Which medicine, according to you, is best for my psychological disorders?

Question

Hi doctor,

I would like to know some treatment recommendations for my condition. I have bipolar disorder type II, social and generalized disorder, and panic disorder. I am having depression for a year. My hypomania is very mild and short-lived. I am afraid to get out of my home due to my constant anxiety symptoms such as sweaty palms and feet, chest pain, high blood pressure, and racing heart.

I need some advice to reduce my depression symptoms. Currently, I am taking Lamictal 200 mg, Tranxene 3x5 mg, Olanzapine, and Venlafaxine 75 mg. Previously, I was taking Lithium Depakote, Carbamazepine, Anxiolytics, Escitalopram, Zoloft, Quetiapine, and Risperidone. I am wondering about Paroxetine, Citalopram, and Prozac. Is it good to take Citalopram for me? I have tried taking Prozac in the past but I was unable to bear its side effects. Which is the best one for me?

Answer 1

Hi,

Welcome to icliniq.com.

Regarding your anxiety symptoms, you have tried taking SSRI (selective serotonin reuptake inhibitor) and SNRI (serotonin-norephedrine reuptake inhibitor) class of medications. I suggest you try taking TCA (tricyclic antidepressants) class of antidepressants like Amitriptyline 75 to 100 mg, Dosulepine 100 mg, or Nortriptyline 75 to 100 mg. They are used in people having partial results with SSRI or SNRI medications. If you are not willing to take TCA, you can try to have alternative options. You can take Paroxetine 12.5 to 37.5 mg, and Citalopram 20 mg. You can also take Mirtazapine 7.5 mg at night along with it. I suggest you reduce the dose of Olanzapine to 2.5 mg. It helps with your anxiety issues. You can also try to have CBT (cognitive behavioral therapy) by consulting a psychologist.