Anxiety is accompanied by fear, increased heart rate, sweating, and heavy breathing. It is normal to feel anxious once in a while. But, when the feeling of worry does not go away and gets worse with time, it requires to be treated.

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I get anxiety from morning to mid-noon and SSRI is not supporting me. Why?

Query: Hello doctor, I cannot get any SSRI medicine to work anymore after 25 years. I have anxiety only from morning to mid-afternoon. Doctor put me on Oxcarbazepine 300 mg daily for anxiety but this seizure medicine is making me dizzy and very tired and off-balance. My head feels weird. I just weaned com...  Read Full »

Dr. Parth N. Nagda

Answer: Hello, Welcome to Considering your age, it will be difficult to try a low dose of TCA (tricyclic antidepressant), but if nothing works that is always an option. Apart from an SSRI (selective serotonin reuptake inhibitors), there is always SNRI (serotonin-norepinephrine reuptake inhibi...  Read Full »

I am not able to concentrate on my studies after I failed a competitive exam. Please help.

Query: Hello doctor,I am feeling depressed, guilty, and low after I failed to clear one of the competitive exams. I am not able to concentrate on my studies.Please help.  Read Full »

Dr. Parth N. Nagda

Answer: Hello, Welcome to I went through your query and understood your concern. Your symptoms are typical of people with mild depression, where there is sadness, ruminative thoughts, guilt or anxiety, and loss of concentration. There can also be irritability, decreased sleep, and appetite. ...  Read Full »

My psychiatrist and I are discussing combining my anxiety medications. What do you suggest?

Query: Hi doctor, My psychiatrist has decided for years to use only a combo (SSRI+Wellbutrin XL) to control and manage my chronic GAD and SAD. It is important to note that I cannot deal with anxiety without these medications. I am discussing a new plan with him and would appreciate your feedback. Furthermo...  Read Full »

Dr. Parth N. Nagda

Answer: Hello, Welcome to I understand your concern. I have found tablet Prozac (Fluoxetine) more effective in my practice than tablet Zoloft (Sertraline), even though textbooks say that is not the case. Also, Fluoxetine helps with weight loss, while Sertraline is supposed to be neutral. The...  Read Full »

What should I do to elevate my low mood and sleep disturbance?

Query: Hello doctor, I have masked depression, anxiety accompanied by sleep disturbances. I often get irritable and depressed. Other conditions are IBS and restless legs. I am prescribed Mirtazapine 3.75 mg along with Clonazepam 0.75 mg. While I can sleep eight hours it has not improved in other parts ...  Read Full »

Dr. Parth N. Nagda

Answer: Hello, Welcome to Considering your other symptoms and other medicines, I would suggest you to take tablet Escitalopram 10 mg once at night after food and raise the dose of Mirtazapine to 7.5 mg at night. The current Mirtazapine dose you are taking is a very mild sedative dose only. ...  Read Full »

Can St.John's wort be replaced for Trepiline?

Query: Hi doctor, I have been having terrible problems with anxiety and depression. I was on Trepiline and Eltroxin for depression when I was younger and I mainly want to know if I can substitute St John's wort for 25 mg Trepiline? These episodes definitely worsen around my period, so might a vitamin B s...  Read Full »

Dr. Parth N. Nagda

Answer: Hello, Welcome to See, just because Prozac did not work for you, does not mean that you will not respond to other medicines. There are at least 15-20 types of antidepressants. Depression and anxiety are very common and a lot of people have it. It basically happens when some neurotrans...  Read Full »

My uncle has schizophrenia. Will I get the same genetically?

Query: Hello doctor, These past few days I have been bad as I have focused back on my schizophrenia obsession. It mainly focuses on times I have been paranoid, or times I have visualized things as something else. Examples: when slacking off at work thinking, what if there are cameras in the office or inte...  Read Full »

Dr. Parth N. Nagda

Answer: Hello, Welcome to Thank you for such a detailed history. It makes things very clear. I will sum up the main clinching reason why you do not have schizophrenia. You have insight. Means you know what is wrong with you and you can attribute a reasonable logical cause to this and know wh...  Read Full »

My friend takes L-Theanine for anxiety. Does it have any side effect?

Query: Hello doctor, My friend is 21 years old and suffers from anxiety. He feels like it is getting in the way of his daily activities and interactions with people. He used to get attacks more often but that is a lot better now. He decided to start taking L-Theanine pills or supplements. I would like t...  Read Full »

Dr. Parth N. Nagda

Answer: Hello, Welcome to L-Theanine is an amino acid synthesized from tea. It helps with reducing stress and anxiety and induces a sense of calmness by increasing serotonin and dopamine in the brain which are the feel-good chemicals. As such, it is a supplement and not a medicine per se, so...  Read Full »

I have low mood, debilitating anxiety, and intrusive thoughts about the past. Why?

Query: Hello doctor, For months I have struggled with low mood, debilitating anxiety, intrusive thoughts about the past, avoiding anything to do with the past, suicidal thoughts, self harm, and daily guilt and shame that has stopped me from hanging out with friends, or being successful in school. Everyday...  Read Full »

Dr. Parth N. Nagda

Answer: Hello, Welcome to I would beg to differ with the psychiatrist who you have consulted and all the symptoms you have mentioned are depressive symptoms which do need treatment with medicines. Therapy can only help increase the effect of medicines, it is not a replacement . I would prefer...  Read Full »

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