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Ask Dr. Kaushik Your Own Question

Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4004
Experience:  MD Psychiatry
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hi.chat please

Resolved Question:

hi.chat please
Submitted: 10 months ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 10 months ago.

Dr. Kaushik :

Greetings !

Dr. Kaushik :

How are you doing ?

Customer:

hi

Customer:

i will wait ypou

Customer:

hi

Customer:

hallo

Customer:

hi

Customer:

hallooooooooooooooo

Customer:







There is a problem with this website's security certificate
Customer:

hi

Dr. Kaushik :

I am sorry, i had connection problem at my end.

Dr. Kaushik :

Please go ahead with your question.

Customer:

Hi

Customer:

Are you there?

Customer:

Haloo

Customer:

I will wait for you

Customer:

Ok?

Customer:

Hallo

Customer:

Hey

Customer:

I will wait

Customer:

Not everything you said was right

Customer:

You was wrong about remeron! Once I move to 30 mg I get manything

Customer:

Like feelings.power.in control my real identity get back memmories

Customer:

But with all + things side effect was big problem

Customer:

I start eat like never and sleep too long

Customer:

I need a soultion for this problem

Customer:

Non of ssri or snri can give same effect of 30 mg remeron

Customer:

Side effect again is very big problem

Customer:

Why 30 mg is better than 15 mg?

Dr. Kaushik :

ok.

Customer:

It is much much better

Dr. Kaushik :

If you try to remember in our previous many conversations the reason i had asked you to bring the dose of remeron down was because of the weight gain and increased sleep that it causes.

Dr. Kaushik :

Never ever i meant that efficacy wise this drug is not good as it was quite apparent that it helped you with your dissociation but it was associated weight gain that bothered you

Dr. Kaushik :

and on that i asked you to come down to 15 mg dose and introduce risperdal.

Customer:

Yes help in dissoction like magic

Dr. Kaushik :

And it may so have happened that the improvement that you are having is because of risperdal now that you are taking a good dose of 2 mg

Customer:

Yes

Customer:

But still if I make 15 mg dissdisscotion increase

Customer:

Why I dont take 22mg

Customer:

And add effexor or anfranil

Customer:

Effexor is very good for anixety and depprission

Dr. Kaushik :

With remeron

Dr. Kaushik :

effexor is very good indeed

Dr. Kaushik :

the combination of effexor and

Customer:

Yes 15 mg remeon

Dr. Kaushik :

remeron

Customer:

75 effexor

Dr. Kaushik :

is called as California Rocket fuel

Customer:

200 zoloft

Customer:

Maybe it helps?!

Dr. Kaushik :

Here comes the problem

Customer:

And give me effect of 30 remeron

Dr. Kaushik :

and the problem is that combination of effexor and zoloft can bring out a very serious often life threatening complication / side effect

Customer:

I took zoloft and effexor at high doses before togther

Dr. Kaushik :

called as Serotonin syndrome

Customer:

Yes but effexor now just 75 mg

Dr. Kaushik :

and you tolerated them well./

Dr. Kaushik :

because i am concerned about serotonin syndrome

Dr. Kaushik :

http://www.mayoclinic.com/health/serotonin-syndrome/DS00860

Dr. Kaushik :

see this link and you will understand why i am so much concerned

Customer:

Can effexor 75 with remeron give effect of 30mg?

Dr. Kaushik :

You mean effexor 75 mg + 15 or 22.5 mg of remeron

Dr. Kaushik :

?

Customer:

15 mg remeron

Dr. Kaushik :

> = 30 mg remeron affect

Customer:

75 effexor+15 remeron=30mg remeron?

Dr. Kaushik :

yes

Dr. Kaushik :

better than that

Dr. Kaushik :

much better

Customer:

Ok very good

Dr. Kaushik :

this combination is world renowned

Dr. Kaushik :

and is called as California Rocket Fuel.

Customer:

Very good

Customer:

Good

Customer:

I wont get over 75mg

Dr. Kaushik :

so you are going to give this a try

Customer:

1 tablet daily

Dr. Kaushik :

ok.

