Dr. Parth Nagda
Psychiatry
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Patient's Query
Hello doctor,
More than 20 years ago, I suffered from anxiety derived from the use of drugs and my family situation, from which I recovered with Deanxit and psychoanalytic therapy. Of course, I quitted cocaine forever. I was in therapy for seven years. At the end I recovered completely, having a full and happy life for more than 10 years. I have a great wife and daughter and very good friends and have a good relation with my family. The fact is that I was feeling very well until about two years ago I began to experiment as if I could not enjoy things.
A few months later, being quiet at home at night, an incredible and strong chemical depletion suddenly came over me. It was like a feeling of chemical depletion of the neurotransmitters or something like that in the brain that caused me a downturn similar to when you use drugs. Like when you have a sudden drop of blood pressure. It was not the depression of being crying, feeling of worthlessness, deep sadness. It was these desperate and unbearable feeling. This lasted about 3 days, so I went to my psychiatrist because I could not take that feeling of intense downturn anymore (I have to say that years ago I had already felt those feelings for short periods of time, like a few minutes, and then disappeared, but I did not give them much more importance).
He prescribed me Deanxit again two times a day and after four days I was fine. The fact is that he withdrew it a month and the next day I noticed again the unbearable symptoms of the beginning. I went back to the medication and felt good again, but I wanted to switch to a stronger one, following my psychiatrist's advice, because sometimes I was still feeling bad. I tried many others that did not work or made me feel worse. I have tried in between other therapies such as cognitive-behavioral, EMDR, acupuncture and I believe that none comes to the heart of the matter, that it is a serious chemical imbalance that is happening to me and that I cannot overcome and balance.
I have also performed neurofeedback, as well as resonance of the head requested by a neurologist and they saw nothing. I am a person who is not obsessed at all with things, very cautious in life and have a successful business for years. I do not usually stress except on some occasions and I consider myself quite rational in general, so I cannot understand why this is happening to me, I am looking for someone who can diagnose my disease, beyond the generic term of depression and anxiety, in which, because of the symptoms that I have explained, I am not reflected. I think that the dysphoria would be the closest, but I also do not feel that irritability that accompanies it.
Have you met a patient with similar symptoms before? Or maybe someone to whom you can refer me to understand what is happening here? I absolutely trust science, and I just want to return to the state of normality that I had before all these crises that, I repeat, are so intense and unbearable that I want to die when I suffer them, and that I need to understand what happens to me, having more opinions from other experts.
Hello,
Welcome to icliniq.com.
You have actually got everything right with what you think you are experiencing. It is dysthymia. Basically the neurotransmitter deficiency, be it for whatever reason is the cause. In males, it usually appears between 30 to 40s. Also, it is not necessary to have irritability to be called dysthymic.
Basically, if you look at a figure of 50 between 0 to 100 as normal and the baseline for mood, you are persistently unable to return to the baseline and are always beneath the normal mood, what people call as mildly depressed. This dysthymic period, when an episode of depression is superimposed, is called double depression which is the episodic problems that sometimes occur.
The core of treatment here is the addition of a mood stabilizer, such as Lithium. That in addition to an antidepressant will show you the greatest improvement. Basically the antidepressant will elevate your mood and the mood stabilizer will hold it there. Rest in addition to the medicines, you should continue your therapies as advised.
I hope this helps.
Patient's Query
Thank you doctor,
I did a genetic test and found Nortriptyline is good for me, so I want to try it together with Deanxit, so I can at the end withdraw it and keep a couple of years with Nortriptyline and see if I can cure my ilness. What do you think?
Hi,
Welcome back to icliniq.com.
Yes, a TCA (tricyclic antidepressant) like Nortriptyline will work along with Deanxit (Flupentixol). Make sure doses are raised every four to six weeks, not too quickly and appropriate levels are reached where you do not have any major side effects. Also, if symptoms still persist, or some residual symptoms are not going away, please add Lithium carbonate 300 mg at night.
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Psychiatry
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