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Doctor Rao
Doctor Rao, Doctor
Category: Mental Health
Satisfied Customers: 641
Experience:  MBBS,MD,DPM,MRCPsych
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dear sir, i want to discuss something with you , very urgent,

Customer Question

dear sir, i want to discuss something with you , very urgent, regarding yesterday's discussion.
Submitted: 2 years ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 2 years ago.
Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Dear Sir,

I know that we have worked together successfully on at least four occasions. I do not recall a conversation with you yesterday, but if you would like to discuss this with me, I am at your service. Please get back to me and I will do my best to attend to your needs

Warm regards,

Elliott Sewell, LPCC, NCC, CCMHC
Customer: replied 2 years ago.

yesterday, i had a talk with Doctor Rao (Psychiatrist), plz get me connected with him.its very urgent.

Customer: replied 2 years ago.
Relist: Other.
I had posted the question to Dr. Rao (Psychiatrist) with whom i had a discussion yesterday. I need an urgent talk with Dr. Rao, plz.
Expert:  Doctor Rao replied 2 years ago.
Hi,
How can i help?

for some reason your question is in the question and answer mode, not live chat mode.
This means you need to tell me what the issue is and the i will get back to you.
Or else I am not sure whether you can change this to live chat mode.
please let me know hat you want to talk about?
Thank you
Customer: replied 2 years ago.

Today I visited a new psychiatrist and he gave me the following meds.


 


1) Clomipramine SR 75 mg daily.


 


2) Aripiprazole 5 mg daily


 


3) Clonazepam 0.5 mg SOS


 


4) Szopiclone for sleep.


 


Now , sir is this a good prescription for my problems ?


 


and sir , kindly get me converted to LIVE CHAT mode.

Expert:  Doctor Rao replied 2 years ago.
Hi,
This is a good combination of medications.At some point you might need to increase the doses of clomipramine and Aripiprazole. Use Clonazepam and Zopiclone only occasionally when it is really necessary.

Sorry, I can not change this to Live chat. This might be because the previous expert who answered might have converted to Q&A mode, I am only guessing.

Please ask for more information if required. I hope you find the answer helpful.
I wish you all the best.
Thank you
Customer: replied 2 years ago.

so sir, can i stay away from Lamotrigine OD and pregabalin ??

Expert:  Doctor Rao replied 2 years ago.
Yes,If the New Psychiatrist is seeing you again.By this way, you would have option of trying the less number of medications and try to the maximum safe dose before you add.Did you tell him the doses of Lamotrigine and Pregabalin.
You might need to cut down the dose of these two medication for a week to ten days prior to stopping them.

If you anxiety becomes worse you know that Pregabalin is better.
Customer: replied 2 years ago.

Sir, I am open to change psychiatrists if his prescription is not correct. coz i suffer from tremendous anxiety, generalized anxiety disorder, depersonalization disorder, depression and severe obsessions.


 


Sir, plz give me yr dream prescription which i shall discuss with my local doctor.

Expert:  Doctor Rao replied 2 years ago.
Hi,
For obsessions,anxiety and depression the following combination is helpful.

1.Clomipramine 75 mg (to increase the dose as necessary)--This is helpful for obsessions and Depression.
2.Aripiprazole 5mg-This is helpful as an adjuvant to antidepressant and also to help mood swings and some paranoia. (again this can be increased up to 15 or 20 mg as necessary But gradually).
3.Pregabalin 75mg twice daily --This is helpful for anxiety.(the dose can be increased as necessary).
4.Clonazepam 0.5 mg SOS--Tis is helpful for anxiety But not helpful in the longterm. Please note that The only reason i have added to the prescription is you have been taking this medication before and if we stop suddenly, it can cause withdrawal symptoms.

Zopiclone --the medication prescribed you doctor is to help for sleep only.You haven't suggested any sleep problems and if you don't have yo don't need this.If you have sleep issue please make sure you realize you can only take short-term only.

Finally,Please don't change doctors unnecessarily. It is important to stick to one professional as long as they are well qualified. This is only my suggestion.

I wish you all the best.

Thank you
Customer: replied 2 years ago.

So, sir, can I start taking these meds from tonight itself. So, will there be any problem if i stop Lamotrigine n Duloxetine abruptly.

Expert:  Doctor Rao replied 2 years ago.
Hi,
Yes.You can start these medications without any problem tonight as you are already on some of these medications. You need to cut down the dos ego half both Lamotrigine and duloxetine. After one week stop them.
I wish you all the best.
Thank you
Customer: replied 2 years ago.

Sir, one last question please. Do i need any SSRI parallely ?

Expert:  Doctor Rao replied 2 years ago.
No. Clomipramine do that job.

Thank you
Doctor Rao, Doctor
Category: Mental Health
Satisfied Customers: 641
Experience: MBBS,MD,DPM,MRCPsych
Doctor Rao and 3 other Mental Health Specialists are ready to help you

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Doctor Rao
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MBBS,MD,DPM,MRCPsych