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Managing Medication Changes in Psychiatry: Addressing Serotonin Syndrome

How to change a dressing? Hello, doctor. I have been diagnosed with autonomic nervous system dysfunction, and I have been taking Doxepin 25 mg at bedtime and 0.75 tablets of Zolpidem (Lunesta) for the past two to three years. However, I have been experiencing persistent side effe...


Dr. Huang Jiabin reply Psychiatry
Hello: Your body is more sensitive to serotonin, so the addition of citalopram has resulted in serotonin syndrome. You may want to discuss with your physician whether it is possible to switch to a different medication or to reduce the dosage of one of the medications to a lower l...

[Read More] Managing Medication Changes in Psychiatry: Addressing Serotonin Syndrome


Assessing Depression: Guidelines for Participation in Youth Activities

Medical assessment I am currently an organizer for a university event and would like to recruit high school students to participate. I would like to inquire whether psychiatrists have methods to assess whether individuals with depression can participate in a specific activity and...


Dr. Huang Jiabin reply Psychiatry
Hello: If the patient has been regularly followed up for treatment in the outpatient clinic, the attending physician can assess and issue a medical certificate. If that physician refuses to issue a medical certificate to confirm the patient's stable condition, it will be dif...

[Read More] Assessing Depression: Guidelines for Participation in Youth Activities


Understanding Sensory Overload After ADHD Medication and Stimulation

ADHD treatment medications combined with sensory stimulation can lead to heightened sensory sensitivity before the effects of the medication wear off? Hello, I am an adult ADHD patient. Today, before attending a concert, I took 20 mg of Adderall to help myself stay awake and focu...


Dr. Huang Jiabin reply Psychiatry
Hello: It sounds like the drug concentration is higher than usual, leading to significant sympathetic nervous system stimulation side effects. The question is: why were there no such severe side effects previously? Food may affect the absorption and metabolism of the medication; ...

[Read More] Understanding Sensory Overload After ADHD Medication and Stimulation


Overcoming Anxiety and Fear Related to Blood Pressure Monitoring

Fear and anxiety issues? Hello Doctor: I previously had unstable blood pressure and was diagnosed with hypertension. I took a beta-blocker (the lowest dose, half a pill) daily for six months, but my blood pressure kept dropping to 88/60. The doctor said I do not have hypertension...


Dr. Huang Jiabin reply Psychiatry
Hello: You have taken the first step in overcoming fear: "self-awareness," by beginning to recognize your irrational anxiety. The next step is to address the physiological responses that fear brings. You can search for "relaxation training" on YouTube, where y...

[Read More] Overcoming Anxiety and Fear Related to Blood Pressure Monitoring


Are These Symptoms Signs of Autonomic Nervous System Dysfunction?

Are these symptoms related to autonomic nervous system dysfunction? Recently, due to high stress, I often feel down, want to cry, experience chest tightness, fatigue, and occasionally dizziness, nausea, headaches, rapid heartbeat, shortness of breath, and palpitations. Do these s...


Dr. Huang Jiabin reply Psychiatry
Hello: The autonomic nervous system regulates most of our invisible physiological functions, including temperature, heart rate, digestion, and sleep. The autonomic nervous system can fluctuate due to changes in external environments and internal psychological states. Stress can i...

[Read More] Are These Symptoms Signs of Autonomic Nervous System Dysfunction?


Should I Seek Psychological Counseling for Anxiety and Stress?

Do you accept psychological counseling? Hello, Doctor! I am currently a senior in college. Perhaps due to family influence, I have always been very conscious of how others perceive me, striving to do my best in everything. Hearing rude or unpleasant comments has greatly affected ...


Dr. Huang Jiabin reply Psychiatry
Hello: It sounds like you have a sensitive constitution, particularly in interpersonal interactions and stress management. This can manifest in your emotions, sleep, and physical sensations. What you currently need is to understand which aspects can be improved through enhanced c...

[Read More] Should I Seek Psychological Counseling for Anxiety and Stress?


Sudden Insomnia: Causes and Solutions for Sleep Disturbances

Sudden insomnia? A few days ago, after catching a cold, I started experiencing severe insomnia and a strong heartbeat. I thought that after taking cold medicine, my symptoms would improve, but it has been three to four days since I stopped the medication, and my condition has not...


Dr. Huang Jiabin reply Psychiatry
Hello: I hope your cold has improved a bit. Sometimes, a cold with fever or the use of cold medications can disrupt your routine, and it may take some time to get back to normal. The blue light emitted by electronic devices can interfere with the secretion of melatonin, thereby a...

