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Dr. Vikas
Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2253
Experience:  MBBS ; M.D Psychiatry, MS. Health Informatics
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Can we have a live chat, i want to discuss something with

This answer was rated:

Dear Sir,
can we have a live chat, i want to discuss something with you please.
Customer: replied 4 years ago.
Relist: Other.
I haven't received an answer till now !

Please ask your question.


Customer: replied 4 years ago.

Presently, i am on the meds as described earlier. but there is still one MAJOR problem which i m facing till date.

Dear Sir, first of all I would request you
to kindly diagnose my problem.

Its regarding my career field. Suppose
there are 3 subjects out of which i have
to choose one and select that to study
and master it.

I keep on asking people on the net or
otherwise which one to study and which
not. If somebody says to study A, I try to
concentrate on A but the very moment I
ask again a second person what to study
and what not...if he says to study B, i try
to concentrate on B but then again
cannot stick to it and i ask somebody else
which one to study and which not and if
a 3rd person tells me to study C, i try to
study C, now this is becoming a Vicious
cycle and thus i have not been able to
start and continue my studies on anything
which has ruined my career. This has
been happening since last 6 yrs. Sir, my
life has been ruined bcoz of this.

Now, sir, is this Obsession or is it
Attention Deficit Disorder or is it
something else ?

Kindly help me diagnose my problem.

1) Can clomipramine be introduced in the
current medication regime.

Hello Ajoy,

Is it only related to studying or it is applicable in other field also?


Customer: replied 4 years ago.

I double check doors whether they r closed/open or not. I double check Freeze doors, gas knobs etc. I also smoke a lot , abt 20 ciggs a day.

Thanks for your reply.

In that case, the symptoms you mentioned indicate the possibility of OCD instead of ADHD.

Now Duloxetine is not the preferred choice for treating OCD and Clomipramine which is the first line medicine should not be given in combination with Duloxetine because of risk of serotonin syndrome.

So to answer second part of your question, since you are already taking Duloxetine, Clomipramine should not be included in the current treatment regime.

If your doctor want to start clomipramine, he or she should taper down Duloxetine first and then start Clomipramine. All other medicines are fine in my view


Customer: replied 4 years ago.

sir, will Clomipramine help me with my Generalised Anxiety Disorder, de-personalization disorder, severe depression too ? secondly, do i really need Lamotrigine.


Clomipramine can be useful for all the disorders you have mentioned. Lamotrigine is useful if you are also having mood swings as an augmenting agent.
Customer: replied 4 years ago.

Sir, which will be better, introducing Clomipramine or introducing Fluvoxamine for all of my disorders mentioned earlier ?

Ajoy, I would prefer Clomipramine for all the disorder you have mentioned.
Customer: replied 4 years ago.

I m sorry for making it too long, but i have just a last question. Duloxetine 60mg per day is helping me combat my other disorders except obsessions. Is there no way like, say, keeping duloxetine and introducing something else for obsessions or say increasing the dosage of duloxetine.


Ajoy, your doctor can try to increase the dose of Duloxetine to 90 mg per day first and see if it helps or not.

If still not useful, Duloxetine can be taper down and then clomipramine introduced by your doctor.
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