Dr. Padmapriya Chandran
Psychiatry
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Patient's Query
Hello doctor,
Six years back, I was diagnosed with serotonin syndrome from an MDMA overdose. The very next year, my mother passed away. I was not myself; I took steroids. I felt confident towards the end of the cycle. I cry for no reason. Three years back, I had LSD-induced psychosis. For almost two years, I was on high-dose antidepressants and felt good, so I tapered off Effexor. I took Lexapro, and I tried stopping it abruptly. This year I tried Lithium 850 mg. It makes me flat, and I also tried Olanzapine. It makes me down when reducing the dose. I got alopecia, and so I changed to Epilim and Effexor. Sometimes when I take one tablet of Lithium for two days and add Effexor, I feel I get good energy, and then I lose it. My sexual drive is low.
All levels are fine.
I want to feel high energy.
I am currently on Epilim 200 and 500 and Effexor 150. I feel better, but I do not feel excited, or I do not feel like talking freely.
What can I do to have high energy?
I do not think I have bipolar, just depression as the past episode induced by drugs.
Hi,
Welcome to icliniq.com.
Your past recurring episodes of depression say that you have to be on a mood stabilizer and antidepressants. Feeling high can be the other side of your polarity. Since you do not have any mood symptoms at present, I advise you to continue the medications prescribed, as it is important to prevent any further relapses. Moreover, I advise you to abstain from LSD (lysergic acid diethylamide) or steroids as they can precipitate a relapse.
Patient's Query
Hi doctor,
Thanks. So why is it when I take one tablet of Lithium and Effexor, I feel good energy for a couple of days, then it evens out, and I do not feel myself and cannot feel normal highs of life. What mood stabilizer can I take that is low dose and only one tablet along with my Effexor so that that I will increase to 225. Also, Effexor makes it hard to reach sexual climax, and after taking Lexapro, I got diarrhea.
Is there something better I can try for increased mood and energy?
Hi,
Welcome back to icliniq.com.
Feeling high or low is abnormal. What you feel right now is normal. It means you have no symptoms now. And, it also suggests that you may have to continue Epilim, which is the mood stabilizer that maintains remission. Effexor is an antidepressant, which can cause delayed ejaculation, and hence a prolonged climax. Since the risk-benefit ratio of Effexor is good, I recommend continued use as an antidepressant for you.
You can take tablet Sildenafil citrate 50 mg thrice a week, half an hour before intercourse, to improve your sexual performance.
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Psychiatry
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