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Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
Satisfied Customers: 29088
Experience:  MD
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Good Evening, I hope you are well and had a good start to

Resolved Question:

Good Evening,
I hope you are well and had a good start to the New Year.
I was really hoping you could help me and give me some advice and recommendations.
A very close friend of mine has been prescribed a 6 month course of antidepressants, the medication in question being escitalopram 20mg. She is into her third month and her doctor has recommended that she stops completely after her 6 month.
In the 4 years I have known her she has suffered from extreme bouts of anxiety and border line depression on a yearly basis. These bouts on occassions have lasted up to 2 to 3 months which has meant she has had to take time of work and generally she tends to shut herself off and suffer in silence as feels she needs to deal with it on her own and not be perceived as being week as she is usually the one offering others advice.
I am really concerned that her doctor my not be aware of her history and just stopping medication cold after 6 months will result in severe with drawl symptoms and put her back to square one as the medication does seem to be working but longer term doesn't want to be dependant on it.
Would it be better to slowly reduce the dosage over the next 3 months after the 6 months say 1 month to 15mg, 1 month to 10 month and final month to 5mg and monitor reactions along with say CBT sessions over that period to help ween of medication slowly and change thinking patterns at same time?
Submitted: 1 year ago.
Category: Medical
Expert:  Dr Basu replied 1 year ago.
Hi there,This is Dr Basu, experienced Internal Medicine Specialist.I am here to address your concerns and provide great service.Really good questions.Yes it is better to taper off escitalopram after 6 months of use to prevent withdrawal symptoms.The dose can be reduced by 5 mg every week.CBT and counselnig also can be considered along with.Also bright light therapy has been shown to be effective to prevent depression.If her symptoms worsen dueing tapering process, then she should remain on escitalopram at 10 mg daily for 3 months months at least or longer.Best wishes,It was my pleasure to help you today.If I have answered all your questions, Please rate my response Excellent (click on the 5th star).Please bookmark my profile for fast, reliable and authentic answers!This is the link to my profile:http://www.justanswer.com/medical/expert-mysticdoc/
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Customer: replied 1 year ago.
There maybe also the physiological dependency that just the fact of taking a so called 'Happy Pill' is making her feel better (placebo affect as it's referred to) - what would be the best way to counteract that?
Expert:  Dr Basu replied 1 year ago.
Newer SSRIs like escitalopram usually does not cause significant physical dependence.It is easy to taper off.If the depression symptoms worsen to baseline over time after stopping escitalopram that suggests persistent brain chemical imbalances which was not corrected fully by escitalopram during its treatment period.Otherwise, physical tolerance should not develop so easily.Best wishes
Customer: replied 1 year ago.
A recent study carried out by the Royal College of Psychiatrists suggests that withdrawl rates of patients coming off such a medication is 75% , this is higher for women over the age of 24.http://www.rcpsych.ac.uk/healthadvice/treatmentswellbeing/antidepressants/comingoffantidepressants.aspx
Customer: replied 1 year ago.
I would also like to send my friend a link to your responses - could you send me the url/link that I could send her - she may have further questions which I can then address with yourselfThanks so much
Expert:  Dr Basu replied 1 year ago.
That is an interesting survey.However the findings are known to the medical community.Withdrawal symptoms usually subside shortly if underlying depression is fully treated.This is the link to this conversation:http://professional.justanswer.com/chat/index/b2e6a4045ab740028be72b547946ea4f Best wishes
Customer: replied 1 year ago.
Dr Basu Thank you so much for your advice thus far.
I have a few replies left in the accepted offer price so may get back with any other concerns/questions my friend may have or raise once she goes through responses.You have a great evening and weekend ahead and thanks once again
Expert:  Dr Basu replied 1 year ago.
very welcomeMy pleasure.