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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Depression, Suicidal, Nausea, Nausea, Vomiting, Stomach Pain, Burning Sensation In Chest, Cough. On Celexa. Suggest?

My 16 year old daughter has taken a few medications for depression since November . Before taking these medications, she excelled in school and in sports, being selected as a top basketball players inher province. In November, she came to me ( her mother) saying she was having suicidal thoughts, but no plan to hurt herself. Since this time she stated on Celexa 10 mg - no effect on her sadness, but she noticed it was harder to concentrate at school. After one month, she was switched to 20 mg - still no positive effect on sadness. Her marks at school were starting to drop and she had increased nausea and difficulty sleeping. The dr. Then added Welbutrin, this was not good for her, within days she was having severe nausea, vomiting, stomach pain ad very irritable. The Welbutrin was discontinued. She was then switched to citaloprex in early April- this med was not helping her sadness either. Two days ago, she experienced an episode ode increased depression and asked me to take her to the hospital as she didn't trust herself. We saw the dr. In the emergency dept and he switched her mess once again. She has been taking fluoxetine 20mg and methylphenidate 5mg. Today, she is experiencing flu-like symptoms such as cough, stuffy nose, severe aches starting at lower back and extending to legs and a burning sensation in throat and heart area. I am not sure if she has the flu or if these are side effects from the new medication. She had the cough and stuffy nose two days before she started taking the new mess. Not sure if we try to ride out the symptoms or if these symptoms merit the attention of a medical doctor.
Tue, 7 May 2013
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Psychiatrist 's  Response
Hello
Welcome to HCM

Depression is pervasive sadness of mood with low energy and lack of interest in day to day routine along with a lot of other somatic symptoms. Antidepressant such as Escitalopram or citalopram usually takes about 4-6 weeks to show full effect. They don't work if taken as SOS basis. She has been recently started on Fluoxetine and Methylphenidate and both are good drugs. Fluoxetine is good antidepressant and it also don't cause sedation so it will help in improving concentration. Methylphenidate is a stimulant drug and it improves concentration. As she is experiencing the symptoms as flu like illness and restlessness along with aches most likely these are due to Methylphenidate. The symptoms will go in a week or two. It is a stimulant drug and it causes activation and may precipitate anxiety. If symptoms persist then visit a Psychiatrist.

Thanks
Dr. Seikhoo Bishnoi, MD
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Depression, Suicidal, Nausea, Nausea, Vomiting, Stomach Pain, Burning Sensation In Chest, Cough. On Celexa. Suggest?

Hello Welcome to HCM Depression is pervasive sadness of mood with low energy and lack of interest in day to day routine along with a lot of other somatic symptoms. Antidepressant such as Escitalopram or citalopram usually takes about 4-6 weeks to show full effect. They don t work if taken as SOS basis. She has been recently started on Fluoxetine and Methylphenidate and both are good drugs. Fluoxetine is good antidepressant and it also don t cause sedation so it will help in improving concentration. Methylphenidate is a stimulant drug and it improves concentration. As she is experiencing the symptoms as flu like illness and restlessness along with aches most likely these are due to Methylphenidate. The symptoms will go in a week or two. It is a stimulant drug and it causes activation and may precipitate anxiety. If symptoms persist then visit a Psychiatrist. Thanks Dr. Seikhoo Bishnoi, MD