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Dr. Vikas
Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2209
Experience:  MBBS ; M.D Psychiatry, MS. Health Informatics
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i need to talk or chat with realy pschatrist know about ptsd

Resolved Question:

i need to talk or chat with realy pschatrist know about ptsd and reexperincing thoughts
Submitted: 1 year ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 1 year ago.

Elliott, LPCC, NCC :

Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Elliott, LPCC, NCC :

Hi Evan from Jordan,

Elliott, LPCC, NCC :

How are you doing?

Customer:

hi

Customer:

are you pschatrist?

Elliott, LPCC, NCC :

You know that part of PTSD involves reexperiencing events that have happened in the past.

Customer:

or have enough exp

Elliott, LPCC, NCC :

No. I am a psychotherapist. Do you think that psychiatrists know more about the same disorder?

Customer:

in midctions?

Customer:

no am having problem with midction

Elliott, LPCC, NCC :

Experience I have. I don't give medications and they are really not the answer to PTSD. They just mask your symptoms.

Elliott, LPCC, NCC :

What medication? What problem?

Customer:

no

Customer:

if you know well about midction

Customer:

then you can help me

Customer:

i already hv theripest

Customer:

i need to ask about midction

Elliott, LPCC, NCC :

I know what medications do, and their side effects, and their contraindications.

Elliott, LPCC, NCC :

Ask me the question and if I am ignorant I will opt out. I

Customer:

ok

Customer:

i hv

Customer:

i was taking

Customer:

seroxat

Customer:

with remeron

Customer:

i reach a 70%

Customer:

improvemnt

Customer:

everything get back

Customer:

after that

Customer:

because i was over weight

Customer:

and because of high blood presser

Customer:

i stops both of midctions

Customer:

and did emdr

Customer:

the stupid arab guy

Customer:

he make emdr while am dissoiated

Customer:

so he make problem on surface

Customer:

after that

Customer:

i get remeron back

Customer:

3x of normal dose

Customer:

but nothing happnd

Customer:

i start reexperince

Customer:

like 10x

Customer:

before emdr

Customer:

just rivotril

Customer:

just that

Customer:

was the thing i need

Customer:

it stops reexperincing and fearing of trauma

Customer:

but when i get here in canada

Customer:

as you know

Customer:

i hd

Customer:

dissoiated fugue

Customer:

one part emerge

Customer:

without axcis the other part that travel from jordan to here

Customer:

and here the problem happend

Customer:

and it looks happning again

Customer:

i cant remember anything again

Customer:

even if i get back to jordan

Customer:

and then get back here

Customer:

i hv very good theripest

Customer:

she told me that

Customer:

and she was right

Customer:

so i book a ticket again

Customer:

and no canada more

Customer:

i want to gv it a try

Customer:

i dont know if it worth it

Customer:

yesterday

Customer:

i take 3 tablet

Elliott, LPCC, NCC :

You are in Canada now, right?

Customer:

yes

Customer:

yesterday

Customer:

i taked 3 tablet of rivotril

Customer:

which mean 6mg

Customer:

emerge

Customer:

and memmories

Customer:

start getting back

Customer:

i start remembering

Elliott, LPCC, NCC :

good memories?

Customer:

but unfortinliy

Elliott, LPCC, NCC :

Your trip?

Customer:

yes

Customer:

but i lost them again

Customer:

but i was right in that

Customer:

but it is not a solution

Customer:

to take benzo

Elliott, LPCC, NCC :

No

Customer:

because it is very dangerous

Customer:

so am thinking

Elliott, LPCC, NCC :

A little bit, \as needed

Customer:

if faster

Customer:

i get the midction

Customer:

that hv stoping reexpering of ptsd anixety

Customer:

if i get that

Customer:

and then remember everything

Customer:

and then wake up

Customer:

at that ground

Customer:

it may work

Customer:

so i want to know

Elliott, LPCC, NCC :

It is coming back, slowly. Don't need to rush it.

Customer:

what midctions

Customer:

no if irush it

Customer:

the problem will happend again

Elliott, LPCC, NCC :

I agree

Customer:

because i hv fugue

Elliott, LPCC, NCC :

You HAD it.

Customer:

so which midctions act directly like rivotril

Customer:

seroxat,zoloft,or prosac?

