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Are these drugs used for the same psychiatric disorder?

Q: My wife is under a psychiatric & psychologist treatment since early this year. The doctor has given Flunil, Rejunix & Clonotril for treatment. The dose is one tablet per day and she has been taking these medicines for 2 months. Her parents have got the medicine changed under a physician & cardiologist's supervision. She is now taking Tryptomer and Serenace (one tablet per day). Are these two medicines given for the same disorder?

A:The first task is to make a correct diagnosis. Is it anxiety or depression? If it is depression, then is it mild or moderate or severe? Is it generalised anxiety disorder (GAD) or is it schizophrenia? Are there any other concomitant disorders? No drug treatment is generally required in mild depression. In moderate to severe depression one should use conventional, mild medicines in the lowest possible dose such as amitryptyline (Tryptomer) 10mg three times daily and increase the dose slowly if at all required. Serenace (haloperidol) is indicated in cases of major disorders such as mania, schizophrenia, substantial aggression and/or agitation and similar disorders. Flunil (fluoxetine) is to be used only in correctly diagnosed moderate to severe depression and Obsessive Compulsive Disorders. It has a large number of side effects, some of which are quite serious such as liver disorders, serotonin syndrome, convulsions, nervousness, tremors, bleeding disorders, etc. Hence it should be used only when there is clear indication. Surprisingly even though this medicine is meant for depression, it is capable of making depression even worse and can lead to suicidal tendency. Clonotril (clonazepam) is actually meant for epilepsy but it has some anti-anxiety properties. However this medicine itself can cause depression, liver disorders, behaviour problems and blood disorders. In mild to moderate cases of depression, it is best to use well-tried and tested conventional medicines such as amitryptyline (Tryptomer). Only when the effect is not adequate should one go in for more potent but also with many more and serious adverse effects.

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