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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
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Experience:  MD Psychiatry
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I would like to speak with a Psychiatrist please OKMH610211

Resolved Question:

I would like to speak with a Psychiatrist please

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

Greetings !

 

Welcome to the site.

 

I am Dr. Kaushik and I am a psychiatrist and i will like to help you with your problem.

 

Please kindly confirm what are you afraid of ? You had mixed what that is bothering you ?Kindly clear this confusion ?

 

Also please confirm that by feeling draggy during the day, do you mean to say you feel drowsy, sleepy , sloppy ?

 

I will get back to you once you reply to my queries.

 

Regards..

Customer: replied 1 year ago.

Hi Dr~ I am Martha~ you had spoken to me before~you advised that I go off of the daily quietiapine of 25 mg~ also I take .5 and one half of clonazepam at noon~ .5 does not sound like much and even 25 of the other does not either ~ some days are fine with no tired feelings~ I decided to continue with them until I get to a Doctor in this new Province I now live in~today I took them and was very tired~ I also take eye drops for high eye pressure~I lie down as I wait for the time to pass to put the second ones in ~ 10 minutes a part~and then I feel tired~ do these make a person drowsy~ anyway what sort of scared me was I took a second coffee this afternoon with one of those power energy bars~my son got them for me~ I felt rather light headed after~ or more like I had taken a drink~ which I do not do on these pills~ I wondered if the cafeine in these was too high ~I never tried them before~ when I wake up I normally do not feel tired and maybe then I should not take a pill until later in the day~if I feel anxiety~I take them since it says morning and noon and whether I feel anxiety or not~I am just afraid to go off or not take what is prescribed to do~ I wonder why some days are fine and others not~ I know I still suffer grief from losing my husband~ I do not have a great support system here either~I am alone a lot~ as my son has his own issues~ but he does do a lot for me~he is why I moved here~I have a persian cat for company~people who have not lost a mate do not seem to understand the pain~ I guess no one can really help ~except God~ but today my concern was these energy bars and the way I felt after~Martha~PS~I called the number on the bar and they want to call me back in two days~ no doubt I scared them ~ maybe they are afraid of a law suit~:-)

Expert:  Dr. Kaushik replied 1 year ago.

Thanks for the valuable inputs.

 

Well I believe the light headed feeling that you experienced was most likely due to excessive intake of caffeine and it seems quite unlikely to be a result of a harmful interaction between coffee and the energy bar although here as i speak i am ruling out the fact that the energy bar was expired or of poor quality.

 

It is actually a well known fact that excess of coffee can at times precipitate light headed feeling, dizziness, palpitations in it's users so i will suggest you to cut down on your coffee intake.

 

Now as far as your drug regime is concerned i have mentioned this before too that it is the morning doses of quetiapine and clonazepam which are resulting in such drowsiness, tiredness and groggy feeling on and off , the fact that you are not taking high doses of each of them prevents you from feeling tired, groggy and sloppy each day but instead you experience these symptoms on those days when your mood is overwhelmingly sad and ridden with your husband's memories and this coupled with the effects of these two drugs brings about the tiredness and sloppiness in you.

 

So i again will reiterate that whenever you see a doctor kindly ask him to shift these two drugs to the afternoon timing instead of morning if you cannot stop taking them in morning in the first place.

 

I hope this helps.

 

Wish you all the best.

 

Regards..

Customer: replied 1 year ago.

Thanks so much~ I wondered to why sometimes I am okay~ would it hurt to take them in the afternoon instead of the Morning~or if I do not feel anxiety to not take them a day~ or maybe just one of them~I was taking them on schedule whether I needed them or not~I thought I might experience side effects worse than the tiredness~ as I always was told to not stop a drug cold turkey~ I know soon I shall have to get to a Doctor~ Martha~

Customer: replied 1 year ago.

Hi Again~I know that getting a Psychiatrist in a new place shall take a while~so I appreciate your input~I wonder if I just take the clonazepam each day and no quietiapine~ just the two night ones~I hate to change that one as it works so well~ would cutting out just that one 25 mg day one make much difference~ I realize when I stayed with my son for 6 weeks when I first moved here~I did not seem to experience this same tiredness~ no doubt because my mind was occupied more off my grief~so you make sense~secondly if I take the medication only when I feel anxiety would that be okay~ again cutting that one quietiapine~or does the clonazepam also make me drowsy~thus far today I have not taken anything and am not sure what to do~ at least I am not feeling tired~but will there be side effects~Martha~

Expert:  Dr. Kaushik replied 1 year ago.

Thanks for the inputs.

 

Well it will be for better if you can just stop the morning quetiapine and continue to take the night time quetiapine dose and as far as clonazepam is considered, yes it too causes sedation / drowsiness but quetiapine is stronger than this drug in terms of drowsiness plus it has an additional fast acting anti anxiety effect which shall keep your anxiety and stress away whole day, so clonazepam shall either be taken on PRN basis that is as and when required basis at times overwhelming stress or else push it's intake to after noon. But as far as night time dose of clonazepam is concerned it shall be continued.

 

So to summarize.

 

-- You shall continue to take night time doses of both quetiapine and clonazepam.

 

-- Stop the morning doses of quetiapine and clonazepam.