Customer:

luvox seem useless

Elliott, LPCC, NCC :

First of all, let me say that it is not a good idea to mix different antidepressants as you did with Seroxat (paroxetine) and Remeron (mirtazepine).

Elliott, LPCC, NCC :

Look at the danger (from www. drugs.com).

Customer:

yes indeed

Customer:

yes i know

Customer:

but iwill stops luvox

Elliott, LPCC, NCC :

Interactions between your selected drugs



paroxetine ↔ mirtazapine


Applies to: XXXXX XXXXX (mirtazapine)



Consumer information for this interaction is not currently available.


MONITOR CLOSELY: Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1 receptor agonists, ergot alkaloids, lithium, St. John's wort, phenylpiperidine opioids, dextromethorphan, and tryptophan may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms of the serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucination, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea.

MANAGEMENT: In general, the concomitant use of multiple serotonergic agents should be avoided if possible, or otherwise approached with caution if potential benefit is deemed to outweigh the risk. Patients should be closely monitored for symptoms of the serotonin syndrome during treatment. Particular caution is advised when increasing the dosages of these agents. The potential risk for serotonin syndrome should be considered even when administering serotonergic agents sequentially, as some agents may demonstrate a prolonged elimination half-life. For example, a 5-week washout period is recommended following use of fluoxetine before administering another serotonergic agent. If serotonin syndrome develops or is suspected during the course of therapy, all serotonergic agents should be discontinued immediately and supportive care rendered as necessary. Moderately ill patients may also benefit from the administration of a serotonin antagonist (e.g., cyproheptadine, chlorpromazine). Severe cases should be managed under consultation with a toxicologist and may require sedation, neuromuscular paralysis, intubation, and mechanical ventilation in addition to the other measures.

Elliott, LPCC, NCC :

Seroxat, Prozac, Luvox, and Zoloft are all very similar SSRIs.

Customer:

ok i know

Customer:

no

Customer:

not with me

Customer:

zoloft seroxat

Elliott, LPCC, NCC :

What not with you?

Customer:

stops reexperincing

Elliott, LPCC, NCC :

Both of them do?

Customer:

luvox seem useless

Customer:

i can bring tom

Customer:

any midcine

Elliott, LPCC, NCC :

Then don't use it.

Customer:

and with my dr in jordan

Elliott, LPCC, NCC :

What works best with you?

Customer:

i can switch

Customer:

effexor was very effective

Customer:

but ididnt know that

Customer:

so

Customer:

i need something has the effect of rivotril

Elliott, LPCC, NCC :

You should use the one that is most effective.

Customer:

wt is it?

Elliott, LPCC, NCC :

Rivotril is a benzodiazepine, as you know (generic name is clonazepam).

Customer:

i hv chocises

Customer:

seroxat,zoloft?

Elliott, LPCC, NCC :

I mean you should use the one that works best for YOU ! ! ! !

Customer:

which one

Customer:

which on act like rivotril

Elliott, LPCC, NCC :

Which one helps you more? Seroxat? Zoloft? Effexor?

Customer:

yes

Customer:

which one

Customer:

this is my q

Customer:

between zoloft and seroxat?

Customer:

both on wekipidia are best for reexperincing

Customer:

what which is better?

Customer:

i take seroxat for 1 year

Elliott, LPCC, NCC :

None of them. Rivotril is a benzo. Other benzos are alprazolam (Xanax), lorazepam (Ativan) and diazepam (Valium).

Customer:

zoloft never try it

Customer:

yes but i cant get out of fuge or dissoiation unliss i make change

Customer:

i cant take benzo

Elliott, LPCC, NCC :

Zoloft may be the best for anxiety. Different drugs are more effective for different people. It cannot be predicted. Do you like chocolate or vanilla better?

Customer:

because they are not stable

Customer:

ok

Elliott, LPCC, NCC :

Have you ever tried bupropion (Wellbutrin)?

Customer:

one thing

Elliott, LPCC, NCC :

Yes

Customer:

no what is that?

Elliott, LPCC, NCC :

It is a different class of antidepressant that is also excellent for anxiety. Unlike the SSRIs it does NOT cause weight gain and does not interfere with your sexual desire.

Customer:

ok but i dont hv pschatrist

Customer:

4 month

Customer:

no 1

Customer:

so iwant to ask you

Customer:

mr

Customer:

when idid emdr

Customer:

the feeling and fearing of being hit

Customer:

get worse

Customer:

so idissoiation get wrose

Customer:

and i had these things

Customer:

just rivrtoil when i take it

Customer:

all that

Elliott, LPCC, NCC :

You should avoid EMDR. I have heard many bad stories about it and very few good ones.

