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Dr. Vikas
Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2219
Experience:  MBBS ; M.D Psychiatry, MS. Health Informatics
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Dr. Vikas only please:Namaste, OKMH815211

Resolved Question:

Dr. Vikas only please:


 


Namaste,


 


No chat please, since I cannot see it properly on my phone


 


You have helped me (44 year old female) and my 8 yr daughter before so I am following up on both of us.


 


Here is how I feel with no medicines in me: I would love to find a way to not have to take medicine.


 


Exercise and therapy have not helped me during the times I am not engaged in them at that moment.


 


How would you diagnose someone like me described below?


 


I feel so low and hopeless


 


I feel no motivation for my life - what's the point for going through like like this?


 


I have no friends and have not been able to make any because I do not have and upbeat energy to me. 


 


I seem to always notice problems instead of being light and breezy.


 


I am a very intense female. I have intensity in my expression and verbage.


 


I tend to be very black in white in my thinking and too sensitive.


 


I assume the worse since I have been let down so much.


 


I worry about certain things before they happen because I feel that I will be better prepared if I start now.


 


I cannot seem to cope with events that trigger failure or stress for me. Ex: Ex spouse calling hearing his voice and news of all of his glory.


 


I am so awkward socially.


 


I feel so devastated by my loneliness and lack of having much to offer.


 


I can't seem to take much initiative. Its too hard.


 


I isolate be it is do hard to interact with people.


 


I am very meek unless I am paying for a service then I take more of a stand.


 


It feels that I have no backbone at times.


 


I have trouble setting boundries with people.


 


I feel truly overwhelmed by appointments and normal tasks such as washing dishes and laundry.


 


I do not know how to comfortably converse with people unless I am leaning on them for support or talking about myself in therapy.


 


I Feel the necessity to use food to feel better by calming, distracting and numbing.


 


I am so fatigued most of the time with no physical energy or stamina.


 


Alot of doctors do not believe in salvia cortisol tests but mine showed extreme low levels of flatlined cortisol.


 


No more gusto like I had 10 years ago.


 


No more guts either


 


Suffer severe emotional stress on a daily basis.


 


It as if I do not have emotional skin I cry alot and am such a overly sensitive and fragile minded female.


 


I feel powerless about how to deal with my self-doubts


I feel powerless about how to get real satisfaction in life


I feel powerless to insure my own safety


I feel powerless to appropriately assert my independence


I feel powerless to fill myself up when I feel empty inside


 


I have had alot of issues and bad side effects with different meds before. I am extremely sensitive to all meds and supplements.


 


I refuse to take something that is likely to cause weight gain since I am already at obesity and am desparate to lose the weight.


 


Wellburtrin causes major irritability


 


Prozac causes no sleep and lower negative mood than I already have


 


Cymbalta made me feel anti social and pissy


 


Celexa helped toughen my life tolerance up, but the excessive sleepiness made me non functional.


 


Neurontin made me sleep 16 hours a day and no function several others that I do not remember at this moment.


 


Is there anything out there can help me feel normal and not like this big ball of stress who is constantly overwhelmed and over sensitive?


 


Since you previously suggested my 8yr old be on abilify, I wanted to update you that after 6-8 weeks it has leveled out.


 


At first she was 90% better and now she is 50% better. I want to keep the dose low at the 2mg for safety/health purposes.


 


A few nights I gave her 3mg without improvement and tried dropping it to 1mg which brought back her agitation and short fuse and fits. I am thinking of adding in here 10mg long acted Ritalin while being on the Abilify to tackle her inability to focus now and concentrate.


 


What are your thoughts?

Submitted: 1 year ago.
Category: Mental Health
Expert:  Camille-Mod replied 1 year ago.

Hello,

I'm Camille, and I’m a moderator for this topic. I sent your requested professional a message to follow up with you here, when they are back online. Unfortunately I do not know when this may be, as the professionals come on line as they are available. You don't have to stand by, you will get an email telling you when you have received a response. If I can help further, please let me know. Thank you for your continued patience.

Best,

Camille

Expert:  Dr. Vikas replied 1 year ago.
Hello / Namaste :)

Thanks for the follow up.

All the symptoms you have mentioned are more or less pointing towards the possibility of depression in your case.

I am giving a link below which is from a very trusted source. Kindly go through it once and let me know whether or not your symptoms are matching with those mentioned in that article.

What does it feel like? -

http://www.rcpsych.ac.uk/expertadvice/problemsdisorders/depression.aspx

By the way, have you ever tried Lexapro or Pristiq ?



Regarding your daughter, she is currently on a very low dose of Abilify. It is a common clinical finding that patients may sometimes stop responding to a particular medicine after taking it for some time and may be the same is happening with her also. In that case, the usual strategy is to increase the dose and see if it helps.

