Although it is not possible to answer the question without checking temporal association between use of medication and tachycardia, principally speaking drug induced tachycardia often lasts longer (hours or round the clock) however tachycardia due to anxiety is often short lasting.

Regarding dose of alprazolam and clonazepam it is advisable to start with lowest possible dose which is 0.25 mg for both options. In case that does not help the dose can be increased by your psychiatrist depending on the response.

I hope this answers you.
Feel free to write back to me if you have more questions.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Ashok Kumar 0 minute later
Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for follow up.

Although it is not possible to answer the question without checking temporal association between use of medication and tachycardia, principally speaking drug induced tachycardia often lasts longer (hours or round the clock) however tachycardia due to anxiety is often short lasting.

Regarding dose of alprazolam and clonazepam it is advisable to start with lowest possible dose which is 0.25 mg for both options. In case that does not help the dose can be increased by your psychiatrist depending on the response.

I hope this answers you.
Feel free to write back to me if you have more questions.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
default
Follow up: Dr. Ashok Kumar 3 hours later
Dr XXXXXXX XXXXXXX
Where do u practice
Can u let us know your address?

Thanks
default
Follow up: Dr. Ashok Kumar 0 minute later
Dr XXXXXXX XXXXXXX
Where do u practice
Can u let us know your address?

Thanks
doctor
Answered by Dr. Ashok Kumar 19 hours later
Brief Answer:
I am practicing in XXXXXXX XXXXXXX

Detailed Answer:
Dear XXXXXXX
Thanks for asking.

I am currently practicing in XXXXXXX XXXXXXX

I do not have any problem in providing address but I must acknowledge that psychiatric treatment often requires long term follow up and it becomes very difficult with passage of time when the distance is too far. In my opinion it is always better to contact nearest psychiatrist.

In case you belong to XXXXXXX or Northern XXXXXXX you can easily approach me at XXXXXXX

Thanks again.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Ashok Kumar 0 minute later
Brief Answer:
I am practicing in XXXXXXX XXXXXXX

Detailed Answer:
Dear XXXXXXX
Thanks for asking.

I am currently practicing in XXXXXXX XXXXXXX

I do not have any problem in providing address but I must acknowledge that psychiatric treatment often requires long term follow up and it becomes very difficult with passage of time when the distance is too far. In my opinion it is always better to contact nearest psychiatrist.

In case you belong to XXXXXXX or Northern XXXXXXX you can easily approach me at XXXXXXX

Thanks again.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
default
Follow up: Dr. Ashok Kumar 13 hours later
Ok thanks
It is just for visit

Our local psychiatrist gave her 40 mg thrice daily methyl amphetamine
Today is the first day and with that she is feeling ok after a long long long time
Also she is tapering acetalopram for 4 weeks and will look at possibility of adding a TCA
So can U let us know what are the effects of very long term use of stimulants
And if TCAs are safe with such does of stimulants or with any dose for that matter
default
Follow up: Dr. Ashok Kumar 0 minute later
Ok thanks
It is just for visit

Our local psychiatrist gave her 40 mg thrice daily methyl amphetamine
Today is the first day and with that she is feeling ok after a long long long time
Also she is tapering acetalopram for 4 weeks and will look at possibility of adding a TCA
So can U let us know what are the effects of very long term use of stimulants
And if TCAs are safe with such does of stimulants or with any dose for that matter
doctor
Answered by Dr. Ashok Kumar 14 hours later
Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for follow up.

The main risk with long term use of stimulants is addiction. The chronic use without medical supervision can cause increase heart rate, blood pressure and body temperature. There are many others which can develop with higher dose such as stroke, heart attack, malnutrition among others.

TCAs should be avoided or should be used in lowest possible dose when you are taking stimulants. It can not be considered safe but when necessary they can be prescribed under regular monitoring.

I hope this helps you.
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:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ashok Kumar 0 minute later
Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for follow up.

The main risk with long term use of stimulants is addiction. The chronic use without medical supervision can cause increase heart rate, blood pressure and body temperature. There are many others which can develop with higher dose such as stroke, heart attack, malnutrition among others.

TCAs should be avoided or should be used in lowest possible dose when you are taking stimulants. It can not be considered safe but when necessary they can be prescribed under regular monitoring.

I hope this helps you.
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:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Ashok Kumar 30 hours later
Pl let us know how to treat insomnia and grogginess due to stimulants
She is taking 40 mg thrice a day. And that has
Inability to sleep
Very early waking up feeling tired
And irregular sleeping times during the day
Today she reduced the dose
default
Follow up: Dr. Ashok Kumar 0 minute later
Pl let us know how to treat insomnia and grogginess due to stimulants
She is taking 40 mg thrice a day. And that has
Inability to sleep
Very early waking up feeling tired
And irregular sleeping times during the day
Today she reduced the dose
doctor
Answered by Dr. Ashok Kumar 15 hours later
Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for follow up.

For management of insomnia due to stimulant use the first thing is to decrease the dose of stimulants. Since she is taking 40 mg thrice a day I feel omitting the last dose of day can be helpful. In case this is not possible the last dose can be taken as half dose (20 mg) as cutting down the last dose may help in reducing the possibility of insomnia.

In case the above option is not feasible or not helping much, the other option is use of sleeping pills such as zolpidem. I often recommend 10 mg of zolpidem to be taken half an hour before going to bed. Since this is prescription only medication you will need a prescription to buy it from pharmacy.

I hope this answers you.
Feel free to write back to me if you have more questions.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ashok Kumar 0 minute later
Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for follow up.

For management of insomnia due to stimulant use the first thing is to decrease the dose of stimulants. Since she is taking 40 mg thrice a day I feel omitting the last dose of day can be helpful. In case this is not possible the last dose can be taken as half dose (20 mg) as cutting down the last dose may help in reducing the possibility of insomnia.

In case the above option is not feasible or not helping much, the other option is use of sleeping pills such as zolpidem. I often recommend 10 mg of zolpidem to be taken half an hour before going to bed. Since this is prescription only medication you will need a prescription to buy it from pharmacy.

I hope this answers you.
Feel free to write back to me if you have more questions.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Ashok Kumar 36 hours later
Just one more question
Can she take a third dose biphentin?
Are methyamphetamine and biphentin compatible
And if so how much dose ?
default
Follow up: Dr. Ashok Kumar 0 minute later
Just one more question
Can she take a third dose biphentin?
Are methyamphetamine and biphentin compatible
And if so how much dose ?
doctor
Answered by Dr. Ashok Kumar 9 hours later
Brief Answer:
Both are same

Detailed Answer:
Hello,
Thanks for reverting back to me.

Biphentin means methylphenidate controlled release. I mean to say that the salt is same in both the names but the preparation is different. Controlled release medications generally last longer in compare to immediate release medications.

The maximum recommended dose of biphentin is 80 mg per day for adults and any prescription beyond this range should have valid indications. In my opinion third dose should be avoided by all possible means as the side effects become more prominent beyond the recommended dose range.

I hope this answers you further.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ashok Kumar 0 minute later
Brief Answer:
Both are same

Detailed Answer:
Hello,
Thanks for reverting back to me.

Biphentin means methylphenidate controlled release. I mean to say that the salt is same in both the names but the preparation is different. Controlled release medications generally last longer in compare to immediate release medications.

The maximum recommended dose of biphentin is 80 mg per day for adults and any prescription beyond this range should have valid indications. In my opinion third dose should be avoided by all possible means as the side effects become more prominent beyond the recommended dose range.

I hope this answers you further.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
premium_optimized

The User accepted the expert's answer

Share on