Customer:

disapprear for shourt term

Customer:

so what realy is that

Customer:

feeling of bieng hit

Customer:

24 hrs

Customer:

feel all ppl will hit me at anytime

Elliott, LPCC, NCC :

Taking Rivotril or Xanax only occasionally, on an as-needed basis can be a very effective medication, as long as you don't have it every day on a schedule. Just when you need it/

Customer:

which symptoms of ptsd is that?

Elliott, LPCC, NCC :

It is reliving the symptoms - called flashbacks.

Customer:

but it didnt stops

Customer:

i t control me

Customer:

so iwlays in deppression

Elliott, LPCC, NCC :

Did the Rivotril help?

Customer:

yes

Customer:

it like magic

Customer:

it like dword

Customer:

sword

Customer:

take all these out

Elliott, LPCC, NCC :

How often do you get flashbacks?

Customer:

always

Customer:

since idid emdr

Customer:

it didnt stops

Elliott, LPCC, NCC :

Xanax works even faster and does not last in your body as long.

Customer:

yes

Customer:

so what you calld that?

Elliott, LPCC, NCC :

Here is an article about bupropion for PTSD:

Elliott, LPCC, NCC :


http://www.ncbi.nlm.nih.gov/pubmed/9790155

Customer:

feeling of bieng hit

Customer:

24 hrs

Elliott, LPCC, NCC :


Fear

Customer:

the anixety of truama

Elliott, LPCC, NCC :

Yes, Exactly.

Customer:

i dont know what is it

Customer:

but fear stops

Customer:

and logic

Customer:

this is not logic

Customer:

and leave you

Customer:

at apoint

Elliott, LPCC, NCC :

It is strongly impressed in your memory because it was so brutal and frightening.

Customer:

ok

Elliott, LPCC, NCC :

You must slowly work it out.

Customer:

but when i take rivtril

Customer:

it erase all that

Elliott, LPCC, NCC :

It lowers your anxiety.

Elliott, LPCC, NCC :

It is an antianxiety medication.

Customer:

so then it is not fear it is anixety

Customer:

but itake luvox

Customer:

as well as most midction

Elliott, LPCC, NCC :

Yes. And anxiety can make you frightened.

Customer:

non of them act dirctly

Customer:

luvox do nothing

Customer:

i feel in control

Customer:

when itake rivotril

Customer:

luvox

Elliott, LPCC, NCC :

Luvox is fluvoxamine, another SSRI.

Customer:

is useless

Customer:

i know

Customer:

ssri

Customer:

snri

Customer:

i know all that

Elliott, LPCC, NCC :

If it does not work for you, it is useless.

Customer:

but until now ididnt get the point

Elliott, LPCC, NCC :

SSRI not SNRI

Customer:

is there two types if anixety?

Customer:

of

Customer:

because i feel that

Elliott, LPCC, NCC :

Anxiety takes many forms: General Anxiety; Panic Disorder; PTSD; Obsessive Compulsive Disorder; Phobias; Social Anxiety.

Customer:

no i mean two type of anixety

Customer:

the first one

Customer:

is known for everyone

Customer:

the secound one that come from trauma

Elliott, LPCC, NCC :

Those are ALL types of anxiety that I mentioned. They are ALL anxiety disorders.

Customer:

the secound one

Customer:

no

Customer:

i take luvox

Elliott, LPCC, NCC :

yes

Customer:

and other midciton

Customer:

non

Customer:

stops

Customer:

stop it

Customer:

they was useless

Customer:

i always was uncontril

Customer:

until itake rivotril

Customer:

it is the only thing

Customer:

that act to anixety i need

Elliott, LPCC, NCC :

They are antidepressants and you have anxiety, Rivotril is for anxiety.

Customer:

and make me out of deppression

Customer:

and in control

Customer:

i dont want ant anxiety

Customer:

i want something

Customer:

hv rivotril effect

Elliott, LPCC, NCC :

antianxiety drugs means that they are drugs that stop different forms of anxiety.

