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Ask Dr. Kaushik Your Own Question

Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 3997
Experience:  MD Psychiatry
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hi chat please

Resolved Question:

hi chat please
Submitted: 9 months ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 9 months ago.

Dr. Kaushik :

Greetings !

Dr. Kaushik :

How are you doing ?

Customer:

hi

Customer:

how are

Customer:

we

Customer:

you?

Customer:

hi

Customer:

yes I have question for you

Customer:

am very good

Customer:

now

Customer:

flashbacks low

Customer:

up and down

Customer:

halo???

Dr. Kaushik :

that is good.

Dr. Kaushik :

please ask your query

Customer:

but up and down

Customer:

sometimes up

Customer:

then flashbacks like hell

Customer:

I feel there is no stabilit

Customer:

stabilty

Customer:

flashbacks

Customer:

is very bad

Customer:

am having to much up and down and up and down

Customer:

too much

Customer:

every hour I switch mood

Customer:

sometimes confidant

Customer:

somtimes

Customer:

very weak

Customer:

sometimes angry

Customer:

somtimes

Customer:

emoctions

Customer:

sometimes I have power

Customer:

sometimes I feel I look at my self from distance

Customer:

whenever I feel stress

Customer:

I loose my identity!!

Customer:

then it come back

Customer:

then whenever

Customer:

I feel stressed

Customer:

I loose my personliaty

Customer:

why like this

Customer:

why whenever am in danger I loose myself?

Customer:

why it didn't stay

Customer:

?

Customer:

ARE YOU THERE?

Dr. Kaushik :

You see this is

Customer:

YES

Customer:

whenever am in stress

Dr. Kaushik :

usually see in the start of dose adjusted like you have recentlu

Customer:

I loose

Customer:

my identity

Dr. Kaushik :

recently increased the dose of effexor

Customer:

and flashbacks come

Customer:

yes

Customer:

I want to

Customer:

what do you think?

Dr. Kaushik :

so your body is trying to adjust to the newly increased dose and hence the fluctuations are there

Customer:

is there effect of increasing dose?

Dr. Kaushik :

soon the stability will come soon

Dr. Kaushik :

but for that to come first the drug needs to get settled in your system

Dr. Kaushik :

so for that you have to wait patiently

Dr. Kaushik :

for some mroe days

Customer:

yes

Dr. Kaushik :

you see it is a gradual process where the drug needs to reach steady state levels before it can produce the desired results

Customer:

ok

Customer:

but my qestiuon

Dr. Kaushik :

with every dose change the steady state levels change and need to be maintained for the drug to produce an impact

Customer:

is there benfit from increasing dose

Dr. Kaushik :

so do not worry

Dr. Kaushik :

yes of course

Dr. Kaushik :

there is

Dr. Kaushik :

because at opimum doses the drug acts at it's peak

Customer:

in anxiety and flashbacks?

Dr. Kaushik :

they are part of your ptsd

Dr. Kaushik :

i know they must be very hard to deal with

Customer:

yes

Dr. Kaushik :

so when you are getting

Dr. Kaushik :

too much affected by them

Dr. Kaushik :

just take one 0.5 mg dose of clonazepam

Customer:

so I don't increase dose?

Dr. Kaushik :

as i have told you earlier that clonazepam will help you to pass the initial time where in the effexor will be adjusting in your body

Dr. Kaushik :

you are currently at what dose of effexor ? is it 150 mg

Dr. Kaushik :

?

Customer:

30 remeron

Customer:

150 effexor

Dr. Kaushik :

yes

Dr. Kaushik :

how many days have you been on effexor 150 mg

Customer:

200 mg

Customer:

10 days

Customer:

or 14

Dr. Kaushik :

so for expecting a good enough response from this effexor at 150 mg

Dr. Kaushik :

you shall have to wait for at least 3 weeks

Customer:

yes but I don't want to stay wating

Dr. Kaushik :

i can understand your situation and i empathize with ypu

Dr. Kaushik :

you

Dr. Kaushik :

but i afraid there are no short cuts

Dr. Kaushik :

you may try any drug given in the book you will have to wait for some time before you get actual response

Customer:

BUT THE PROBLEM MY FRIEND

Dr. Kaushik :

yes go on

Customer:

that I did emdr

Customer:

which make flashbacks more

Customer:

once I leave town

Customer:

flashbacks stops

Customer:

and I start getting fast fast fast imrovment

Customer:

imrovment

Customer:

now

Customer:

I feel flashbacks is the problems

Dr. Kaushik :

have you heard about

Dr. Kaushik :

hypnotherapy

Customer:

is problem

Customer:

yes

Dr. Kaushik :

this therapy can help you with your ptsd flashbacks.

Dr. Kaushik :

in this therapy your deep seated distresing memories which take shape of flashbacks will be dealt with and you will be helped to overcome them

Dr. Kaushik :

it uses the special technique of hypnosis aka deep sleep to extract your past traumatic memories and help you to bring closure to traumatic past experience

Dr. Kaushik :

so you may try that

Dr. Kaushik :

but if this is not possible

Dr. Kaushik :

then there is no other alternative but to wait for some more time say 1 week or so in order to expect improvement

Dr. Kaushik :

If you think that by rapidly increasing the dose you may get more benefits then you are wrong as the drug needs to be given some time to act at a particular dose plus there always looms a possibility of development of dependence on the drug by such rapid increase of dose

Dr. Kaushik :

I hope this makes sense to you

Dr. Kaushik :

All i am asking you is to wait for some more time

Dr. Kaushik :

if there is too much of anxiety and flashbacks

Dr. Kaushik :

then you may ask your doctor to prescribe you xanax ( generic -- alprazolam) to be taken at dose of 0.25 mg -0.5 mg

Dr. Kaushik :

PRN

Dr. Kaushik :

that is as and when required basis.

