Recent Medication Adjustments in Psychiatry and Dermatology: A Patient's Journey

Recently, I visited a psychiatrist and had my medication regimen adjusted?

Recently, I consulted with both a psychiatrist and a dermatologist, and my medications have been adjusted.
I would like to thank the doctors.

Psychiatry:
- At bedtime:
- Leeyo (Escitalopram) 10 mg, 2 tablets
- Lendormin 0.25 mg, 2 tablets
- Eurodin 2 mg, 2 tablets
- Lorazepam 0.5 mg, 4 tablets
Dermatology:
- At bedtime:
- Doxepin 25 mg, 2 tablets
- Lyrica (Pregabalin) 75 mg, 2 tablets
- Xyzal 5 mg (for skin itching that disrupts sleep)
Metabolism:
- Metformin HCL 850 mg
Urology:
- Tamsulosin 0.2 mg
Gastroenterology:
- Before breakfast:
- Promethazine 3.84 mg (Gastric protective film-coated tablet)
- After meals: KASCOAL
- Before lunch:
- Promethazine 3.84 mg (Gastric protective film-coated tablet)
- After meals: KASCOAL
- Before dinner:
- Promethazine 3.84 mg (Gastric protective film-coated tablet)
- After meals: KASCOAL
I have been taking all of these medications long-term.

1.
Is this psychiatric prescription still within a normal and acceptable range? Thank you, doctor.

Niming, 30~39 year old female. Ask Date: 2020/07/28

Dr. Qiu Junda reply Psychiatry

Hello.
These psychiatric prescriptions are still within the normal acceptable range.
They should be adjustments made by your attending physician based on your condition.
We hope you can cooperate with the treatment.
If you have any concerns, you can also discuss them with your physician.
The attending physician will be happy to provide answers.

Reply Date: 2020/07/28

More Info

Your recent adjustments in medication for both psychiatric and dermatological conditions reflect a complex interplay of treatments aimed at managing multiple health issues. It’s essential to understand how these medications work together and their potential side effects, especially given your history of mental health challenges and skin conditions.

Psychiatric Medications
1. Escitalopram (Leeyo): This is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed for depression and anxiety disorders. At a dosage of 20mg (10mg twice daily), it is within the typical therapeutic range. SSRIs can take several weeks to show their full effect, and they may cause side effects such as nausea, fatigue, and sexual dysfunction.

2. Lendormin (Bromazepam): This medication is a benzodiazepine used for anxiety and sleep disorders. The dosage of 0.25mg twice daily is relatively low, but caution is advised due to the risk of dependency, especially with prolonged use.

3. Eurodin (Zolpidem): This is a sedative primarily used for insomnia. The prescribed dose of 2mg twice daily is lower than typical doses, which may help mitigate the risk of dependence while still providing some sleep aid.

4. Lorazepam: At 0.5mg four times daily, this benzodiazepine can help with anxiety but carries similar risks of dependency and withdrawal symptoms if used long-term.

Dermatological Medications
1. Doxepin: This medication serves dual purposes as an antidepressant and an antihistamine, particularly effective for itching and sleep disturbances. The dosage of 25mg twice daily is common for managing severe itching associated with skin conditions.

2. Pregabalin (Lyrica): This medication is often used for neuropathic pain and anxiety. At 75mg twice daily, it can help alleviate pain and discomfort, particularly if you experience nerve-related symptoms.

3. Xyzal (Levocetirizine): This is an antihistamine used for allergic reactions and itching. At 5mg, it can help manage your skin-related symptoms, especially if they are allergy-related.

Other Medications
- Metformin: Typically used for managing blood sugar levels in diabetes, it is essential to monitor kidney function while on this medication.

- Tamsulosin: This medication is used to treat urinary symptoms associated with benign prostatic hyperplasia (BPH).

- Promeran (Metoclopramide): This medication is used for nausea and gastroparesis. Long-term use can lead to side effects such as tardive dyskinesia, so monitoring is crucial.

Safety and Interactions
The combination of these medications can lead to potential interactions. For instance, combining multiple central nervous system depressants (like benzodiazepines and sedatives) can increase the risk of sedation, respiratory depression, and impaired cognitive function. It is crucial to communicate openly with your healthcare providers about all medications you are taking, including over-the-counter drugs and supplements.

Recommendations
1. Regular Monitoring: Regular follow-ups with your healthcare providers are essential to monitor the effectiveness of your medications and any potential side effects. Blood tests may be necessary to check liver function, kidney function, and blood sugar levels, especially with long-term use of medications like metformin and Promeran.

2. Mental Health Support: Given your history of bipolar disorder, consider engaging in therapy or support groups to complement your medication regimen. This can provide additional coping strategies and emotional support.

3. Lifestyle Modifications: Incorporating lifestyle changes such as a balanced diet, regular exercise, and good sleep hygiene can significantly enhance your overall well-being and may help mitigate some symptoms.

4. Open Communication: Maintain an open line of communication with your healthcare providers. If you experience any new symptoms or side effects, report them immediately to adjust your treatment plan accordingly.

In conclusion, while your current medication regimen appears to be within acceptable ranges, it is vital to remain vigilant about potential interactions and side effects. Regular consultations with your healthcare providers will ensure that your treatment remains effective and safe.

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