Customer:

just the same way rivotril

Customer:

ok

Customer:

i want the fourm

Customer:

that rivtroil act it

Customer:

this is my q simply

Elliott, LPCC, NCC :

Same way as Rivotril are, once again: alprazolam, lorazepam, and diazepam.

Customer:

no not benzo

Customer:

even valuim

Customer:

work great

Customer:

i need other midcin family

Customer:

can i find it in ssri

Elliott, LPCC, NCC :

Rivotril (clonazepam) is a benzo and so is valium (diazepam).

Customer:

i know

Customer:

but i cant take benzo

Elliott, LPCC, NCC :

You have tried them and they don't work.

Customer:

everyday

Elliott, LPCC, NCC :

Do you need it everyday?

Customer:

yes

Customer:

what i was telling you

Customer:

i hv very strong

Customer:

dissoition

Customer:

as dissoition fugue

Customer:

last time iget out hospiatl

Customer:

i run away to jordan

Customer:

come on man it is not hard

Elliott, LPCC, NCC :

I know.

Elliott, LPCC, NCC :

There is one other medication that you can try. It is for anxiety and is NOT a benzo.

Customer:

i need to take midction for long term and hv same effect of benzo

Elliott, LPCC, NCC :

It is buspirone (BuSpar).

Elliott, LPCC, NCC :


http://www.ncbi.nlm.nih.gov/pubmed/7951643

Customer:

no benzo

Customer:

or others

Customer:

i hv ocd

Elliott, LPCC, NCC :


No. It is NOT a benzo.

Customer:

so i dont want to add more midction

Customer:

i can change luvox

Customer:

to something good

Customer:

effexor

Customer:

gv me the same effect of rivotril

Elliott, LPCC, NCC :

Try it then.

Customer:

no icant

Customer:

it is snri

Customer:

i need ssri

Elliott, LPCC, NCC :

So what?

Customer:

because of ocd

Elliott, LPCC, NCC :

Who says?

Customer:

it should be ssri

Customer:

best midction for ocd

Customer:

are ssirs family

Customer:

snris are secound family

Customer:

i dont want keep switching

Customer:

midctioon

Customer:

i just move from luvoc

Customer:

luvox

Customer:

to something good in ssri

Elliott, LPCC, NCC :

Effexor is used to treat PTSD. Look at this article.

Elliott, LPCC, NCC :

http://www.ptsdinfo.net/Treatment_meds_venlafaxine.html

Customer:

am sure zoloft and paroxtin

Customer:

is effective

Customer:

i take seroxat for 1 year

Customer:

then i stop it for one year

Customer:

so

Customer:

if i take it

Customer:

it may work quicker than new midction?

Customer:

because iremember frind telling me that midction sometimes may work qucker

Elliott, LPCC, NCC :

What do you mean?

Elliott, LPCC, NCC :

Medication may work quicker that what?

Customer:

mr realy iapprite your help but ineed pschatrist

Elliott, LPCC, NCC :

OK. Goodnight.

Customer:

goodnight

Expert:  Dr. Vikas replied 1 year ago.
Hello


So you are looking for an effective SSRI antidepressant, is that correct?

Thanks

Vikas
Customer: replied 1 year ago.

yes,i tried seroxat,work well for symptoms,i change to luvox i thing it gets worse,because i hv dissoiated identity as well as dissoited fugue,rivotril was like magic but i cant take any more of it,and many bad effects i want something work like rivotril for long term can i find it in ssri?is luvox ok or not am takeing 200mg


 

Expert:  Dr. Vikas replied 1 year ago.
Thanks for your reply.

I personally don't use Fluvoxamine (Luvox) at all because most of my patients don't respond to it like they do to other SSRI antidepressants.

In your case, either Lexapro (Escitalopram) or Zoloft can be a very good option in my view. Both of these medicines are well tolerated by most of the patients are very useful for all the diagnosis you have mentioned.

Rivotril is a benzodiazepine as you must be knowing but can be used for short term only because of the risk of dependence and tolerance to its effect. SSRI antidepressants like Lexapro or Zoloft are a better option if you the medicines are to be continued for long durations.

I hope this helps. Please feel free to discuss further if you have any doubt / query in your mind.

Kind regards

Vikas
Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2209
Experience: MBBS ; M.D Psychiatry, MS. Health Informatics
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Dr. Vikas
Dr. Vikas
Mental Health Professional
2209 Satisfied Customers
MBBS ; M.D Psychiatry, MS. Health Informatics