 

-- Shift morning dose of clonazepam to afternoon dose or else take clonazepam only occasionally when the need arises.

 

I believe this shall take care of your tiredness and drowsiness although it may take some time for you to stabilize once you start following this regime.

 

I hope this helps.

 

Wish you all the best.

 

Please kindly leave a Positive rating if you are satisfied with the answer.

 

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

 

Regards..

Customer: replied 1 year ago.

Thanks so much~I only took the clonazepam at one o' clock and missed my morning dose of quietiapine~and clonazepam~ I will continue it at night as you said~ I was taking it at one o'clock as well as the morning~the clonazepam that is~as was prescibed~ so from what I understand you are saying to skip the morning dose completely and only take the one o' clock one of clonazepam ~ one and one half tablets~plus a B 12~ should I continue with B12~ or can one over take it too~ can you explain to why when I took marijuana ~ I have not in a few months now since on this medication~ why I felt so much better than I ever did in my life~even people noticed I seemed so much better with OCD ways~ where I tend to put everything on a pile~will I have withdrawal symptons by missing my morning dose~ I sleep in so was taking it late and then the noon one perhaps too soon~will I never take the quietiapine again in the morning~ perhaps some from the night before would be still in my system~I have half tablets for in between if I have anxiety~of quietiapine~ should I continue with this~ I do not always take them however~I do not feel drowsy right now and yet not real well either~ kind of down~ maybe it is lonliness~it still is better than being real drowsy all day~as I told you before I was told never to take an anti depressant~ as I have a bipolar background~I lost my husband and moved all so fast~what time in the afternoon should I take the medication~ as it was morning noon and night in the capsules from the drug store~if I feel anxiety will one clonazepam help ~ sorry for so many questions~ BUT to summerize she had me take the medication at nine in the morning and then again at one~is one a good time to take the morning dose and will waiting for bedtime be too long in between~ boy I ask a lot of questions~a year has passed since my husband died~ but I still miss him so and live in a new place~Thanks for all your help~can you think of a better medication if I was your patient~what is best for OCD people~ I just figure I am that~ from reading about it~

Expert:  Dr. Kaushik replied 1 year ago.

Thanks for the inputs..

 

I shall answer your queries one by one.

 

-- You should take the afternoon dose of clonazepam at 1-2 pm. But if the need arises at times of abrupt onset of anxiety / panic attack then you can taken 1 tablet of clonazepam in the morning too but it is unlikely to develop due to your night time intake of clonazepam and usually clonazepam is given in twice a day dosing, not thrice a day the way your doctor has been giving you.

 

-- I do not think you will have any withdrawal side effects if you discontinue morning clonazepam reason being you will still have enough. probably the right amount of clonazepam in your system to work for your symptoms without any withdrawal symptoms to develop.

 

-- No, quetiapine should not be taken throughout the daytime at any point and only night time dosing should be continued , you see quetiapine has a 24 hr long half life which is enough to allow it to have an effect whole day long in a single daily dose, so a night time dose shall be sufficient , yes the dose at night time may be increased by 25 mg every 1 week to as high as 300 mg/day if the need arises but I feel as of now you should stick to your current dose.

 

--- Yes I concur to your mentioned format of clonazepam intake, kindly continue it and at times when you are feeling anxiety despite taking the regular dose then you may take 1 more clonazepam tablet over it.

 

-- Yes you shall continue taking B12, it is a good supplement to help your cause plus it has no side effects. You shall continue taking it for at least 1 month.

 

-- As far as why marijuana use made you feel better is concerned, the reason lies in the fact that marijuana has a tendency to mask one's subjective emotional tone aka feelings and provide a sense of tranquility and peace within and therefore people tend to stay on it quite unaware of the fact that it has a lot of abuse potential and it causes life threatening addiction / dependence , so it is only better to keep yourself off it.

 

-- Well for me irrespective of your vulnerability to bipolar disorder, I shall have tried you on a formidable anti depressant drug such as Lexapro at dose of 10-20 mg / day or Zoloft at dose of 50-150 mg / day, the reason being OCD is best managed when a combination of an anti depressant , an anti anxiety drug like clonazepam and an anti psychotic drug like quetiapine are used together , in your case unfortunately owing to your morbid fear of developing bipolar disorder you are only using 2 of the desired drugs which is an incomplete regime and I must mention here that despite using an anti depressant in your case you are more likely to escape bipolar disorder development for the simple reason that you are also placed on quetiapine which is known to prevent manic / hypomanic episodes.

 

I hope this helps.

 

Wish you all the best.

 

Regards..

Customer: replied 1 year ago.

