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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Severe Depression

Hello Doctor, I was recently hospitalized for major depression with psychosis for the first time in my very long (and seemingly hopeless) battle with depression/psychotic depression, anxiety and panic attacks. I was released on Friday 5/15/2015. In addition to changing the times and dosages of the medications my regular Psychiatrist had me currently taking (5mg Klonopin (to 2.5mg), 200mg Lamotrigine (to 300mg), 250mg Nuvigil, 120mg DULoxetine (to 60mg) and most recently ?mg Seroquel XR), the Doctor in charge of my care removed Nuvigil from my regime, changed Seroquel XR to 200mg QUEtiapine Fumarate and added (PRN) 25mg hydroxazine several times a day as needed. I also take otc (PRN) 600mg Motrin and 150mg Tylenol for my constant RA and OA pain. Upon my discharge I was given prescriptions for all of the medications except for the hydroxizine and now I am having a constant amount of mid-level anxiety with some pretty intense episodes. The hydroxizine seemed to help alot with the anxiety and I felt much better and calm in general without feeling drowsy even though I still had/have rapid mood swings, and at the same time my body is trying to adjust to the new regime to level out which has yet to happen :( But is it a safe medication to take on a regular basis? The nurse told me I could buy any antihistimine otc and it would do the same thing so I bought Unisom Sleep Tabs (25mg Doxylalmine) because I can t take diphenhydromine as it has always made me jittery and more anxious and now I ve found that the Doxylamine makes me sleepy and gives me a headache. I don t know what to do but I have to do something as the anxiety isn t subsiding at all. I always feel like I m over-reacting and don t want anyone to think I m drug-seeking because I m not but I don t know whether to ride it out a few more days until I see my regular Dr. but the longer I m anxious, the worse it gets. I feel like I ve been spinning my wheels for way too long. Should I call the Dr. that was in charge of my meds in the hospital or my regular Psychiatrist? Is hydroxizine safe to take with all of my other medications? Any input, advise or opinion would be greatly and sincerely appreciated. Thank You, Priscilla
Thu, 25 Jun 2015
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Psychiatrist 's  Response
Hello thanks for asking from HCM for your health related queries

I can understand your concern. You were on antidepressants and then developed psychotic episode and were hospitalised. Your current medicines are Duloxetine, Nuvigil, Seroquel, Clonazepam and Lamotrigine. You were on high doses of clonezepam and now the doses have been reduced and this could be the cause of anxiety or restlessness you are having. Seroquel and Quetiapine Fumarate are same drugs only so no need to worry. Hydroxyzine is an antihistamines drug with good efficacy in anxiety, but that doesn't mean that every antihistaminic drug would work as anti anxiety drug. In my opinion Doxyalmine doesn't have much effects on anxiety and you should take prescription of hydroxyzine only.

The drug can be taken regularly and there are not much side effects. The drug can cause tolerance and have some abuse potential but if taken as per prescription the drug is totally safe. The drug can be taken with the other medicines you are taking and there are no significant interactions.

Please visit your psychiatrist for your persisting symptoms and take opinion.

Thanks, I hope this helps you. Take care.
Dr. Seikhoo Bishnoi,
Psychiatrist
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Suggest Treatment For Severe Depression

Hello thanks for asking from HCM for your health related queries I can understand your concern. You were on antidepressants and then developed psychotic episode and were hospitalised. Your current medicines are Duloxetine, Nuvigil, Seroquel, Clonazepam and Lamotrigine. You were on high doses of clonezepam and now the doses have been reduced and this could be the cause of anxiety or restlessness you are having. Seroquel and Quetiapine Fumarate are same drugs only so no need to worry. Hydroxyzine is an antihistamines drug with good efficacy in anxiety, but that doesn t mean that every antihistaminic drug would work as anti anxiety drug. In my opinion Doxyalmine doesn t have much effects on anxiety and you should take prescription of hydroxyzine only. The drug can be taken regularly and there are not much side effects. The drug can cause tolerance and have some abuse potential but if taken as per prescription the drug is totally safe. The drug can be taken with the other medicines you are taking and there are no significant interactions. Please visit your psychiatrist for your persisting symptoms and take opinion. Thanks, I hope this helps you. Take care. Dr. Seikhoo Bishnoi, Psychiatrist