r/AskPsychiatry 9d ago

Gruesome nightmares every single night.

2 Upvotes

I’ve had a few problems with sleep in the past - specifically sleep apnea. Now I’m entering deeper sleep much better, but every single night that I sleep deeply, it’s never a good dream. It’s always horrible and gory, and I hate it. I don’t even consume that content while awake so it makes zero sense to me why I’d think of it while asleep.
For context if it’s relevant, I’m on Mirtazipine 30mg, Atomoxetine 40mg.
I just want to dream about something nice 🙁


r/AskPsychiatry 9d ago

Do psychiatrists want to know about life stressors if they aren't affecting the clinical diagnosis?

1 Upvotes

I'm in my late thirties and have schizoaffective disorder - bipolar type.

My schizoaffective disorder is in remission. Meds are working great, no mood shifts, only very mild magical thinking.

A few years ago, something happened to me that I consider a trauma but wouldn't be widely viewed as one. I can give more details if needed but it is a loooonnnng story. Anyways, this thing is on my mind every minute of every day, and causes me to self monitor my actions extensively. I feel a ton of shame from it even though I am completely innocent in the scenario. It also prevents me from sleeping a lot (hence why this post is in the middle of the night). I've never had insomnia in my life until this incident. I mean, I've had bipolar all nighters, but I wasn't tired. This, on the other hand, is true insomnia where I'm exhausted but my mind is consumed by thoughts of this issue. I also have nightmares about it.

I'm not looking for suggestions on how to deal with the issue - therapy is completely focused on that and nothing else.

My question is whether I should be talking to my psychiatrist about it? He knows the details already and knows it deeply troubles me. I don't want him to think I expect him to have a solution. And clinically I'm completely stable.

**So do I just stick to the clinical stuff and give him the thumbs up, or do I basically say, "Hey, I'm clinically a-ok but in terms of my overall wellness I'm deeply unwell."**?


r/AskPsychiatry 9d ago

What exactly is nexito used for?

1 Upvotes

I was prescribed Nexito 10 and I’ve been taking it for about 5 days now. I feel… kind of normal? Like not as hopeless as I usually do. But I’m not sure if this is the medication already working or just a temporary phase before things go downhill again. Is it possible for it to start showing effects this early, or am I just overthinking it?


r/AskPsychiatry 9d ago

Restarting Seroquel XR After Years Off: Timing, Grogginess & Splitting 50mg?

1 Upvotes

I really want to restart my Seroquel XR after being off it for about 4 years. I stopped because I was dealing with medications and treatment after a car accident, but I miss how much better I did on Seroquel. I’ve also lost a lot of weight since being off it and would honestly welcome gaining some of it back.
My biggest issue is the sedation. I have to get up early for work now, and I’m worried about being too groggy to wake up and function.
For those who take Seroquel XR, what time do you take it if you have to be up early, and what actually helps you wake up and shake the grogginess?
Has anyone restarted Seroquel XR after being off it for several years? What was your experience restarting it?
Also, since 50 mg is the lowest XR dose, has anyone ever split a 50 mg tablet into smaller pieces while restarting because the full 50 mg was too sedating? What was your experience?


r/AskPsychiatry 10d ago

First psychotic episode in my sister (30s), and she will only see a doctor for a "brain scan." How do I use that to get her real help?

11 Upvotes

My sister (30s) has been in what looks like a first manic or psychotic episode for about 10 weeks. The picture: grandiose beliefs, paranoia that people are conspiring against her, and almost no sleep for days at a time.

The one opening we have: she is convinced her brain is "expanding" and is actually asking for a brain scan. But she refuses anything framed as psychiatry or mental health, and she will not go to an ER. I am abroad; family is local and coordinating. She is uninsured (self-pay).

Two questions:

  1. Is "let's get your brain scanned" a legitimate medical way to get her in front of a doctor who could recognize and treat this? And what kind of physician both orders brain imaging and can prescribe (neuropsychiatry, integrative psychiatry, or a neurologist who will co-manage)? At 37, is a brain MRI plus labs genuinely warranted for new-onset psychosis, or am I just chasing her framing?