Thanks for explaining things so well~I don't know if I have OCD~I have never been told this by four different Psychiatrists ~ they all call me a Perfectionist~I do not have all the symptons~I never get high so I don't think I am Bipolar~ also I have been on B12 for quite a while and she said to take it until someone tells me to stop~ so will continuing it hurt~ the extra pills she gave me in halfs for anxiety are half a quietiapine~ they are really small of course~ the drug store breaks them up for me~ I think what you are saying is instead if I have anxiety to take a clonazepam or half of one of them~not the quietiapine as she said~I am not so afraid of an anti depressant ~just the fact four Doctors disagreed its use for me ~ as well as one on line one~Marijuana has seratonin Sp~I think my brain may lack this~ is it in any of the drugs I am using~ sometimes an anti depressant can take a long time to work~ as well it sure made my family members gain a lot of weight~ lithium was really bad for that~ of course it is not an anti- depressant~it ruined my brother's kidneys and my mother got so big no one knew her~my poor brother now is on dialysis~ do you feel I will feel good on what I now shall take or still continue to complain~ as I sound like such a pest~I am in great grief I know~I guess that there is no pill for that~ I used to like a drink and yet I do not think it is good on this medication~I seem to feel so tired and yet sleep well on the medication~ does grief cause this~wold a GP be able to help~ as my son's will take me on~ A Psychiatrist is hard to get in a new place~Martha~

Expert:  Dr. Kaushik replied 1 year ago.

Well yes grief can make you feel tired but I reckon that it is no longer grief now but a depressive state of mind which has been making you tired along with some contribution to the same being made by the use of naturally sedative drugs like quetiapine and clonazepam in the morning and hence I suggested the changes.

 

I think what you can do is that you can try an anti depressant drug say Lexapro at it's very low dose of 5 mg in the morning while continuing on the discussed drug regime. If you are able to tolerate this low dose for Lexapro for first 3 weeks then you shall up the dose to 10 mg/ day as a single morning intake and maintain on this moderate dose which shall prove to be quite effective to relieve you of your depression and associated tiredness.

 

Well yes a GP actually can help you in this regard as far as prescription of the mentioned drug is concerned but if he is not keen on prescribing you the anti depressant then you shall at least seek a referral from him for a psychiatrist.

 

To sum it all I believe it is high time for you to start doing things a bit differently as far as your regime is concerned because your symptoms have persisted for a long enough time so as to warrant a new drug's role to bring you relief.

 

So kindly discuss Lexapro at it's low dose of 5 mg/ day with the GP and seek it's prescription or at least seek a referral for a psychiatrist who is the best person to prescribe this if the gp is not willing to prescribe it in the first place.

 

I hope this helps.

 

Wish you all the best.

 

Regards..

 

 

Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4032
Experience: MD Psychiatry
Dr. Kaushik and 5 other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.

I rated you and closed off and Thanks for so much help~I do not have access to marijuana here~ but one thing I wondered about it~ how would it react with the drugs such as I now take~ as when I took it I was taking Lectopam for sleep and could take a drink with no problem~I know that most Doctors do not agree with it for medical reasons~in hind sight I think my problem is scoliosis~ I should have mentioned that to you~ no Doctor picked up on it~ except that I had a shorter leg and a chicken chest and so on~ actually Nurses noticed it moreso~or dressmakers~I hate to ask this last question~ but having this could put the brain in the wrong position~ could it not~posture wise I mean~if I really watch my posture it improves the way I feel~ does this make sense~being a lone so much I tend to look downwards more and not upright~have you ever heard of this maybe silly explanation~Martha

Customer: replied 1 year ago.

I also did not get an answer to if I should take the half quietiapines for anxiety in between times or stay off it completely~during the daytime~Martha ~again~

Expert:  Dr. Kaushik replied 1 year ago.

Thanks for the rating, I appreciate it.

 

Well you need to stay completely off half quetiapine tablets during daytime for in between use because if they are taken occasionally on a PRN basis like clonazepam it may lead to imbalance in the steady state plasma levels of quetiapine which shall cause worsening of the symptoms and destabilize your recovery.

 

Now as far as use of marijuana is concerned with the present drugs in use, it is not recommended since it may lead to clouding / impairment of your cognition/ thought process and even excessive drowsiness, thereby compromising your quality of life and functioning plus most importantly it leads to dependence and abuse which can become life threatening so even if it looks like a tempting option for you please stay off it to achieve full recovery.

 

I hope this helps.

 

Wish you all the best.

 

Regards..

 

 

Customer: replied 1 year ago.

Hi Dr.~I appreciated everything that you advised~I can't see why that other Doctor would put me on a quietiapine during the day~ she must hsve known that it would make me tired???~Will I feel any side effects from not taking it ~ like today~ would it be too much to add yet another medication to my night ones ~ if I took this extra one with my bedtime ones I mean~


 


I wrote down the names of your medications~ I ask what if I am not OCD~ this is my own assumption~ would that combination still be good~I may have been just depressed and full of anxiety due to the sudden way my husband died~I signed myself into a hospital~ as I was not sleeping and was exhausted~is how all this came about~ Martha~

Expert:  Dr. Kaushik replied 1 year ago.

Greetings !

 

Welcome.

 

Yes, what you can do is that you can add the morning quetiapine dose which is to be stopped to the night time dose so that the total intake of quetiapine remains the same but the whole dose is now on to be taken at night time.

 

No side effects are usually expected when you are changing the timing of dose.

 

Yes the recommended names of drugs together with your quetiapine and clonazepam is most suited for OCD as well as depression and anxiety.

 

I hope this helps.

 

Wish you all the best.

 

Regards..

 

Customer: replied 1 year ago.

