Patient's Query
Hello doctor,
I am a 43 year old male. I started masturbation at the age of 17 and soon developed anxiety, depression, fear, and weakness due to guilt of severe masturbation. I had taken lots of ayurvedic, homeopathic medicine but there is no effect. Presently I have severe anxiety, depression, PTSD, too much sweating, and IBS diarrhea problem. I have consulted a psychiatrist and he suggested taking Paroxetine CR 12.5 mg, Nortimer 25 mg, and Pronol H.
I am not getting much benefit in IBS diarrhea symptoms and anxiety problems. My psychiatrist suggested replacing Nortimer 25 mg with 10 mg of Amitriptyline in the morning and evening. Another doctor suggested adding Duloxetine 30 mg. Some medicines like Clonil and Veniz XR do not suit me well.
I am confused about which combination of medicine should I choose for my IBS diarrhea, severe anxiety, depression, PTSD, and fear. Is Amitriptyline better than Nortriptyline for IBS diarrhea problems?
I have been suffering from the above problem for the last 20 years. Please help me and suggest a suitable combination of medicines.
Hello,
Welcome to icliniq.com.
I read your query and understand your concern.
Here are my suggestions-
For IBS (irritable bowel syndrome) diarrhea, start taking Paroxetine with Duloxetine and start taking Levosulpiride medicine for better improvement in IBS.
Continue Pronol H (Propranolol), and if possible start taking a combination of Propranolol with Etizolam.
Avoid smoking and drinking, if possible.
Avoid quick and oily foods.
I hope this helps.
Thank you and take care.
Regards.
Patient's Query
Hello doctor,
Thank you for your reply. Duloxetine has created some anxiety and sweating issues in the past. How good is Amitriptyline in controlling the IBS diarrhea symptoms? May I go with Amitriptyline and Paroxetine for IBS diarrhea? What should be the doses?
Kindly suggest.
Hello,
Welcome back to icliniq.com.
Duloxetine initially causes sweating and anxiety but gradually it will settle in the body. Start with a low dose of Duloxetine and then gradually increase the dosage.
Amitriptyline is good but it has sedative properties. So, if sedation is not an issue then you can start with 12.5 mg of Amitriptyline and then gradually increase to 25 mg to 50 mg.
I hope this helps you.
Take care.
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