The usual dose range of Abilify is from 15-30 mg in Adults and children may tolerate lower dose better.

Still, 2 mg of Abilify is a comparatively low dose and if she is not responding to it, you can discuss with her doctor about increasing the dose further to 4 or 5 mg and see if it helps.

Ritalin can help in improving focus and attention / concentration but can also worsen the mood symptoms and this should be kept in mind by her doctor.

Kind regards

Vikas
Customer: replied 1 year ago.

Yes, I do match most of those depression symptoms.


 


I think I tried Lexapro for a day or so and felt sick.


 


Doesn't Lexapro have that fatigue and weight gain affect.


 


Have not tried Prestiq but would like to know more about its affects on weight gain and sleepiness.


 


Is it a form of Effexor?


 


Would a med even help me with all the awful feelings and perceptions I experience?

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

See, all SSRI antidepressants like Prozac, Lexapro, Celexa can cause gastrointestinal side effects like nausea / vomiting sensation, constipation and or diarrhea. In addition to this, all SSRI antidepressants can initially worsen the anxiety symptoms like dizziness, sweating, palpitation, chocking sensation, insomnia to name a few but these symptoms are transient.

We usually prescribe SSRI antidepressants like Lexapro or Prozac in combination with Benzodiazepines like Clonazepam initially which can control these side effect till the antidepressant start working.

Probably, you also experienced the side effects of SSRI antidepressant which made you think that you are not able to tolerate those antidepressants. This time, you can ask your doctor to prescribe you any SSRI antidepressant like Lexapro or Prozac or Zoloft in combination with a benzodiazepine like Clonazepam .25 or .5 mg twice a day and this should be enough for controlling the initial anxiety symptoms caused by SSRI antidepressants. Clonazepam will also help you in relaxing a bit.

Lexapro is weight neutral as seen clinically. Few patients may find it sedating but most other patients find it activating. We usually prescribe it at night in combination with .25 or .5 mg of Clonazepam.

Pristiq usually dose not cause weight gain or sleepiness. It is prescribed in a single daily dose of 50 mg per day. It is a slightly modified version of Effexor. Many patients who are not able to tolerate Effexor find Pristiq useful.
Customer: replied 1 year ago.

Is Pristiq a SSRI?

 

What made made you think of that one for me?

 

I really like the sounds of it after reading other' reviews

.

When I start it do I take it every other day like I read or daily?

 

How would you suggest I handle it if when taking it I feel more aggitated and mean and anti social?

 

I end up quitting usually when those symptoms be unbearable like that in the first few days. Feeling worse than I already do really stinks!

 

How is Pristiq for social anxiety?

 

What can I expect feelings/mood wise if Pristiq works like it is supposed to?

 

Would you tell me about Modafinal?

 

I have a very sensitive system and did not know if I could handle such a s med but I am so extremely tired all the time.

 

Since I suffer from chronic fatigue, I wonder if this could help me feel more energy. I do not want to feel like I am on speed where I have the crazy jitters.

 

I used to take Ritalin. Is it similar in the way that Ritalin works which is really intense and causes me to feel down as it wears off in the night.

 

Can Modafinal be split in half?

 

Is it a time released pill?

 

In Canada it is so much cheaper but the manufacture differs. It is made by Sun Pharmaceutical Industries in India. Are the medicine standards strict in India? Does the non active part change the way the medicine works on my brain compared to the US manufacter?

 

Would you trust ordering it from outside the US such as Canada or the UK when it is manufactured in either India or Singapore or UK?

 

In the US the generic and not vary from the generic by more than 2%. Do you happen to know if the Indian version is alot higher than that?

 

Can Pristiq and Modafinal be taking together and what are your thoughts on that?

 

Does Modafinal show its benefits and effects the same day you take it or does it have to build up over time?

 

Is there anything that should not be taken at the same time as this?

 

Expert:  Dr. Vikas replied 1 year ago.

So many questions in one single post :)

 

No, Pristiq is a SNRI antidepressant which acts on serotonin as well as norepinephrine neurotransmitter. Those patients who are not responding to SSRI antidepressant usually respond well to a SNRI antidepressant.

 

It is taken daily in a single dose.

 

Pristiq can be useful for social anxiety, depression, other types of anxiety disorders. May be useful for chronic fatigue as well.

 

No it is not like Ritalin.

 

Not able to comment regarding the drug from different manufactures from different countries.

 

Modafinil and Pristiq can be prescribed in combination by your psychiatrist.

 

Modafinil may take some time to show its effect.

Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2219
Experience: MBBS ; M.D Psychiatry, MS. Health Informatics
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Dr. Vikas
Dr. Vikas
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MBBS ; M.D Psychiatry, MS. Health Informatics