I wonder maybe that three quietiapine might be too much ~ for sleep~ only because you said that three would give me a good night's sleep~without the one of clornazapam and the zopiclone~I hate to cut those last two out~ since they work well~ does these anti- depressants cause weight gain and does quietiapine also~ would this make me go to sleep forever~ as one Doctor already said I was taking like a sledgehammer for sleep as it was~if I add the third quietiapine ~ will it give me an even better sleep~ or too much~I guess I shall never run out of questions~I live alone now and worry more about drugs~I can't figure out yet how the Doctor I had did not suggest this~can you understand WHY she would give me a quietiapine during the day~if this is not normally done~sadly I guess every one has different ideas and not all are right~you are the only Doctor who agreed with an anti- depressant for me~ Martha~

Expert:  Dr. Kaushik replied 1 year ago.

Well you see 3 tablets of 25 mg quetiapine each will sum up to a total dose of 75 mg / night which is still a low to moderate dose since one can go as high as 300 mg / day on quetiapine without any problem , so even if you start taking 3 tablets of 25 mg each of quetiapine still the dose will be within a low to moderate range and will be safe and effective enough to bring you good night sleep and also to allay your anxiety and act as an adjuvant to the chief anti depressant which we have discussed earlier to alleviate depressive features as well. However if you are hesitant then you shall stick to the 50 mg dose at night but add the morning anti depressant to have a better drug regime to control your symptoms.

 

Well the anti depressant mentioned before like most other anti depressants have the potential for weight gain but it is not certain that a user will gain weight while being on the anti depressant , in fact only handful of users tend to gain weight which is reversible as well can be controlled with proper diet and exercise , so please do not draw any random conclusions based on this and neither should you start applying this possible side effect upon yourself even before start of the drug.

 

I really do not know why quetiapine was given during the day or for that matter in a twice a day dosing schedule as guidelines support use of quetiapine in once a day dosing schedule and that once a day dose is to be given at night because the sedative action of quetiapine can be put to use to get a good night sleep which otherwise may cause unnecessary sleepiness, sloppiness and lethargy all day long if the drug is used in the morning.

 

If you want you can discuss this explanation on quetiapine with the doctor and also ask her logic behind use of quetiapine in the morning and also in twice a day dosing when usually once a day dosing is used because it is effective as a single dose / day owing to it's longer half life.

 

I hope this helps.

 

Wish you all the best.

 

Regards..

Customer: replied 1 year ago.

Hi Again~ I always seem to have one last Question~ I have taken the extra 25 mg of quietiapine last night for the first time~I was a bit afraid that I would sleep forever~:-)~It did not seem to make any difference in my sleep one way or another~I still woke at four to go to the wash Room~ anyway now that I move my morning clonazapam to Noon~ when should I take the Noon ones~ one and a half tablet~this morning I took a half~ as I was feeling a bit of anxiety~or should I use them for PRN's~since I no longer take the morning quietiapine I feel much better and not all tired all day~a tired laying down did not even help~ so is it possible this was my main problem and not so much needing an anti- depressant~ Martha~

Expert:  Dr. Kaushik replied 1 year ago.

Greetings !

 

Welcome.

 

First of all only one or two days on revised night time quetiapine shall not bring any additional benefits in terms of sound sleep since the added dose will require 5-7 days to re-establish it's additive effect but you shall be rest assured that this added dose will not lead to excessive morning time sleep as this will be just sufficient to provide you a sound sleep at night that you desire.

 

Secondly you shall take 1 mg of clonazepam at 1-2 pm in the afternoon and the remaining 0.5 mg of it to be used on PRN basis , so this sort of dose revision will neither make you sleepy during the day but at the same time will ensure control over anxiety and stress.

 

I hope this helps.

 

Wish you all the best.

 

Regards..

Customer: replied 1 year ago.

By my just taking the one at Noon or so~ what I am saying is there was already a dose for Noon~ another one and one half~ after the ones in the Morning~ so can you perhaps see that along with the quietiapine in the Morning and also two doses of the clonzapam ~ that all this was too much~I am still adding the cloneazapam at night along with that blue tablet~ so you are saying I will not notice a sounder sleep for a few days~ as I said~I am not even sure if I slept as much last night~I need this night sleep~ so to sum it up ~by pushing my morning clonazapam up to Noon~ the Noon dosage is in limbo then~ can you perhaps see why I was feeling so tired~ Martha~ Many Thanks for so much help~

Expert:  Dr. Kaushik replied 1 year ago.

Well it was the morning doses of both quetiapine and clonazepam which were leading to sloppiness and tiredness and sleepiness. So while now that quetiapine morning dose has been shifted to night time dose, the clonazepam morning dose is to be stopped and used only on PRN basis when you are too much overwhelmed with anxiety despite being on the regular doses.

 

The Noon and night time doses of clonazepam shall be continued as they are being used without any change.

 

So to summarize..

 

-- You shall take noon and night time doses of clonazepam + night time dose of quetiapine ( which has been revised with addition of morning time dose).

 

Both clonazepam and quetiapine doses in the morning to be stopped and clonazepam morning dose may be used on prn basis.

 

I hope this helps.

 

Wish you all the best.

 

Regards..

 

 

Customer: replied 1 year ago.