Customer:

my friend

Customer:

look

Dr. Kaushik :

please go ahead.

Customer:

I want to say something

Customer:

in my life I look at problem directly

Customer:

I don't have time

Customer:

for anything

Customer:

after 1 year

Customer:

I will be in canda

Customer:

again

Customer:

I will do everything

Customer:

right now

Customer:

am taking very good midctions

Customer:

I don't have time

Customer:

I have 1 qestioun for you

Customer:

just 1 qestiuon

Dr. Kaushik :

yes

Customer:

is there benfit about anxiety and flashbacks if I increase dose of Effexor?

Customer:

over 150?

Dr. Kaushik :

yes there will be you can go up to the maximum dose of 225 mg / day in two divided doses

Customer:

good

Customer:

that it

Customer:

225 effexor

Customer:

30 remeron

Customer:

200 zoloft

Dr. Kaushik :

but that is what i am trying to tell you here and that is first you need to exploit this dose of 150 mg to it's maximum capacity and then think of going up the dose

Customer:

no

Dr. Kaushik :

are you getting me what i am trying to tell you

Customer:

am wating 1 month

Customer:

I don't think so

Dr. Kaushik :

you are currently on 150 mg effexor for past 2 weeks

Dr. Kaushik :

is this right to say

Customer:

mmm

Customer:

for 18 days

Customer:

am taking effexor

Customer:

and 150 for 14 days

Customer:

but if increasing dose

Customer:

will help me

Customer:

then why not

Customer:

after that

Customer:

I decrease it

Customer:

if I am very good

Dr. Kaushik :

because every dose needs to be given time to act

Customer:

yes

Customer:

but the problem now in anixety

Dr. Kaushik :

in 14 days effexor at 150 mg is not yet at it's peak action

Customer:

you cant imagin my life with flashbacks

Customer:

rivotril

Customer:

is very hard to bring

Dr. Kaushik :

if you give it more time say 3 weeks then by that time the dose 150 mg shall have reached it's peak and will produce the desired results

Customer:

as well I run of it

Customer:

as well

Dr. Kaushik :

so why cannot you wait for another week

Customer:

it is effect temprory

Customer:

because I feel it is uselesss

Customer:

that flashbacks stops

Customer:

I don't think 150mg will make it stop

Dr. Kaushik :

ok

Customer:

even if I wait 1 month

Customer:

what do you thik?

Dr. Kaushik :

ok.

Customer:

but look

Dr. Kaushik :

i feel that you are being hasty in increasing the dose which may lead to poor results

Customer:

since I start

Customer:

dose

Customer:

of effexor

Dr. Kaushik :

because rapid increase in the dosing sometimes make the drugs ineffective

Customer:

I feel flashbacks reduced

Customer:

do you remember when I used to make remeron 30mg?

Customer:

about derliazation

Dr. Kaushik :

yes

Customer:

now once I did it 30mg

Customer:

it didn't stop

Dr. Kaushik :

ok

Dr. Kaushik :

i got it

Customer:

there was no derliazton

Customer:

I think Effexor very good

Customer:

but I can wait 1 week

Customer:

it is ok

Customer:

but I think it is useless

Dr. Kaushik :

really

Customer:

I don't know

Customer:

you are the dr

Dr. Kaushik :

right now you said effexor is good then you say it is useless

Dr. Kaushik :

i am confused

Customer:

no it is good

Customer:

but I think 14 days

Customer:

is enough

Customer:

to stop flashbacks

Customer:

so I think I have to increase dose

Dr. Kaushik :

ok.

Dr. Kaushik :

then you may do

Dr. Kaushik :

so

Dr. Kaushik :

you may increase the dose to 225 mg

Customer:

no but if you think

Customer:

wating

Dr. Kaushik :

but this is your decision not mine

Customer:

may make change I wait

Dr. Kaushik :

it is just that i am thinking your safety first

Customer:

ok

Dr. Kaushik :

because rapid dose increase like this is not advisable since the drug may lead to side effects

Customer:

then I shall wait 1 week

Dr. Kaushik :

if it's values int he blood change too frequently

Customer:

I feel imrovment

Customer:

improvment

Dr. Kaushik :

plus 2 weeks is a short period for a dose to be judged

Customer:

but I just want to end that

Dr. Kaushik :

i expect more improvement to come your way

Dr. Kaushik :

if you can wait for one mroe

Dr. Kaushik :

more

Dr. Kaushik :

week

Dr. Kaushik :

if that comes

Customer:

yes

Dr. Kaushik :

great

Customer:

I will

Dr. Kaushik :

but if not

Dr. Kaushik :

then go up the dose to 225mg

Dr. Kaushik :

is it ok with you ?

Customer:

indeed

Customer:

yes

Customer:

I will

Customer:

wait one week

Customer:

it is ok

Dr. Kaushik :

Take care.

Dr. Kaushik :

i hope and pray that you come out of this

Dr. Kaushik :

soon

Customer:

thank you

Dr. Kaushik :

i shall add

Customer:

:-)

Dr. Kaushik :

Regards

Customer:

thank you

Dr. Kaushik :

bye

Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 3997
Experience: MD Psychiatry
Dr. Kaushik and other Mental Health Specialists are ready to help you

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