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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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Since we last spoke I have undergone 8 shock treatments. My

Customer Question

Hi Doc
Since we last spoke I have undergone 8 shock treatments. My medicine consists of 75mg lyrica morning and noon. 60 mg cymgen, 1 mg rivortril three times a day. 50 mg Seroquel morning and lunch timevand 200 mg Seroquel at night with 2 mg loramet at night. I still feel anxious and lethargic and depressed. Should I go up 60 mg on my cymgen or take more Seroquel. My lat shock treatment was on Friday.
Submitted: 4 years ago.
Category: Mental Health
Customer: replied 4 years ago.
Relist: Other.
Dr Kaushlik has gone off line. I would still like a psychiatrist to answer please.
Expert:  DrRussMd replied 4 years ago.

Hello from JA

I am Dr. Thomas, MD, board certified in internal medicine and integrative medicine, so I cover a lot of ground and can help you with your question.

I will either give you an answer right away or have questions for you. Either way, use reply until you are ready to rate the answer: Please note that answers for information and education only.

No psychiatrist is on line at this point...
would you like help?

Expert:  Dr. Vikas replied 4 years ago.

In my view, all the medicines you are taking currently could be the reason behind your feeling lethargic and tired because all of them cause significant sedation.

Therefore, instead of increasing the dose of Seroquel or Cymbalta, you can discuss with your doctor about adding an augmenting agent like Modafinil for symptoms you have mentioned. Modafinil is a wake promoting medicine and is an excellent augmenting agent for treating residual sleepiness and fatigue along with depressive symptoms.

Another possible option could be to add Bupropion which is an activating antidepressant and is specially useful in patients complaining of tiredness, fatigue, sanders.

You are already taking 3 mg of Rivotril per day so can ask your doctor to prescribe an additional dose of 1 mg occasionally if you start feeling anxious.

Please feel free to discuss further if you have any other query.

Kind regards

Vikas (You can bookmark this link for future questions)
Expert:  Dr. Vikas replied 4 years ago.

Do you have any other question or would like to discuss further about my suggestions?