[Read More] Sudden Insomnia: Causes and Solutions for Sleep Disturbances


Understanding Signs of Mental Distress: A Guide for Concerned Individuals

Psychotic symptom inquiry Hello, Doctor: I would like to inquire about a situation where an individual appears slightly unwell (fragile, pale) and seems very anxious when talking to others. Even when there is a chair available, they hesitate to sit down, and their body language a...


Dr. Huang Jiabin reply Psychiatry
Hello: The situation described can be characterized as being under extreme emotional tension while trying to suppress those feelings. When the suppression becomes overwhelming, it can lead to an emotional breakdown. There are many possibilities; it could be temporary or pathologi...

[Read More] Understanding Signs of Mental Distress: A Guide for Concerned Individuals


Managing Withdrawal Symptoms After Stopping Rifampin and Antidepressants

Rifampicin Drug Issues Doctor!! I have been taking Rifuxin and Prozac, two pills each daily, for 11 months due to anxiety. After that, I stopped taking the medication on my own. Since stopping, I have experienced confusion, memory decline, decreased concentration, comprehension i...


Dr. Huang Jiabin reply Psychiatry
Hello: After abruptly stopping the medication, the aforementioned conditions could be attributed to two possible scenarios: 1. Withdrawal symptoms; however, these should gradually diminish over the course of several weeks, especially considering that both Rifampicin and Fluoxetin...

[Read More] Managing Withdrawal Symptoms After Stopping Rifampin and Antidepressants


Is Depression Affecting My Taste Buds? Understanding Flavor Changes

Taste disorders? Today, I had a curry pork cutlet bento, drank cola, and when I tasted the curry, it had a medicinal flavor! It was a bit bitter, and when I drank the cola, it reminded me of the taste of a slushie! I have depression; is this due to my depression affecting my tast...


Dr. Huang Jiabin reply Psychiatry
Hello: Your description is indeed related to taste perception. However, to determine if there is a real issue, it is necessary to rule out any ingredients in that curry recipe that might cause a bitter taste for some individuals (since curry is made with a variety of plant spices...

[Read More] Is Depression Affecting My Taste Buds? Understanding Flavor Changes


Should I See a Doctor for My Mental Health Concerns?

Do I need to see a doctor? Hello, I am currently a high school freshman. Since last year, I have experienced several months of feeling down, poor sleep, frequent crying spells, and overall weakness. I have lost interest in other activities and often have very negative thoughts. H...


Dr. Huang Jiabin reply Psychiatry
Hello: Please seek medical attention as soon as possible; delaying it will have a greater impact on your life and result in more significant losses. The consultation fee is covered by the National Health Insurance, so it will only be a couple of hundred NT dollars at most, unless...

[Read More] Should I See a Doctor for My Mental Health Concerns?


Understanding Communication Errors: Strategies for Mental Clarity

Verbal response and coping? If someone asks me a series of questions where the answer is "yes," and then there are follow-up questions that extend incorrectly, I might subconsciously respond "yes" to those incorrect follow-up questions as well, without realizi...


Dr. Huang Jiabin reply Psychiatry
Based on the above issues, I suspect that it may be related to auditory working memory or attention, somewhat akin to the concept of "shooting at shadows." The test result of PR99 indicates that if it was purely a written assessment, it demonstrates that you have no iss...

[Read More] Understanding Communication Errors: Strategies for Mental Clarity


Understanding the Side Effects and Precautions of Jing An Ning for Anxiety

Medication Consultation I would like to ask about the side effects of Jing An Ning. Currently, my doctor advised me to take one when anxiety occurs. I am also taking St. John's Wort, and during the first few days of taking it, I experienced full-body weakness and even stomac...


Dr. Huang Jiabin reply Psychiatry
Hello: Because St. John's Wort is a selective serotonin reuptake inhibitor, some individuals may experience abdominal discomfort as a side effect. On the other hand, Xanax, which is a benzodiazepine, may cause sedation, drowsiness, and dizziness in some individuals, and its ...

[Read More] Understanding the Side Effects and Precautions of Jing An Ning for Anxiety


Navigating Gender Identity: A Personal Journey Towards Transition

Regarding gender transition? Hello, Doctor: I first attempted to dress as a woman around the middle grades of elementary school, and no one noticed. Since middle school until now, I have dressed as a woman alone in my room, and again, no one knows because I am not yet mentally pr...