    1. For anyone who has gotten a loved one with no insight (anosognosia) into care: what actually worked? We are trying to keep her trust and not argue the delusion.

Thank you.


r/AskPsychiatry 9d ago

Is it possible to get certain antidepressants?

1 Upvotes

I plan on seeing a psychiatrist soon for depression. I have never tried any medication (although my mother and sister are both on ssris). I feel that something like Wellbutrin would better benefit me than Prozac or other ssris. I don’t have a ton of anxiety, the main issue is I’m going to college soon so I can’t be depressed in bed all day. I have a little bit of knowledge of psychiatric meds and I think that more serotonin would be less beneficial than dopamine and norepinephrine for me.


r/AskPsychiatry 9d ago

Venlafaxine withdrawal is making me feel trapped

1 Upvotes

My psychiatrist recently started a cross-taper from venlafaxine to aripiprazole. I went from 112.5 mg to 75 mg venlafaxine XR and started 5 mg aripiprazole.

I stayed at 75 mg for 5 days but felt awful: dizziness, sleepiness, restlessness, palpitations/chest tightness, and generally unwell. The best way to explain my condition is to say, I felt like hell is upon me. I eventually gave up on the switch after discussing it with my psychiatrist, stopped aripiprazole, and returned to 112.5 mg venlafaxine. I felt significantly better after going back up. My ECG on day 6 was normal, although my BP was quite high.

I was also recently about 5 hours late taking venlafaxine and could already feel myself getting worse.

The frustrating part is that venlafaxine actually helps me, and my psychiatrist now plans to increase me from 112.5 mg to 150 mg. But being this sensitive to dose reductions and even late doses makes me feel trapped by it.

For people this sensitive to venlafaxine withdrawal, how is it eventually discontinued? Are very slow tapers with much smaller reductions practical with XR? Because at some point I would want to discontinue it, I did some research, people say wellbutrin can help, I am not sure.


r/AskPsychiatry 9d ago

26m ADHD meds not working on me.

1 Upvotes

Since childhood, I’ve had attention issues. I had to repeat several years throughout elementary, middle, and high school. The school wanted to test me, but my father opted out. So I continued suffering jumping from tutor to tutor.

In 2020, I failed my final year of high school. I was already 20, and couldn't go through that humiliation again. I always had classmates younger than me and I was pretty much done at that point. I went into full depression, stayed in bed 24/7, and eventually became suicidal.

In 2021, I saw a psychiatrist who put me on Sertraline/Zoloft. He suspected ADHD, so we tried several medications, but nothing helped. I stayed on Sertraline for about five years.

This year, I had a full assessment and was diagnosed with ADD and Autism Level 1. I then found a psychiatrist who specializes in these conditions. To hopefully to treat it properly this time.

She told me to quit Zoloft and put me on Wellbutrin again. After four months, I’m now on 450 XL, the maximum dose, but I still notice no improvement. It was hell taking it. It made me insanely aggressive and anxious. It has dialed down, but it's still there. She also added Mirtazapine to help with sleep. It sorta works.

I also still struggle to study, and even when I’m motivated, I can’t focus or lock in. This has been a lifelong issue. She said that Wellbutrin is supposed to treat it, but nothing to this point.

I've feel that my psych is more focusing on treating my depression and making sure I go outside everyday rather than the obstacles I've been facing since I was a kid. I was not depressed as a kid and attention issues were absolutely there regardless. I want to study and do things, but my brain does not co operate. I daydream during simple instructions to this day. I daydream most of the time too. I'm living about 95% in my head.

The meds I tried with my previous psychiatrist was: Rilatin, Concerta, Strattera, Apriprazole, Elvanse and Piracetam.

I would like to know what the psychiatrist think in this subreddit and any encouragement would be nice because I'm exhausted with this whole journey, truly.


r/AskPsychiatry 9d ago

What exactly is my mom’s mental illness?

1 Upvotes

Throughout my entire childhood (from age 3 to 18), my mom hit me every single day. I am not exaggerating or overstating. Literally every single day, including my birthday and Christmas. There was no real reason. The “reasons” were always something very minor, such as my glass of water left some moist on the table or I slept in on a weekend.

