Dr. Vishal Anilkumar Gandhi
Psychiatry
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Patient's Query
Hello doctor,
I am a 41-year-old male. I have had severe anxiety, depression, a fast heartbeat, too much sweating, IBS diarrhea, and nervous weakness over the last 15 years. I have consulted many psychiatrists. However, any medicine has not helped me. Currently, I am using tablet Nexito forte twice daily, tablet Pronol H twice daily, and tablet Pristiq 50 mg at night. I have taken this medicine for the last two years with some relief. However, the tablet Prestiq causes excess sweating during the daytime and does not control IBS-related diarrhea. Twenty days ago, my doctor changed my medicine from tablet Prestiq 50 to Libotryp DS at night. Libotryp DS improved my IBS diarrhea problem but is causing more sedation during the day. Now, I am very much confused about what to do and how to continue with my daily activities. I cannot take a leave every day due to my anxiety and depression.
Kindly help.
Hello,
Welcome to icliniq.com.
I understand your concern and would be happy to help. Thank you for taking help from a psychiatrist. You have an anxiety disorder. Tablet Nexito Forte is a combination of Escitalopram and Clonazepam. Tablet Libotryp DS is a combination of Chlordiazepoxide and Amitriptyline. Tablet Pronol H is a combination of Propranolol and Alprazolam. Clonazepam, Alprazolam, and Chlordiazepoxide are responsible for sedation. You need to adjust the doses of all the above medications. I suggest you take plain tablet Amitriptyline 10 mg at night, without Chlordiazepoxide. It will help you to deal with oversedation.
There is non-pharmacological management for anxiety; you should follow few guidelines to deal with it. It will help you: You should exercise daily for 30 to 45 minutes, like going for a walk, if possible join the gym or swim, it will boost your confidence. You should do meditation for 20 minutes daily, sit in one place in a comfortable position and try to concentrate on your normal breathing, do not stop or force yourself to stop your thoughts; just let it be. It will help you to relax. You should eat healthy home-cooked foods and avoid junk foods. You must drink enough water. You should spend quality time with friends and family daily or do video calls if you are living away from your family. It would help if you spend time on creative hobbies like reading good books, writing journals, painting, drawing, and learning new skills, language, or musical instruments. You should get enough sleep of seven to eight hours daily. It would help if you avoid tobacco or alcohol or any substance abuse. Live your life, do not just spend it. Be bold and confident. Do not be afraid of anyone. Stop overthinking.
I hope that you get your answer. Please, let me know if you want some help.
Thank you.
Investigations to be done
Patient's Query
Hello doctor,
Thank you for the reply.
I have got all the tests done, and the reports are fine. Which is the best medicine for long-term anxiety, depression, and IBS diarrhea that causes less sedation. Is it tablet Libotryp DS or Pristiq or Mirtazapine 15. My doctor suggested continuing the tablet Libotryp DS and said I would adjust to it with time.
Kindly advise.
Hello,
Welcome back to icliniq.com.
I suggest you take tablet Amitriptyline 10 mg to deal with IBS diarrhea. Tablets Mirtaz and Pristiq are best for depression, not IBS. You should also follow the above-mentioned lifestyle to deal with your problem. It will help you.
I hope this helps.
Thank you.
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Psychiatry
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