Do you perhaps see that it was no wonder I was so tired~ I was sleeping in besides and taking the Morning dose and Noon one almost too close together~the odd thing is some days I seemed okay on this ~ it did not hit as hard as towards the end~ I hope that I always can continue on the night doses~ as it makes me sleep so well~would three quietiapine alone~ without the other two work as well for sleep~ and are you saying the sleep shall actually gets better as it is more in my system~ as I did not notice a big change last night~ as I already said~is Lectopam much the same as clonazepam~I used to use that for sleep~ also Ativan~ is it the same~I used that when my husband first died~ from an Out Patient Doctor~Many Thanks ~Martha~

Expert:  Dr. Kaushik replied 1 year ago.

Yes you were loaded on too much of drugs in the morning which were making you feel drowsy.

 

Well 3 quetiapine are sufficient for a good night sleep so they alone can be sufficient at night but not as yet since it will take around 5-7 days for the added quetiapine to bring over it's effects.

 

I hope this helps..

 

Regards..

Customer: replied 1 year ago.

I hate to ask this again~ is Lectopam the same as what I am taking~also Ativan~thank you for being so patient with me~I would like to continue my present night time ones~ hopefully with the added quietiapine it will not me too much~ since you now see I was over drugged in the Morning~perhaps it is not an anti- depressant that I need~ I am not feeling near as tired now~ a little sad though many times~lonely as well~ no pill can take this a way I realize~I wonder why she would give me the half quietiapines for in between anxiety~does clonazepam eventually wear off as one becomes immune to it~ when I see a GP First~I want to mention these things ~there would be no need to take an anti- depressant if I was so down because of being so tired~a couple of days when I saw the eye Doctor and so on and I did not feel this~this part is confusing~as it was a lot of sedative drugs at once~no one even wants to exist feeling like that~how I could have a few good days on it all is a mystery~the Noon one she had an added half~ as the morning dose of clonazepam~I think that you said to also cut out the half at Noon and take only the one~

Expert:  Dr. Kaushik replied 1 year ago.

Yes lectopam( bromazepam) AND Ativan ( lorazepam) belong to the same class of benzodiazepines as does your present clonazepam and they all have more or less same actions.

 

Yes after 2 weeks on the 1 and half dose of clonazepam you may decide on curring down on the dose first to 1 and 0.25 mg and after 1 week to 1 mg dose and maintain on it.

 

I hope this helps.

 

Wish you all the best.

 

Regards..

Customer: replied 1 year ago.

Hi Doctor~You have been so kind and patient~ in your opinion then the PRN would be better with clonanzapam than half a quietiapine~ anyway my Morning and Noon Clonanzapam are only .5 and not a 1~ the one number is XXXXX the night batch~ were you aware of this~ .5 does not sound like a lot and half even less~would I still cut the morning out on this small dose~ Martha~I guess it is so confusing~

Expert:  Dr. Kaushik replied 1 year ago.

Well I was not aware you were taking 0.5 mg in the morning and afternoon, you seen anyways clonazepam is prescribed in two times a day dosing and not thrice a day dosing as you are currently taking so what I suggest is that instead of taking 0.5 mg clonazepam in the morning and afternoon each, instead you shall start taking 1 mg in the afternoon and again 1 mg in the night but there shall not be any morning dose ( 0.5 mg) of clonazepam. After 1 month once you seem to have stabilized on this you may ct down the afternoon dose further to 0.5 mg while maintaining 1 mg night time dose and use 0.5 mg clonazepam on prn basis then maintain on this regime.

 

So to summarize this --

 

As of now you shall take 1 mg in the afternoon and 1 mg in the night of clonazepam.

 

After 1 month you shall take 0.5 mg in the afternoon and 1 mg in the night and if the need arises an additional 0.5 mg can be taken at any time of day on prn basis.

 

I hope this helps.

 

Regards..

Customer: replied 1 year ago.

Thanks again~I guess to get to the one number I shall have to steal from the Morning ones and thus the two .5 's will make the one~hopefully this is enough to control any anxiety~ since adding the extra 25 quietiaine at night my sleep maybe is not as sound as before~ it seems I wake up sooner during the night~ maybe this is my imagination though~to me I should sleep even more sound~ what a case I am~ Martha~What would happen if I just cut out that third quietiapine entirely~although I am not all tired today~I feel sad~other days I am okay~ and can go out~ is this normal~I moved to a new Province and do not know anyone ~also a larger place and thus do not drive here~I lived in a Country setting before~ so I have a lot coming against me~my son's wife is not nice to me~he is my only child is why I moved here~ this makes it more difficult~I do not have any support system~ I thought I would tell you and thus maybe you can see why I am down~the only woman I befriended in my Condo building is facing cancer ~ she just told me two days ago~would all this make my situation hard~I do not have any financial problems~ Martha~

Expert:  Dr. Kaushik replied 1 year ago.

Well I will still persist on the use of 3rd quetiapine reason being it is too early for you to appreciate it's benefits but eventually this additional dose will not only take care of your sleep problems but also it shall help you with your sad mood which is most of the times fluctuating.

 

Also I may add here that along with the emotional baggage of past, moving to a new place too can act as a stressor which gives us more reasons for why you should stick to additional quetiapine which I shall reiterate is not an excess dose as the total quetiapine dose amounts to 75 mg / day which is well within the normal range.

 

So to summarize..

