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Ask Dr. Kaushik Your Own Question
Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4505
Experience:  MD Psychiatry
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In the last year I've lost my mother OKMH530100

Customer Question

In the last year I've lost my mother to dementia (she's alive but has infant level functioning), started divorce proceedings after my husband's affair, and was diagnosed with a terminal illness (cardiomyopathy). Then the illness was cured with surgery
and I've been deemed totally recovered with almost zero chance of relapse. However I still feel every second like I'm dying and don't belong I'm cured. Have been on Prozac for 3 weeks and in therapy twice a week. My illness was cured 4 months ago. I'm so scared
all the time and so scared that my fear is going to make me sick again so it's like a horrible cycle of fear and more fear. What would be a reasonable time frame in which I might start to feel some relief and actually believe that I am no longer sick? I have
so much going on but if I can just believe I'm physically well I know I could cope. I know there is no one answe for Everyone. I was diagnosed 7 months ago so I believed I would have a dramatically shortened life for about 2 1/2 months and I fear I will never
be myself again. Hoping to hear illness PTSD has a typical course that starts to get better within a few months. My doctors don't really have answers about timeframe which I understand. I just can't stand feeling so scared all the time.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 1 year ago.
Greetings.
Welcome to the site.
I am a psychiatrist and i believe i can help you with your problem.
Well, it indeed has been an immensely testing period for you since last year as both your personal health and family life have got themselves entangled into a major upheaval, which caused a lot of stress and emotional exhaustion for you. Anyone in your position would have experienced similar state of mind when he/ she had known that things are goings exactly in a different direction than expected and one just could not do much to change them.
I empathize with you greatly since you have been enduring a lot of emotional trauma all this while but have shown a lot of courage and resilience in surviving this ordeal. It goes without saying that your divorce and mother's deteriorating health are highly unfortunate events which have taken away your peace of mind and added extra pressure upon you while you struggled against cardiomyopathy to save your life. However, since you have beaten the condition, so some sort of reprieve on the health front is to be appreciated which shall partly unburden your present predicament.
All these situations which invariably led to stress and possible depressed state of mind, need to be tackled one by one while you seek therapy and medication to help you cope better with this stressful period. It usually take 3-4 weeks for prozac to start its action, provided you have been stabilized by now on a potent dose of 40 mg/ day which usually works for an adult. I will like to suggest that you ask your prescribing doctor to add an anxiolytic medication with prozac such as klonopin ( clonazepam ) at dose of 0.25-2 mg/ day albeit for a short period of 3-4 weeks so that the latter drug helps you to calm your nerves, bring peace to your mind, takes away stress and most importantly buys time for prozac to act which is a slow starter as far as showing its effect is concerned, yet it is a good potent remedy in such stressful situations. Also it will be prudent for you to know about other options of drugs which can replace prozac if it fails to deliver in the coming few weeks and these are -- lexapro ( escitalopram ) at dose of 10-20 mg / day or zoloft ( sertraline ) at dose of 25- 100 mg/ day, these are highly potent and relatively faster acting anti depressants which can considered if you do not find expected relief from prozac.
As far as your therapy is concerned, i will endorse its use since it will help you to learn coping skills so as to fight against present and future life stressors without letting your body to go into a depressed state. However, just try to remain patient with therapy as it take some time to provide results but it eventually does help to provide more strength to your mind.
I hope this sums it up for you.
Wish you all the best and speedy recovery. I shall keep you in my prayers.
Please kindly leave a Positive rating if you are satisfied with the answer.
Regards
Customer: replied 1 year ago.
Thank you, ***** ***** am taking 20 mg of Prozac, 60 mg of buspar, and .5 mg of aprazolam three times a day. I want to stop the aprazolam just as soon as I can, once the anxiety is under control.I am having terrible startup anxiety with the Prozac. Yesterday I took just 10 mg and felt less anxious. In the past Prozac has worked well for me but I'm so anxious this time that it's been much harder to get started.
I am considering switching to lexapro or fluvoxamine. I am terrified of weight gain. Which of the SSRIs are least likely to cause weight gain?
Customer: replied 1 year ago.
Also could 10 mg Prozac be enough to be a therapeutic dosage? I have OCD and understand generally the dosages for that are higher but I also have panic disorder and generalized anxiety and am just very sensitive to medication right now.
Expert:  Dr. Kaushik replied 1 year ago.
No, 10 mg dose is a sub- standard dose which is not going to help your case, so if you are going to use such a sub standard dosage of this drug fearing rebound anxiety then I reckon that you may actually switch to lexapro at dose of 10 mg per day and since both prozac and lexapro belong to the same class of ssri anti depressants plus prozac has a longer half life, this allows easy and safer and direct switch over from the current 10 mg prozac to 10 mg lexapro per day.
Also lexapro causes less weight gain. Plus this drug is most effective against OCD among its class. You also can safely up the dose to the optimal dose of 20 mg per day for better outcome in terms of control over your old and stress.
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.
So if I switch to Lexapro I can do so without waiting for the the Prozac to leave my system? Would you say Lexapro at 10 mg is about equivalent to the Prozac at 20 mg?
Expert:  Dr. Kaushik replied 1 year ago.
Well, yes you can switch over directly from prozac to lexapro owing to their same class and due to the longer half life of prozac which maintains it's level in the body for long enough duration so as to enable the body to adapt to its absence, moreover replacement of his drug with lexapro shall make the transition even far more easy.
Yes 10 mg lexapro shall equate to 20 mg prozac, so the switch over between these two doses of drugs will be safe.
I hope this helps.
Wish you all the best.
Please kindly leave a Positive rating if you are satisfied with the answer.
Regards.

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