How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask Dr. Vikas Your Own Question
Dr. Vikas
Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2253
Experience:  MBBS ; M.D Psychiatry, MS. Health Informatics
4079050
Type Your Mental Health Question Here...
Dr. Vikas is online now
A new question is answered every 9 seconds

I am a 50 YO male having anxiety and obsessive thought manifesting

This answer was rated:

I am a 50 YO male having anxiety and obsessive thought manifesting in jealousy issues with my wife. I have a strong family history of anxiety and anxiety attacks. I have been taking Elavil (25mg) for 15 years for Fibromyalgia. It has been a miracle for me and I'm not willing to stop it. I have been prescribe Cymbalta and Pristiq and could not deal with the extreme drowsiness (which may have been because of the Elavil). Is there any other drug you could suggest or should I try to fight through the drowsiness with one of the two drugs I have already been prescribed?

Dr Vikas :

Hello ! Thank you for your question, I’m Dr. Vikas (M.D Psychiatry) and I’ll try to help you today.

Dr Vikas :

Elavil (Amitriptyline) is a Tricyclic antidepressant which mainly acts on serotonin and norepinephrine neurotransmitters. Cymbalta and Pristiq are SNRI antidepressants which also mainly acts on serotonin and norepinephrine neurotransmitters.

Dr Vikas :

Therefore usually, it is not recommended to take Elavil with a SNRI antidepressant because this combination can cause excess of serotonin in the body leading to serotonin syndrome which although not very common but is a life threatening syndrome.

Dr Vikas :

The usual dose range of Elavil is from 75 to 225 mg per day and you are currently taking only 25 mg per day. Elavil itself is a very effective medicine for anxiety related symptoms and a very good option in your case could be to ask your doctor to simply increase the dose of Elavil.

Dr Vikas :

Increasing the dose of Elavil can effectively control your anxiety symptoms and you won't be needing any additional antidepressant other than Elavil for fibromyalgia as well as anxiety symptoms.

Dr Vikas :

I see you are online now, would like to know your thoughts on my suggestion.

Customer:

I have accidentally doubled my Elavil dose to 50mg and the drowsiness that would help me sleep would carry into the next day. Do you think that would subside after a while?

Dr Vikas :

thanks for your reply. Elavil is very sedative in nature and drowsiness as a side effect may appear after increasing the dose but it usually subside within 3-5 days.

Dr Vikas :

still 50 mg is comparatively low dose and for effectively controlling your anxiety symptoms the dose should be around 75-150 mg per day or may be higher. You can discuss with your doctor about increasing the dose by 25 mg every 3-4 days till your symptoms are under control.

Dr Vikas :

are you able to see my reply?

Dr. Vikas and other Mental Health Specialists are ready to help you