 

-- Please continue on the additional quetiapine for 1 more week and then assess it's usefulness based on which you shall take a decision on it's fate.

 

-- As of now you are facing adjustment problems which is quite normal for anyone who is re-establishing herself in a new surrounding and after a loss of a near and dear one and that is why I support the use of the already discussed drug regime since it will help you to move on in life and prevent you from succumbing to the life stressors.

 

I do not think befriending an ailing person will lead to any major setback in your persona life, in fact you can seek courage from the lady from her struggle with her condition and help each other to encourage each other to endure challenges of life. You see this friendship/ acquaintance can teach you that there are other people other than you who are dealing with much more tough situations and still trying to fight them off so please do not give up on this person and try to provide her support and in return she shall provide you support to go through this temporary touch phase of life.

 

Wish you all the best.

 

Take care.

 

Please kindly leave a Positive rating if you are satisfied with the service.

 

Regards..

Customer: replied 1 year ago.

Thanks so much for the encouragement~I am sleeping well with the added quietiapine~I may wake up and go to the Bathroom and yet seem to be able to go back to sleep~ do you feel now ~ since you know why I was being so tired~ that not taking an anti- depressant may be okay~ do you think this combination will work I mean~since we know why I was so tired with that Morning quietiapine~ I guess also you do not feel the two added medications at night is too much with the extra quietiapine~ Martha~ I thought it would be almost an overdose~ not knowing much about medication~can a person be kind of OCD or kind of Bipolar~or maybe a bit of both~Martha

Expert:  Dr. Kaushik replied 1 year ago.

Well I believe from now on you will get to sleep better only with this type of drug regime and yes I re-confirm that the total dose of quetiapine that you are right now taking at night still amounts to be within the normal safe dose, so do not worry about this.

 

Yes, this drug regime comprising of quetiapine may actually take care of your depression but you got to monitor your symptoms as more time elapses and see how well this drug helps your depression and then based on the level of improvement you may decide on the need of anti depressant although there is a good possibility that quetiapine's use may actually bypass the need of the anti depressant.

 

Well one can have features of both ocd and bipolar so these conditions are not mutually exclusive of each other.

 

I hope this helps..

 

Wish you all the best.

Take care.

 

Please kindly leave a Positive rating if you are satisfied with the service.

 

Regards..

 

Customer: replied 1 year ago.

Hi Doctor~Thanks for so much help~ I have tons of half quietiapines from my prescriptions and yet I think that you said it was best not to use these as PRN's as this Doctor meant them to be~what would they do if I did need help with anxiety~ as these were meant for~I don't know if a half clonazepam will do it if anxiety comes~this sick woman has lots of family near by~ no doubt she will stick close to them during this time~I agree that some people are much worse off than me~ I am just afraid that I inherited some of my famalies mental illnesses~ Bipolar and OCD~no one ever came up with the name OCD however until my sister did ~ she is a Social Worker and read about it~ I guess they are both bad to have ~either one I mean~it seemed marijuana was curing mine for a long time when my husband was alive~ yet you state the opposite~many people swear by it~I hope my medication is as good now~I worked in a Bank for 30 years and never minded the Public~I would be the first to go to the front seat any place~NOW I have Social Phobia and at times find it hard to even go to an appt.~ what causes this~Martha~

Expert:  Dr. Kaushik replied 1 year ago.

Well again I will like to state that you should not take quetiapine on PRN basis reason being on and off use of it will lead fluctuation in it's levels in the blood serum resulting in side effects and worsening your condition. You see quetiapine is a drug which requires longer time to produce it's action unlike a benzodiazepine like clonazepam therefore the use of clonazepam works for a person while quetiapine's not.

 

As far as use of marijuana is concerned well to be frank this substance just gives one an illusion of being in healthy state but slowly yet firmly the same person begins to become dependent on this substance and this is followed by poor health.

 

Yes I feel the current drug regime has the potential to provide you much relief in your underlying symptoms, however your drug regime could still have been better if you had added a morning dose of an anti depressant drug.

 

Social phobia that you are enduring could be related to your lack of confidence in self that you must have picked up after the loss of your partner who in many ways was a pillar of strength and core moral support, so loosing him must have given a bit jolt to your self belief and confidence which possibly had transpired into social phobia/ anxiety.

 

I hope this helps.

 

Wish you all the best.

 

Regards..

Customer: replied 1 year ago.

Hi Again~I think that you hit it right on about losing my partner~ we went always together to places or he did my errands~ my son is now doing them~ yet going out with him is not the same as with my husband~ my son can't seem to see this and wants me to go for drives and so on~it is in my husband's Jeep~ so it makes me sadder~how am I going to get wanting to go out again alone~Why would that Doctor give me all these quietiapine for PRN's~she should know this fact~ I guess if I took six halves I could have a good sleep~ as it would add up to three pills~ I had been taking them at times~ no doubt this added to my already tired feelings~marijuana has such a bad reputation among Doctors~ yet so many testify to it helping them~ can one not get addicted to anti- depressants also~ would this be a life time thing for me~my friend is having her surgery today~ so I feel down and yet I will not know anything for awhile~her family is in charge and I don't know them~she said she would let me know in a few days how she is doing~ I had a big home before to keep up and thus find myself with not much to do here~I feel ashamed when I am fortunate in many ways~I don't seem to have an interest in doing things~ my daughter in law's treatment of me did not help~ so I don't go to their place~ she is Japanese and a different culture from me~I am not used to a City either and lived in a Country setting~ I am afraid what will become of me~Martha~PS Does it not take quite a while before an anti- depressant works or to know even if it does~ so even trying it could be a long process~????Is there any drug that helps Social Anxiety~???

