Resolved question:
My mother a stroke patient since 6 years. 1 year ago, she was diagnosed with congestive heart failure as well. She was hospitalized for 2 months in OCT 2013. She is back home and since then her moods is very weird. Cries frequently, doesn't want to Sit in wheelchair for long, doesn't want to travel in the car.. If travelling in Car, she cries continuously for end destination. I'm not sure, if the medication is bothering her... We also give her antidepressant during night time... During day time she is having lot of problems with anxiety.... Following are list of medicine... Please HELP.. our family is tearing apart with her anxiety... no social life cannot go out of home....
1. Clopidogrel + Aspirin
2. Trimetazidine Modified
3. Methylcobalamin
4. Metformin Hydrochloride 500mg
5. Amdlodipine 2.5mg
6. Clonazopam ---> Antidepressant 1mg
7. Diltiazem Hydrochloride 30mg
8. Digoxin 0.25mg
9. Sodium Valproate & Valproic Acid 200mg
10. Atorvastatin 10mg
11. Thyroxine Sodium 100mg
12. Omegae 3, FAtty Acids tabs
Please help if any of the above medication is causing her more anxiety during daytime... or should we need to give antidepressant during day as well... Not sure if it's motion sickness which is causing her to shout, cry continuously while traveling in the car.
Submitted:
4 Days
Category:
Psychiatrist
Hello.
Thanks for using DoctorSpring.com for posting your query.
I have gone through your question in detail and I can understand what you are going through.
Its very common to see people with serious medical illnesses having depression. However, I would like to clarify that she is not on any antidepressant. The clonazepam that you are talking about is a hypnotic and sedative with anti-anxiety potential. She will definately require an antidepressant.
Among the available options, Pristiq (Desvenlafaxine) should be a good option as it has least interaction with the other medicines she is on and is effective as well. It is generally started at 50mg and then gradually increased to 100mg.
Further you may have to provide her some supportive psychotherapy as well by showing her to a psychologist.
Please remember that she is not doing it wantingly, but she is herself suffering from her bad mood.
These options are going to help her.
If you have any further query, do let me know.
Kind regards,
Dr. Srikanth Reddy MD.
Hello Dr Srikanth,
Thank you for the detail analaysis.
My mother is also a Afib patient and I believe one of the medicine is a blood thinner.
Wondering if she can take Pristiq (Desvenlafaxine) with afib.
Also, I'm in the US and not sure how I can get Pristiq without prescprtion.
Appreciate your help and guidance.
Thanks
Azam
Hello Mr. Azam.
Pristiq can be taken by patients of AFib. Regular monitoring would be required as this may cause a rise in heart rate in some individuals along with a rise in BP. However, when the patient is on treatment for AFib, there is no reason to worry.
Regarding prescriptions, in the United States, as you know, one would require a prescription from a local Psychiatrist or GP as this medicine cannot be procured OTC.
You may discuss this issue with your GP who may prescribe the needed medicine.
Regards.
Hello Dr Srikanth,
Thank you for the detail analaysis.
My mother is also a Afib patient and I believe one of the medicine is a blood thinner.
Wondering if she can take Pristiq (Desvenlafaxine) with afib.
Also, I'm in the US and not sure how I can get Pristiq without prescprtion.
Appreciate your help and guidance.
Thanks
Azam
Hello,
I can see the previous question replicated here. May be a technical glitch - you are welcome to get with any further follow-ups.
Regards
Hello Dr,
My apologies for the replicated e-mails.
I'm not sure if you received my this e-mail, but wanted to check base with you.
Wondering if we need to continue "Clonazopam" tabs when we start Pristiq (Desvenlafaxine) for my mother.
Also, if you can mention when and how many doses she may need for Pristiq per day?
Appreciate your help.
Thanks,
Azam
Hello
Yes clonazepam needs to be continued. Its a different group of drug.
Pristiq we generally start at 50 mg per day at night and the patient may simply stay at that dose.
Thanks
Dr. Srikanth Reddy MD