Ask a Psychiatrist and Get Answers to Mental Health Questions ASAP
I am sorry to hear that you are experiencing multiple emotional symptoms that are so problematic in living a fulfilling life with a minimum of symptoms. Of course you are experiencing the after effects of all the abuse. At the same time, you may be experiencing problems that result from severe mental illness (the cause of which maybe a brain disorder in its function and the neurotransmitters that make it work effectively. With the proper treatment, both medication and psychotherapy you have every reason to hope that things will improve. That is not to say that all the problems will disappear and everything will be normal. At best given the severity of the problems the best outcome that you can probably look forward to is improvement with reduced symptom, not a complete cure.
I have a number of questions in order to provide a more in depth diagnosis?
1. What diagnoses have you been given?
2. What medications are you taking now and what have you taken in the past, and to what degree has any of them helped?
3. Have you been hospitalized? How many times and when was the most recent?
4. Are you under the care of a. a psychiatrist? b. neurologists?. c. What type of psychotherapists?
5. Who is in overall charge of your care?
4. What is the most important question that you wish answered?
Complex post traumatic stress syndrome, coupled with depression and severe anxiety.
I currently take 14mg Diazepam a day. Bumetanide 1mg twice a day. Venlofaxine 75mg three times a day.Pramipexole dihydrochloride 250mcg (180 mcg base).Cetirizine hydrochloride 10mg once a day. Ferrous sulphate 200mg twice a day. Paracetamol 500mg up to 8 tabs per day (for frozen shoulder). I used to take citalopram and zopiclone, but they didn't help after a few months. Three months ago i was given an antipsychotic drug (can't remember the name) but it interferred with the drug for restless legs and so I am waiting for a review of my medicines. I am under the care of a psychiatrist, with a community mental health nurse and a care plan is in force. I am in art therapy for 6 weeks now. I have been hospitalised three times in the last 6 months. Once for an overdose, and twice for cutting myself severely. I want to die all the time and so I am only allowed 2 days meds at a time. My psychiatrist Eva Dietrich is in overall care of me, but my care co-ordinator has just left to go to another job. I think I will never get better and the voices are getting worse, so can I be cured? Can I take any antipsychotic which won't interfere with my restless leg meds? Right now I have murderous thoughts, but am very passive and miss my care-co-ordinator so much , I really don't feel safe or trust myself. Should I stop taking all the drugs?
I am going to be candid and share my thoughts and then turn it over to other experts for their input. It sounds like you are receiving excellent care both treatment and custodial care. I have looked up all your medication and it appears that only 2 are psychotropic. The diazepam for anxiety and the Venlofaxine which is a SNRI antidepressant anti anxiety. medication. The other medications are for pain, , anemia. restless leg, and anemia. There may be good reasons but you describe psychotic symptoms, but are not presently receiving an anti psychotic and psychosis appears to be the worst of your symptoms so I would ask the prescribing doctor about that. I do not believe that you should stop taking any of your medications without consulting with your physicians as the results could be disastrous.
So to recap you are taking at present 2 psychotropic medications and I would question why you are not on an anti psychotic. I would ask the doctors if you are experiencing in their opinion a psychotic disorder as well as the possibility of borderline personality disorder. I would continue with the CBT psychotherapy as it is proven effective in both depression and anxiety. Again, I am sorry that I could not provide you with more information and I am sending this as needs information so there is no charge and will be opting out so that another expert more familiar with your disorders will have an opportunity to respond.
I am not taking an antipsychotic (dopamine something) because it reverses the effect of the restless legs tablets which is also dopamine something but does the opposite.
Thankyou for your help. Maybe one of the others will know of a different antipsychotic drug that will enable me to keep my legs under control.
I certainly hope so, because the psychotic symptoms are the most pressing. I appreciate that you understand my desire to get you the best and most complete information available on the JA site. Best wishes and good luck.
TheRLS medication is Pramipexole dihydrochloride 250mcg(180mcg base) and the dose is two each evening.
I'm sorry but I can't remember the name of the anti-psychotic drug we tried together with the pramipexole, but it had the effect of acting in the opposite way to the RLS drug which meant that my legs were back as though I wasn't taking the pramipexole, and I spent hours each night pacing up and down rubbing my legs to ease the pain. Are you saying that Gabapentin would work together with the Pramipexole?
I have been giving this question a great deal of thought and all was as I explained to you in that the psychotic symptoms need to be addressed and you should be speaking to the doctor. Although Carol is correct about Neurotin helping with mood swings (I am not a physician but am quite aware of psychotropic medication) but the type of drugs usually indicated for RLS are of the Anti Parkinsonian type such as pramprexole and levodopa rather than anti seizure medications such as Neurotin which is indicated for mood stabilization which I have not heard you mention. Again, I believe as does Carole that the priority issue to be addressed is the psychosis and the appropriate anti psychotic medication to control it without worsening your RLS. So your next step should be to contact Dr. Dietrich to obtain a medication to control your psychotic symptoms. Best Wishes and Good Luck..
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