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Insomnia , depression, anxiety
My relative has been suffering from insomnia from 5 years we approached a doctor and taking the following medicine
LONAZEP 2
MAGPROL CR 400
BUPRON XL150 from one weak after using them sleeping sufficiently but getting suicidal thoughts, un able to walk and speak clearly, feeling too weak, repeated thoughts, irritation and angry.... Please help whom shall we approach.
Answers (8)
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I'm very sorry to hear about what your relative is going through. Based on the symptoms you've described- such as suicidal thoughts, weakness, speech and mobility difficulties, and increased irritability- it is very important to seek urgent medical attention.
Next Steps
1. Stop Bupron XL only under medical supervision.
2. Consult a psychiatrist immediately.
3. Neurological evaluation: Symptoms like weakness, inability to speak or walk, and cognitive changes also warrant a neurological assessment to rule out other medical causes such as stroke, Parkinsonism, or electrolyte imbalance.
4. Hospital evaluation if symptoms worsen: If suicidal thoughts persist, or if she is unable to care for herself, it may be safer to consider inpatient care for close monitoring and treatment.
Health Tips
1. Elderly patients are more sensitive to psychiatric medications, so close monitoring is essential when starting new treatments.
2. Do not adjust medications without medical supervision.
3. Please seek urgent medical care and do not delay. Her condition can be managed with the right treatment and support.
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Your information about your patient is very limited. There are many reasons for insomnia. Insomnia is more of a symptom than an illness itself. One needs to treat the underlying condition for which she needs to be evaluated thoroughly. I'm not understanding why they have prescribed her these medicines. She is 73 yrs & she was prescribed 2mg of clonazepam. Obviously she would not tolerate that. Slowness in walk & speech can be secondary to that. Again, I don't know why magprol cr given to her. If it's for seizure disorder, then bupron XL will increase seizures. No sense. If it's for mood stabilizing, we use sodium valproate or divalproate not magnesium. Sometimes valproate toxicity can lead to increased ammonia level & these kinds of symptoms. Bupron XL can increase anxiety & agitation.
Next Steps
Stop all medicines. Consult Psychiatrist in person. Thorough evaluation for current symptoms as well as insomnia. Please check her ammonia levels in blood. Treatment needs to be rationalised.
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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.
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The medication can be revised, consult your psychiatrist again and explain
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Visit again to psychiatrist, need to adjust the dosage
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Was Magprol started newly? Or a previous medication ?
The symptoms point more towards adverse effects of medications.
Only for insomnia the doctor wouldn't have prescribed three medicines.
She needs to be evaluated in detail by psychiatrist.
Next Steps
to consult psychiatrist immediately
Health Tips
careful observation, and not to leave the relative alone at any time. Keep harmful objects away.
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Hello. I understand that she is on Clonazepam 2mg, Valproate 400mg and Bupropion 150mg. But it is not clear for what reason, Clonazepam and Valproate are prescribed. Clonazepam is also prescribed in epilepsy cases apart from sleep issues; whereas Valproate is prescribed in both epilepsy and bipolar disorder cases. She seems to be in depression but to conclude if it is unipolar or bipolar needs a fair amount of assessment and evaluation. Also, Bupropion can be further increased till 300mg if needed, and 1 week is a shorter time for an anti-depressant to start working. Ideally, one has to wait for atleast 2-3 weeks to appreciate any response of an anti-depressant medication.
Next Steps
Consult me online for further evaluation.
Health Tips
Please tell her to maintain a thought diary and to follow sleep hygiene techniques.
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Ms. Rupali Mohbe
Clinical Psychologist
25 yrs exp
Ahmedabad
Hi, I appreciate that you reached out with your concern.
I recommend you to consult therapist as well. Taking medications and therapy simultaneously help in faster and better recovery.
Meanwhile, for sleep, practice Bhramari pranayama and progressive muscle relaxation. Also engage in daily exercise, walk before sleep and try journaling.
Next Steps
For therapy, you can book an appointment with Rupali Mohbe/BIRDY ME at Practo
Health Tips
Daily do Progressive muscle relaxation techniques to calm yourself.
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