Dr. Anjali Viswanath
Psychiatry
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I have had delusions and paranoia in the past due to marihuana use. I have had problems with depression and bipolar symptoms due to substance abuse. It has been two weeks that I increased Fluoxetine from 20 mg to 40 mg and Aripiprazole from 10 mg to 15mg. I switched tobacco smoke to IQOS during this period. I drink coffee often. I do not abuse other substances. I am unemployed due to COVID and make myself busy with painting. I often walk also. I do not have much will for other hobbies. I think I do not have a better mood increasing my medications, although I do not have anger anymore. How should I continue my therapy? Previously I use to take Risperidone and Zoloft. Kindly give your opinion.
Hello,
Welcome to icliniq.com.
From what you mentioned, I understand that you are on these medications and are concerned about continuing therapy. It is always better to continue treatment. There will be a relapse of symptoms if you stop the medication abruptly. And also, it would be nice if you elaborate on your symptoms.
I hope this was helpful.
Patient's Query
Hi doctor,
Thank you.
I feel apathy, and somehow I do not feel happy but more bored, and dont know what to do most of the time. I also feel upset for no reason. Kindly help me.
Hello,
Welcome back to icliniq.com.
So you have a low mood. Is there a loss of interest in pleasurable activities? How are your sleep and appetite?
Please answer the questions for better help.
Patient's Query
Hi doctor,
Thank you.
I sleep for eight to nine hours and eat well homemade foods. Kindly give your opinion.
Hi,
Welcome back to icliniq.com.
From the symptoms you mentioned, you need to continue medication. Why do you have a doubt about the continuation of treatment? Do you have any side effects?
I hope this was helpful.
Patient's Query
Hi doctor,
Thank you.
I do not have any side effects, but perhaps Fluoxetine is not working well since I feel upset for no reason. I thought maybe I should change medications, and I have doubts whether I should drink coffee and smoke (heating, not burning tobacco). Kindly give your opinion.
Hi,
Welcome back to icliniq.com.
You might need a dose adjustment of your medication. You can go a little high on Fluoxetine to 60 mg to get the desired effect. These drugs should be taken in an adequate dose for maximum effect. And please do not think about smoking. You can have coffee in the morning but not in the afternoon.
I hope this was helpful.
Patient's Query
Hi doctor,
Thank you.
I will follow your instructions.
Hi,
Welcome back to icliniq.com.
Please get back if you have further doubts.
Patient's Query
Hi doctor,
I have increased Fluoxetine from 20 mg to 40 mg to 60 mg, and I still have a loss of interest in activities of pleasure. I have increased Aripiprazole from 10 mg to 15 mg. I drink one coffee in the morning and quit smoking this period of time. What should I do to feel better? Kindly give your opinion.
Hello,
Welcome back to icliniq.com.
It takes time for the medicine to act. These medications need to be taken for four to six weeks in the adequate dose. Please wait for at least two weeks after increasing the dose of medication. If no response, increase the dose a little more. Fluoxetine can be taken up to 80 mg for depression. Aripiprazole can be taken up to 30 mg. So these drug doses are to be increased slowly to maximum doses if there is no response.
Along with that, you can practice breathing exercises for relaxation. You can do physical activities for at least half-hour in a day. Also, make sure that you open your issues to someone who cares. Ventilation of your thoughts itself is therapy. Also, include a balanced diet in your routine.
I hope this was helpful.
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Psychiatry
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