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Well I will like you to come off remeron and Ritalin and replace these two with any one of these two drugs namely -- Zyprexa (olanzapine) or Risperdal (risperidone) both of which are anti psychotic drugs which are found to be useful in dissociative fugue and which along with Zoloft and rivotril will form a good drug regime to treat your fugue effectively. If zyprexa is chosen which personally prefer over Risperdal due to it's better efficacy then it has to be started at a dose of 5 mg / day to be taken in the night time as a single daily dose but if you choose Risperdal then it has to be started at dose of 1 mg at night time as a single dose.
Kindly discuss this and get the necessary changes donE , after the changeover you shall patiently wait for 2 weeks at least to see any sort of improvement in your fugue/ dissociation as this much time the chosen new drug will require to settle in your body system..
I hope this helps.
what maing this problem is ptsd anixety.when am taking zoloft it helps alot.rivotril as well.but my friend i dont want to keep change midcines.if ritalin in ptsd anixety then i will not change it.and fugue.as well.if not why you give it to me?.be sure it is fugue.i dont want over midction.i cab make remeron 15mg.if that help.if you are sure ritalin wont help me tell me.am taking 60mg daily?
Well Ritalin was supposed to work for your fugue but it does not seem to be working for you that is why I suggested to drop it and replace it with the above mentioned any one anti psychotic drug. Yes it is fugue that you are dealing with.
I have not asked you to change Zoloft and rivotril kindly see the above post of mine again, but I have asked to discontinue remeron because along with another anti depressant drug like Zoloft it can precipitate a serious life threatening condition like Serotonin syndrome other than other side effects, but if you feel you can tolerate the two together then you shall use it but at a lower dose of 15 mg / day.
But I will again ask you to revise your drug regime since Ritalin is not working for you as your condition has not improved after starting it and now some significant time has elapsed so although this was not expected to happen but you can never predict about the drug efficacy at times as it varies from person to person so this Ritalin which works in others who have condition similar like you but unfortunately it is not being effective in your case.
So the final drug regime shall include
-- Zyprexa at 5mg / day or Seroquel at 25 mg / day or Risperdal at 1-2 mg / day , any one of these three to be started and taken as a single dose at night time.
-- Remeron, if decided to be continued by you shall only be taken at low dose of 15 mg / day.
( Ritalin needs to be brought off over a course of 25 days by reducing 10 mg every 5 days).
Wish you all the best.