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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4053
Experience:  MD Psychiatry
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Customer Question

Dear Sir,

My latest diagnosis is SCHIZOPHRENIC DEPRESSION with severe GAD and OCD features.

My Psydoc has put me on the following meds since a couple of days :

1) DULOXETINE 30mg ( 1----x-----1 )

2) Aripiprazole 20mg ( 1----x----x )

3) Clonazepam 1mg ( 1-----1------1 )

4) Pregabalin 150mg ( x----x----1 )


I am feeling a little better on these meds. But my chief complains are :

1) Absolute Lack of motivation to study

2) Working Memory problem ( I was tested for memory and the result was that I am suffering from moderate impairment of working memory, visual learning and memory )


Sir, kindly provide some input and add necessary meds (for my extreme anxiety and Memory) to my drug regimen which I shall discuss with my Psydoc ( she is very understanding ).

I cannot tolerate Quitiepin as it worsens my condition.


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

Welcome to the site.

Well as such your drug regime seems to be fine for your underlying diagnosis of schizophrenic depression but i feel that the drug regime can be improved by making some changes in the regime such as mentioned below.

1) Add Lamotrigine at dose of 100 mg in the morning to start with and after 1 week raise the dose to 200 mg / day and maintain on this dose.
This drug is a mood stabilizer which will manage your low mood, lack of motivation and poor working memory.

2) Take clonazepam in twice a day dosing that is 1 -1.5 mg in the morning and 1-1.5 mg in the evening since this drug is not given in three times a day dosing usually. Taking it three times a day may be contributing to poor working memory as it slows down the thinking process and makes one sluggish.

3) Aripiprazole needs to be taken as 10 mg in the morning and 10 mg in the night dosing instead of 20 mg in the morning dose since by taking it twice a day the effect will last whole of 24 hrs.

4) Duloxetine is to be taken as 60 mg single dose in the night instead of 30 mg dose taken twice a day. This change is suggested because taking duloxetine in the morning may lead to poor alertness and poor concentration and focus, so switching over to the night time dosing will resolve your symptoms

Kindly discuss this with your doctor and carry out the changes and hopefully in 2-4 weeks you will find relief from your current symptoms.

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.

Thanks a lot Sir :)


 


Sir, do u think I need to take MODAFINIL or DONAMEM for memory and concentration.


Expert:  Dr. Kaushik replied 1 year ago.
No, not as of now , just make these changes and wait and watch over your symptoms over 1 month course and if that does not help then we may think using one of these, but certainly not right now.

Regards
Customer: replied 1 year ago.

Thanks. My last request is Can u plz tell me a brand name for Duloxetine 60mg as a single capsule here in India...I m unable to find 60mg capsule.


 


Regards


Expert:  Dr. Kaushik replied 1 year ago.
Duzela , Duvanta, Delok all are brands which have 60 mg duloxetine.

Regards
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4053
Experience: MD Psychiatry
Dr. Kaushik and other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.

Dear Sir,


 


I have another question Please. I sweat very very heavily when i go out. Do i need to take Propanolol or any other drug for this. Is this bcoz of Anxiety which i m having.


Expert:  Dr. Kaushik replied 1 year ago.
Yes it is quite like due to anxiety as it leads to excessive sweating.

Have you ever got your thyroid hormones checked ?

Regards
Customer: replied 1 year ago.

Dear Sir, Yes, many times....my thyroid is under control.


Expert:  Dr. Kaushik replied 1 year ago.
No problem then excessive sweating is most likely due to anxiety which will be controlled by any one of the above mentioned drugs starting with clomipramine which in India is available in the brand name of clonil or clofranil.

While Bupron XL is the brand name for bupropion extended release is available in India, while escitalopram in India is available in the brands like stalopram , s-zetalo, nexito, feiz-s, rexipra.

I hope this helps.

Wish you all the best.

Regards.
Customer: replied 1 year ago.

do i need to add any of these meds to my above drug regimen, if so, which one and at what dose ?

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Expert:  Dr. Kaushik replied 1 year ago.
I have given you these three options as a replacement for your currently used anti depressant , first choice will be clonil/ clofranil at dose of 25 mg / day and then raise the dose to 50 mg dose after 1 week and stay on it. The dose may raised to as much as 150 mg / day as per te need. It is taken as a single dose at night.

I hope this helps.

Regards.
Customer: replied 1 year ago.

Thanks a lot sir.


Expert:  Dr. Kaushik replied 1 year ago.
Take care.

Wish you all the best.

Regards.
Expert:  Dr. Kaushik replied 1 year ago.
However as of now you got to first try out the revised drug regime that i have made for you in the first post and the 3 options of anti depressants namely clonil/clomipramine , bupron XL and nexito are for use ( one of them ) when the above revised drug regime does not work out for you.

I hoep thsi clears it out.

Regards.

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