Customer:

Yes

Customer:

But you make me scared

Dr. Kaushik :

but if you have any of the below mentioned symptoms

Customer:

About serotonin syndrome

Dr. Kaushik :

agitation

Dr. Kaushik :

restlessness

Customer:

no

Dr. Kaushik :

No,

Dr. Kaushik :

i am saying that once you

Dr. Kaushik :

start on this 75 mg effexor and 15 mg remeron combination

Customer:

I took 300 effexor + 200 zoloft for 1 year

Dr. Kaushik :

just watch out of these symptoms of serotonin syndrome

Customer:

Nothing happend

Dr. Kaushik :

like agitation, increaed heart rate and blood pressure fluctuation,

Dr. Kaushik :

dilated pupils

Dr. Kaushik :

heavy sweating

Dr. Kaushik :

diarrhea

Dr. Kaushik :

shivering , anxiety,

Customer:

I see

Dr. Kaushik :

fever of high grade

Dr. Kaushik :

irregular heart beats

Customer:

Yes indeed

Dr. Kaushik :

, seizure

Customer:

But my friend am just taking 75 effexor

Dr. Kaushik :

then yon need to immediately stop this combination and report to your doctor

Dr. Kaushik :

Yes i know

Customer:

This should happend when?

Dr. Kaushik :

but you probably do not know that at low

Dr. Kaushik :

dose also serotonin syndrome

Dr. Kaushik :

can be precipitated

Customer:

If there a risk when it should happend?

Dr. Kaushik :

also it can occur a second

Dr. Kaushik :

time

Customer:

No I mean in first month?

Dr. Kaushik :

if it has not occurred in the first time

Dr. Kaushik :

3-4 weeks

Dr. Kaushik :

initial period after starting the drug combination

Customer:

if the first month pass then ok?

Dr. Kaushik :

yes

Customer:

Can effexor work for ocd?

Dr. Kaushik :

most likely there will not be any problem if the first month pass safely

Dr. Kaushik :

yes of course

Dr. Kaushik :

it is a very good drug for that

Customer:

At which dose?

Dr. Kaushik :

75-225

Customer:

I see

Dr. Kaushik :

but you shall not take high dose more than 75

Customer:

Yes indeed

Dr. Kaushik :

so better stick to 75 mg dose

Customer:

Yes indeed

Customer:

So ptsd dose is 75?

Dr. Kaushik :

yes

Customer:

And depprission

Customer:

?

Dr. Kaushik :

at least 75 mg is essential to make a difference

Dr. Kaushik :

yes for depression too

Customer:

I see

Customer:

Maybe I ask dr

Customer:

To take out zoloft

Dr. Kaushik :

you should consult doctor

Customer:

And give effexor +remeron

Dr. Kaushik :

because if you can take out zoloft then you can up the dose of both effexor and remeron to as much as 150 and 30 mg respectively

Customer:

Yes I will see

Customer:

But the problem zoloft work better for ocd

Dr. Kaushik :

no i think the combination will work equally for ocd

Customer:

I see

Customer:

Ok I think this combination should work good

Dr. Kaushik :

Actually this combination can be used for anxiety, depression and ocd when all the other drug regimes have failed

Dr. Kaushik :

that is why it is given that name

Customer:

15 remeron 75 effexor and 200 zoloft

Customer:

Yes 200 stops ocd

Customer:

I think it is very good

Dr. Kaushik :

This is what you shall try with strict vigilance over the above mentioned symptoms of serotonin syndrome

Customer:

Am feeling hapoy

Customer:

Happy

Dr. Kaushik :

Good.

Customer:

Ok

Customer:

I will read about it

Dr. Kaushik :

yes please do so.

Customer:

I just bring effexor 75

Customer:

Am taking the tablet

Customer:

75mg

Customer:

Ok

Dr. Kaushik :

ok.

Customer:

Thank you mr

Customer:

I shall wait 1 week

Customer:

And contact you

Dr. Kaushik :

yes you shall do that.

Dr. Kaushik :

yes for sure.

Dr. Kaushik :

Take care

Customer:

Thanx

Dr. Kaushik :

Wish you all the best.

Dr. Kaushik :

Regards.

Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4004
Experience: MD Psychiatry
Dr. Kaushik and 2 other Mental Health Specialists are ready to help you

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