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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4004
Experience:  MD Psychiatry
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My American daughter, who lives in Italy, was given a formulation

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My American daughter, who lives in Italy, was given a formulation of Nortriptyline and another drug together, which formed a new drug called Desira, or Definida, or something like that, to help with her recent onslaught of Anxiety. Do you know what this new drug is? She was also given a tiny amount of Prozac, plus xanax drops.

I thought Nortriptyline (which I used to take) was an older drug with more side effects, and not given much anymore. Similarly, Prozac is a bit outdated, too. I don't know how to help her find a doctor who knows a lot aboaut medications.
Submitted: 5 years ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 5 years ago.

Hi there !

 

Welcome to Just answer !

 

Well, as such it is difficult to know the exact name of the drug , as there are a lot drugs with diferent names which are added to nortriptyline , but , it seems that irrespective of its name , the drug in question is an anti anxiety drug ,as an anti anxiety drug is very commonly added to nortriptyline to make such a combination , available as a single drug .

 

Kindly mention the formal diagnosis of your daughter so that i can help you with the best drugs available for her condition?

 

Regards..

Customer: replied 5 years ago.
I don't know the exact formal diagnosis in Italian, but I think it is something like "Generalized Anxiety Disorder"
Expert:  Dr. Kaushik replied 5 years ago.

Thanks for the reply.Well, yes there is a diagnosis in psychiatry medicine by the name Generalized anxiety disorder ( GAD ). For GAD , she has been rightly started on a combination of an anti depressant such as Nortriptyline / prozac and anti anxiety drug such as xanax (alprazolam ).While nortriptyline is a Tricyclic anti depressant ( TCA ) , which is an older generation anti depressant , but prozac ( fluoxetine ) , is an SSRI anti depressant , which is a newer generation anti depressant . And , please take note that since you mention that your daughter was put on a small amount of Prozac , such kind of substandard dosage of an anti depressant would not have possibly helped her , so what is required in her case is consistent use of an anti depressant plus an anti anxiety drug in adequate doses.

 

So, i am mentioning below a treatment regime , for treating her GAD , which she should discuss with her doctor / psychiatrist , and get started on it .

 

1) Anti depressant-- Either continue with Prozac at a dose of 20 mg , to be taken once a day , in morning or instead start on Paxil CR 20 mg , also to be taken only once a day , in morning.

 

2) Anti anxiety drug-- either xanax 0.5 mg at night or Klonopin ( clonazepam ) 0.5 mg at night.

 

So, i summarize the regime as 1 Anti depressant drug either Prozac 20 mg / day or Paxil CR 20 mg / day PLUS , 1 Anti anxiety drug such as Klonopin ( clonzaepam ) 0.5 mg at night or xanax 0.5 mg at night . This regime needs to be continued without any break in between for 2-3 months atleast , and then she may be withdrawn from them slowly.

 

Please make sure that your daughter discusses these above mentioned drugs with her prescribing doctor and gets these doses reviewed by him , and only then get started on it . I am quite sure that this above mentioned treatment regime will work just fine for her and all her anxiety sympotoms will be relieved.

 

I am mentioning below a few links which will throw more light on the uses of Prozac / Paxil CR .

 

http://en.wikipedia.org/wiki/Fluoxetine

 

http://www.rxlist.com/paxil-cr-drug.htm

 

I wish your daughter best of health. Take care.. God bless..

 

I hope my answer serves your query according to your satisfaction.

 

Please press the ACCEPT button if you are satisfied with the answer as only then will i be credited for my service.

 

Regards...

Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4004
Experience: MD Psychiatry
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