Dr. Huang Jiabin reply Psychiatry
Hello: From the perspective of gender issues, a person's gender encompasses many layers: biological sex, gender identity, sexual orientation, and gender roles, among others. It seems that you are most troubled by the physical characteristics of biological sex. In the clinica...

[Read More] Navigating Gender Identity: A Personal Journey Towards Transition


Understanding Autonomic Nervous System Disorders and Their Impact on Mental Health

Autonomic nervous system Hello, doctor... Ten years ago, I suddenly experienced symptoms of bloating and constipation. I have undergone examinations at major hospitals in Taipei, including a CT scan and three colonoscopies, all of which were normal. The doctors have said it is du...


Dr. Huang Jiabin reply Psychiatry
Hello: It sounds like these symptoms are truly troubling you. Fortunately, there are no structural abnormalities in your organs, and the focus should be on addressing their functional aspects. You are currently caught in a vicious cycle where physical discomfort leads to anxiety ...

[Read More] Understanding Autonomic Nervous System Disorders and Their Impact on Mental Health


Understanding Autonomic Nervous System Disorders and Gastrointestinal Issues

Autonomic nervous system dysfunction, gastrointestinal issues? I have been experiencing issues with my stomach making noises and feeling restless for several months. Sometimes, I have difficulty having a bowel movement; when I do, it can be watery. I visited a gastroenterology cl...


Dr. Huang Jiabin reply Psychiatry
Hello: The main function of the autonomic nervous system is to regulate the internal functions of the body in response to external environmental demands. This regulation can be excessive or insufficient; for example, if you eat something bad and experience diarrhea, it is a norma...

[Read More] Understanding Autonomic Nervous System Disorders and Gastrointestinal Issues


Understanding Bipolar Disorder: Managing Symptoms and Self-Harm Risks

The condition of bipolar disorder? Hello, Doctor. I have bipolar disorder and have been on medication for over two years. Recently, I've noticed an improvement in my depressive symptoms over the past six months (my pace has quickened, and my memory has improved). I generally...


Dr. Huang Jiabin reply Psychiatry
Hello: It sounds like your emotional state has reached a point where even when you're feeling down, it doesn't last all day, and this has been occurring for more than two weeks. The current issue is how to cope with negative emotions (which everyone experiences) without...

[Read More] Understanding Bipolar Disorder: Managing Symptoms and Self-Harm Risks


Struggling with Depression and Skin Picking: A Journey to Healing

Depression / Dermatillomania I am currently unemployed and have only done some part-time jobs. After graduating from university, I prepared for civil service exams due to my parents' expectations, even though I understood that this was not what I truly wanted. I reluctantly ...


Dr. Huang Jiabin reply Psychiatry
Hello: It sounds like you have been unable to resolve the current conflicts. You are anxious, which leads you to pick at the edges and inner skin of your thumbs; you are depressed, which causes you to pick until it hurts, making you aware of it; perhaps you feel a sense of nihili...

[Read More] Struggling with Depression and Skin Picking: A Journey to Healing


Am I Exaggerating My Mental Health Issues? Understanding Self-Perception

Exaggerating symptoms? / Feeling like you're not yourself? Hello, doctor. This year, I have received psychiatric treatment. During my follow-up visits, the doctor asks me questions, and I always tend to focus on the negative aspects of my situation. For example, when asked i...


Dr. Huang Jiabin reply Psychiatry
Hello: The situation described above is referred to as "dissociation." Dissociation occurs when, under strong psychological pressure, our subconscious attempts to exclude certain experiences, leading to a temporary inability to connect with those experiences on a subjec...

[Read More] Am I Exaggerating My Mental Health Issues? Understanding Self-Perception


Understanding Paroxetine and Metformin: Safety, Side Effects, and Interactions

Drug Information Previously, I experienced shortness of breath, weakness, and felt faint, so I visited a nearby clinic where the doctor diagnosed me with hyperventilation syndrome. Recently, the symptoms have become more frequent, and I consulted a psychiatrist at a large hospita...


Dr. Huang Jiabin reply Psychiatry
Hello, I would like to ask if Paroxetine and Metformin can be taken together? (Metformin is taken at bedtime) -> There is no conflict in their treatment. May I ask if Paroxetine causes weight gain? (My obstetrician has advised me to lose weight, and I am concerned it may affec...

[Read More] Understanding Paroxetine and Metformin: Safety, Side Effects, and Interactions


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