Expert:  Dr. Kaushik replied 1 year ago.

Dear XXXXX, you have gone through a lot of pain and emotional trauma owing to your partner's death, while this is very unfortunate and really tragic but may I take this as an opportunity to urge you to invest some of your time and energy in reaching out to those who are also like you lonely and in need of someone to hear them out. This will infuse a great sense of gratification in you and make you feel attached to life and value your existence more since you would be making some positive differences in the lives of others.

 

So while your husband's loss is irrevocable but it is a fact which you need to accept and start living your life once again possibly this time with a motive to make a difference in the lives of those who are less fortunate and needy, so take up some social service in your area and invest your time in bringing happiness to others and I am sure the happiness that you are going to bring in the lives of others will not only give you more motive and incentive in your life but also it will rub some happiness on you as well.

 

I hope this helps you to see the bigger picture.

 

Wish you all the best.

 

Regards..

Customer: replied 1 year ago.

Hi~I guess I must sound very self centered~it is hard in a new City to meet people~I do not drive here~ plus I have been feeling so down and worried~ I do not want to be a burden to my son~the people in this Condo building believe in sticking to themselves~ cities are often like this~ Ontario is known to be not a friendly place as compared to the Maritimes~N.B.~ I feel very lonely and afraid~sorry to have taken so much of your time~ the medication is also a concern ~hopefully it will help me feel well again~I guess it will be hard to feel the same~ when you are missing part of your heart~I divorced at age 29 too~ thus suffered rejection as well~then brought up a young son alone~ I do not mean to bore you~ I am just afraid I will not make it this time~ I am a millionaire and yet the money my husband left me brings me no happiness~ yet I realize if I did not have it it could be much worse~I even know the answers~ it is how to apply them~the saying that money cannot buy happiness is very true~ the extreme tiredness has left ~thanks to you~ but I wish the down feeling would also go~I want to laugh again~even if I am lucky enough to get the right medication~it could take ages to actually work~or even to get the right Doctor in a strange City~ Thanks for Caring~Martha~

Expert:  Dr. Kaushik replied 1 year ago.
I suggest that you consult a clinical psychologist and seek from him/her CBT which stands for cognitive behavior therapy , a special type of counseling technique that will teach you some core coping strategies so that you can overcome your pain and endure the huge stress of spouse loss and move on in life. This therapy is usually taken in one to one sessions lasting anywhere 1 to 1 and half hrs varying from session to session and with 1 such session occurring once a week this therapy is extremely flexible and lasts 12 -16 weeks but the results are very effective so perhaps this therapy is what you need.

I hope this helps.
Wish you all the best.

May I ask you to kindly leave a Positive rating if you have been satisfied with my service.

Regards.
Customer: replied 1 year ago.

Hi Again~I had hoped for your sake I was finished bothering you~I was reading the comments between us and it seems to say that my adding the extra 25 mg of quietiapine at night ~ instead of the morning~ I also see now I did not over dose by doing this~ as I am still here bothering you~:-)~ anyway I read I think that it shall take a few days for me to actually notice any difference in how I feel~by my taking this extra dose at night????~I am thankful the tired feeling is gone~ but I can't say I feel 100%~ so maybe I should give the extra pill some more time~I guess I did not quite take this in the first time when you wrote it~ 5-7 days I think~I only took it two or three times thus far~ you seem like a very good Doctor~I would Trust you with giving me an anti- depressant~ but who says I have OCD~ except me~the last Doctor could not even say~I was under great stress ~ selling my beautiful home on 6 acres~ and the death~ all so fast and moving so far~ plus women I had hired here to help me unpack stole from me~ even my wedding rings and an Apple I Pod~to make a LONG story short my son managed to get them back~ that was very upsetting~as they seemed like such nice people~ anyway all this could be causing my stress and not exactly OCD~this Doctor called me having a grey area~ what is that~ anyway I was hoping in time I would heal with the medication I am on~ as I am 68 and never took these before~until this death happened~I even went through menopause with no drugs~lectopam and marijuana were all I ever took in later years~I do help my son and listen to his problems~and try and encourage him~ this cancer woman would not bring me down~ I just feel discussed with myself for making a fuss when some are worse off~ Thanks again~Martha~I guess here my main question is will it take a couple of more days with this extra quietiapine at night for me to notice a difference????All I feel now is a lot less tired during the day~Thank goodness~

Expert:  Dr. Kaushik replied 1 year ago.

Yes it shall take around 2-5 days from now foe the drug to start showing it's effects although for much better results you got to take it for 2-3 months continuously.

 

I hope this helps.

 

Wish you all the best.

 

Please kindly leave a Positive rating if you are satisfied with the answer.

 

Regards..

Customer: replied 1 year ago.

