Heyy I can help you better with further treatment course needed. U can connect me via whatsapp on seven zero eight two zero two two zero six two.

Winters can cause significant increase in stress levels. Also you will be fine if you take regular counseling technique

You didn’t mention about your problems, for which you consulted psychiatrist.. it will be better if you talk about your problems in details.. aripiprazole is not only for schizophrenia patients, it has multiple other functions also. So don’t worry.. consult your psychiatrist for all your queries.. if needed you can try therapy also with psychiatrist or psychologist.. therapy will help you to recover fast..

Hi, You Just mentioned your treatment part/side effects (serotonin syndrome) not your problem or illness part. So pls mention proper history of illness and symptoms so that proper answer/advice can be given.

Hi.. sometimes antipsychotic is added in resistant depression. However will need further history regarding the same to advise appropriately.

Hello Evaluate first about ur presenting complaints for which u have visited Doctor, whether using medication made u to feel better or not.Every drug has risks and benefits, based on the risk benefit ratio Doctor prescribes medication and  every drug has different indications at different doses . Don't worry about the medication that u are using, be adherent to medication , consult the Psychiatrist for better evaluation and awareness of the illness.

Both your main medications are SSRI - selective serotonin reuptake inhibitors namely escitalopram and paroxetine. Both have multiple indications for administration, at the doses mentioned they are just the starting dose. Your 1st query is regarding serotonin syndrome with present prescription- it’s a very rare clinical condition which is extremely unlikely with present prescription. It requires a certain genetic vulnerability plus high dosages of medication for a prolonged period of time. Your consultant psychiatrist would be assessing you for any adverse side effects of the present medications, so be rest assured about not developing serotonin syndrome. Second concern is regarding Aripiprazole, a low dose antipsychotic has a very strong anti anxiety effect and acts beautifully as an augmentation with SSRIs. It’s a common practice and nothing to worry about. In psychiatric practice you can’t classify use of drugs for only one diagnosis, due to multimodal action of drugs on neurotransmitters, various doses and drugs are used in various diagnosis as per need that commonly google or other Internet source might not be able to clearly highlight. Your 3rd point was regarding developing symptoms all of a sudden at 35 years, here again there are a lot of factors ranging from genetics, family medical history, personal medical history, psychosocial stressors, substance use history, sometimes the cause can be idiopathic as well. Every psychiatrist illness has certain age of presentation when it is commonly manifested, for example depression in adulthood maybe near 30s, psychosis in early adolescence, neuro degenerative conditions after or around 60s etc. In your case a detailed history assessment may show the probable cause of onset of ur symptoms and your diagnosis.

It's not good practice to give two SSRI at same time. However aripiprazole is used as augmenting agent along with antidepressants. I am a professor with 22 years of experience in treating patients. You can consult me online through my Google page or Facebook page. Dr SUNEET UPADHYAYA from JAIPUR