How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr Basu Your Own Question

Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
Satisfied Customers: 28689
Experience:  MD
23744323
Type Your Medical Question Here...
Dr Basu is online now

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/
Dr Basu, Experienced Specialist
Category: Medical
Satisfied Customers: 28689
Experience: MD
Dr Basu and 4 other Medical Specialists are ready to help you
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.

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me FROM a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O.
< Previous | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me FROM a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O.
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C.
  • This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!! Alex
  • Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult. GP
  • I couldn't be more satisfied! This is the site I will always come to when I need a second opinion. Justin
  • Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around. Esther
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C.
 
 
 

Meet The Experts:

 
 
 
  • Family Physician

    Family Physician

    Doctor

    Satisfied Customers:

    2418
    GP with over 27 years experience including emergency medicine
< Previous | Next >
  • http://ww2.justanswer.co.uk/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor

    Satisfied Customers:

    2418
    GP with over 27 years experience including emergency medicine
  • http://ww2.justanswer.co.uk/uploads/DO/DoctorRich/2012-9-12_72454_Doctorweb.64x64.jpg Dr. Natasha's Avatar

    Dr. Natasha

    Doctor

    Satisfied Customers:

    7887
    American Board Certified in Emergency Medicine, Ivy League trained
  • http://ww2.justanswer.co.uk/uploads/DR/DrK99/newpic2.64x64.jpg Dr. K.'s Avatar

    Dr. K.

    Board Certified MD

    Satisfied Customers:

    255
    Board certified with experience in primary care.
  • http://ww2.justanswer.co.uk/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Board Certified Physician

    Satisfied Customers:

    76
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.co.uk/uploads/JA/JACUSTOMERjtu60wne/2011-2-14_183449_passportphoto2.64x64.jpg docwithheart's Avatar

    docwithheart

    Board Certified Physician

    Satisfied Customers:

    0
    Board certified pediatrician, with special experience in general pediatrics, hospital pediatrics, and pediatric cardiology
  • http://ww2.justanswer.co.uk/uploads/DR/drappapo/2013-8-16_22576_drdavid.64x64.jpg Dr. David's Avatar

    Dr. David

    Board Certified Physician

    Satisfied Customers:

    224
    Treat children/young adults, former chief resident, multiple publications
  • http://ww2.justanswer.co.uk/uploads/TA/tazechip/2012-6-7_135230_drpic.64x64.png Dr. Chip's Avatar

    Dr. Chip

    Board Certified Physician

    Satisfied Customers:

    12373
    20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
 
 
 

Related Medical Questions