I think that you mean it will take a while for me to notice a change in just this extra 25 mg at night in how I feel~I thought it would be right away~in your expert opinion then~I may feel even better taking it and not just leaving it out ~as i thought I would do to get rid of the tiredness~ thanks again~Martha~

Expert:  Dr. Kaushik replied 1 year ago.

Yes you got it now how the medication works.

 

Regards..

Customer: replied 1 year ago.

Hi Doctor~ I was hoping that I would not need to bother you again~ I am not feeling that terrible drained feeling anymore~after taking your advice~but my cat woke me at five AM and I got up and played around with my computer for an hour~then I saw daylight coming and was afraid I would not be able to go back to sleep and thus took a small glass of wine~I am not sure if I slept again or not~but laid in bed later than normal and have felt not well all day~ I don't think the added pill would do this~ as it did not all along~would this be normal starting something different~I guess I just do not have a lot of energy and yet do all my chores anyway and look after everything~my Computer was down and that stressed me and I am just wondering if all this would cause my sort of out of sorts feelings today~I should have stayed in bed ~ as I realize that Computers can be stimulating before sleep time~it being down and trying to work with Technical support is stressful also~ again I am sorry to bother you~ for the past 10 months I managed on this medication and had some good days~maybe being alone too much is not helping either~ Martha~

Expert:  Camille-Mod replied 1 year ago.

Hello,

I’m Camille, and I’m moderator for this topic. It seems the professional has left this conversation. This happens occasionally, and it's usually because the professional thinks that someone else might be a better match for your question. I've been working hard to find a new professional to assist you right away, but sometimes finding the right professional can take a little longer than expected.

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Customer: replied 1 year ago.

Hi Camille~I feel badly that I must have been over doing my questions to this Doctor~I miss my husband and it is very hard to adjust to life alone~I do not have much of a support system or friends in my new Province~ some care takers even stole from me~I only have my son and his wife is not wanting me around~I guess no one can help me~I was worried about the pills I was on~ as they were making me so tired~this last Doctor advised taking them a bit differently~maybe if possible I could get a second opinion~as taking this extra quietiapine at night should to me make me sleep better and yet I don't seem to~maybe it is just me~if you don't think that anyone else can advise me better I understand~ Martha~

Expert:  Camille-Mod replied 1 year ago.

Hello,

Thank you, XXXXX XXXXX continue to look for a professional to assist you. Please let me know if I can be of any further assistance while you wait.

Best,

Camille

Customer: replied 1 year ago.

I guess my main concern and question is to a Psychiatrist~the other Doctor was right about the day time quietiapine making me so tired~ I thus stopped it and took it along with my other two at night~ he said it would be okay~the tiredness left in the daytime~ BUT I seem to feel more depressed during the day and wonder if I should have done this~ maybe I should have just stopped it all together during the day and not take it at night either~ I also take clonazepam at night and during the day~a small dose of .5 and thus take two at Noon now and no quietiapine ~ my Doctor prescribed this in my other Province~I was always told since I have a Bipolar background that I should not take an anti- depressant~ yet this Doctor on line said he would advise it~I am kind of mixed up and would appreciate another opinion~along with three 25 mg of quietiapines at night I also take a 1 clonazepam and a zopiclone~I kind of would like another opinion since I do not feel well~maybe I should have continued the daily quietiapine and yet no one likes to go around tired all day~if you could let another Professional look at this~I would appreciate it~ do I continue with the daily quietiapine or switch it to night or leave it out completely is my main question~it does not seem to make me sleep any better~I also have have quietiapines to be used as PRN's~this last Doctor said not to use them for this~again I would like another opinion~ please try hard to get a Professional soon~I am having a bad day~Martha~

Expert:  Camille-Mod replied 1 year ago.
I am sorry for the long wait. Thank you for your continued patience while I continue to look for a professional for you.
Customer: replied 1 year ago.

Is there a shortage of Psychiatrists On Line~I liked Dr.Kaushik very much~yet there are just a couple of things I would like a second opinion about~the ones I mentioned above~thanks for trying to help me~Martha

Expert:  Camille-Mod replied 1 year ago.

Hello,

I'm sorry to say we have exhausted all our efforts at this time to find the right professional to assist you with your question.

While we were not able to assist you with this question, please keep in mind that JustAnswer has multiple categories, from Health, Pets, Computers, Taxes, Cars, Finance, Law, to Home Improvement, and more, to assist you with any question you may need answered.

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Customer: replied 1 year ago.

I guess my questions are getting boring to the Doctors~I guess I may be depressed and lonely~ living alone is a big change for me~I get afraid maybe~ anyway I wonder if one last question could be answered by a Professional~ last night I noticed for the first time that the extra quietiapine did make me sleep better and longer~I was concerned~ for good reason~ that all along it actually made me wake up more~ and not sleep as well~ which did not make sense to me with an added pill~ I guess the Doctor was right when he said it would take a few days~ My main concern now is staying in bed in the morning too long~ more or less to pass the time~ is this a bad thing~ it may make me feel worse~ I think that this is a good question~!if someone could at least answer this~ I have used many of your different services and enjoyed them~ pets and eyes mainly~so if someone could comment on this I would appreciate it~ staying in bed perhaps does not make a person feel more rested~ but maybe the opposite~Thanks if you can help with this~Martha~

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