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Ask Dr. Kaushik Your Own Question

Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4038
Experience:  MD Psychiatry
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ptsd

Resolved Question:

ptsd
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 1 year ago.

Hi there,

Welcome to Just answer !

Kindly please elaborate your question and give some details , so that i can gain more insight about your condition ?

Regards..

Customer: replied 1 year ago.

hi am in canada now.but i dont feel good.i still feel emtional block how emdr with that?

Expert:  Dr. Kaushik replied 1 year ago.

What have you tried before ?

Regards.

Customer: replied 1 year ago.


i did some emdr but the re experining increase.i start living that moment over and over

Expert:  Dr. Kaushik replied 1 year ago.

How about medications and CBT counseling ?

And are you amenable to trying them if not tried earlier ?

Regards..

Customer: replied 1 year ago.


am taking remeron 60mg and luvox 200.no i dont do cbt

Expert:  Dr. Kaushik replied 1 year ago.

Thanks for the valuable inputs.

Well you see PTSD is a very stubborn condition which requires rigorous and relentless treatment comprising of a combination of Drug regime and psychotherapy / counseling .

Now as of now since you have started to revisit the traumatic past life event/s either in the form of nightmares or recurring uncomfortable thoughts which are quite a hallmark feature of PTSD , it suggests that your present drug regime has lost it's steam, meaning that they have become ineffective owing to your body's development of increased tolerance / resistance against the drugs which is not so uncommon scenario.

Since this seems to be the case so i reckon it warrants a revision of your drug regime with most likely solution to your recurrence of your ptsd symptoms being replacement of your current drug regime with a new drug regime , because you see the present doses of these two drugs-- 60 mg of remeron and 200 mg of luvox , are optimal doses of these drugs and if at these doses they cannot contain your ptsd symptoms with emotional recoil of traumatic past life events clouding your mind at present then by all means a reasonable and most plausible solution to your present predicament will be to come off the present drugs and get started on a new drug combination.

I am mentioning below two drug regimes which you shall discuss with your doctor and ask him to choose for you and start you on after bringing you of the current drugs.

1) effexor xr ( venlafaxine ) at dose of 37.5 mg twice a day, as a chief anti depressant and Trazodone at dose of 50 mg at bedtime as an adjuvant supporting anti depressant .

OR

2) Lexapro ( escitalopram) at dose of 10-20 mg / day as the chief anti depressant and Wellbutrin xl ( Bupropion ) at dose of 150-300 mg / day as an adjuvant anti depressant.

Either of these two drug regimes are formidable to help you to overcome your PTSD symptoms effectively , but when one of them is chosen as a replacement of the present drug regime, just make sure that your doctor first weans you of the present drugs albeit slowly and then gets you started on the chosen drug regime , this is important to prevent development of unwarranted and distressing withdrawal syndrome.

Now i must also address here that CBT ( Cognitive Behavior Therapy ) has proved to be a very effective specialized counseling tool to manage PTSD symptoms as it besides helping to ease emotional tensions within the person related to past , it also teaches one some coping skills and mental strengthening exercises which the person can practice regularly to keep the ptsd symptoms mitigated.

So it will only help you in the long run if you can seek CBT from a clinical psychologist , which is a very appropriate counseling technique for your condition of PTSD , while you get the necessary drug changes done on the other hand.

However if it is too much for you to get started on CBT and do the drug revision at the same time , then i will suggest that you should atleast get the drug revision done so that your current symptoms will be managed effectively thereby buying you some more time to think over starting on CBT.

I hope this helps.

Wish you all the best.

Please kindly leave a positive rating if you are satisfied with the answer as only then will i be credited for my service.

If there is any further assistance needed please feel free to ask using the reply button.

Regards..

Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4038
Experience: MD Psychiatry
Dr. Kaushik and other Mental Health Specialists are ready to help you

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