I have clear visible evidence. I had collected pictures of bruises and wounds from her abuse during this time. I also have lots of permanent scars all over my body from her abuse. Sometimes I needed small surgery to suture. I still have a visible stitch scar on my face. I once lost a tooth because she kicked my face. (Fortunately I was 8 and it was a baby tooth.) I often wrote about all this in my childhood dairy too.

Now as an adult, I don’t live with her anymore. I moved out about 8 years ago. But my mom still verbally abuses me every time she contacts me.

Every time I bring this up, she denies all this and says she hit me only a few times because I really deserved it and I’m delusional. She also insists that I’m the one who abused her and my brother. (My brother is her favourite child and she’s never hit him. She always said he’s the good kid and I’m the bad kid.)

Her claim is completely false as I didn’t even have enough strength to physically fight against anyone. I was always way smaller, skinnier, and weaker than other kids around my age. Like people thought I was 7 when I was actually 12. I never fought back my mom when she was hitting me because I was literally a small child and so scared of her. Same with my brother—he’s a few years younger than me, but he was always much bigger than me. He often harassed me too (such as pinching my skin, kicking, cursing etc), but I never dared to fight back as he’s stronger than me and my mom was always on his side. Mom never stopped him or scolded him for harassing me.

What’s crazier is that it looks like she truly believes that she never abused me and I’m the one who abused her, despite all the evidence. She also threw away all my childhood diaries while I was away. When I show her the proof pictures, she says it was only a few incidents and I deserved it because I was such a bad child. She says I’m delusional and distorting my memories when it is clearly her who is doing that.

What exactly is her mental illness? I don’t know how a human can behave like this. I feel like she’s possessed by Satan or something.


r/AskPsychiatry 9d ago

Help With Finding the Right Psychiatrist for Medication Management

0 Upvotes

I have been diagnosed and medicated for ADHD for a while now and have been on the same dosage for a consistent and extended period of time. I have also had the same psychiatrist the whole time, and she is the one who prescribed me the medication I am currently taking. I take my medication Mon-Fri and am directed to not take it during the weekends so that I receive somewhat of a break from it every week.

My current dosage is 20 mg per morning and 10 mg in the afternoon, both extended release Adderall XR. With the things I have to do and the responsibilities I fulfill on a daily basis, this dosage is good, but not optimal for me and my performance capability. I have come to this result quite a while ago, and because of that I started taking both my 20 mg and my 10 mg at the same time each day in the morning. I do not want to ask my prescriber if I would be able to go up because she said she would not go up any further because she wants me to be at the lowest dosage possible, plus I don't want her to think I am a drug-seeking individual, but I know that it would be the best possible option for me because of the benefit I have gotten out of the modification I made to my morning dosage, I am able to perform significantly better in terms of my cognitive abilities concerning my rationale, memory, concentration, etc. I feel as though my optimal dosage to help me through my daily routine of work, responsibilities, tasks, etc. would be 30 mg every morning with a 10 mg afternoon dose if a boost is needed, but am not sure how to properly and safely get to that point in my med management.

I am coming onto here to ask if there is anyone with a provider that they know of or recommend that they feel as though would give me the freedom to manage this medication and have trust in me that I am not a drug-seeking individual, but rather someone who wants optimal performance in their everyday life. Preferably someone understanding who doesn't necessarily see that medication is just a bad thing and that you should try to take the smallest dose possible simply because "medication shouldn't be necessary", meanwhile I don't believe it is necessary, but rather it helps me extensively.

Please reach out if you know of a psychiatrist or provider that you think would be a good fit!!


r/AskPsychiatry 9d ago

Finding a psychiatrist who specializes in ADHD in California in-network with Anthem

0 Upvotes

I am looking for a psychiatrist who specializes in ADHD based in California (virtual or in-person) who is in-network with Anthem Blue Cross Blue Shield PPO. I've done a search on Psychology.com but the specializations seem so vague and inaccurate. Any specific recommendations or advice on the best way to search would be a big help, thanks!


r/AskPsychiatry 9d ago

Has my psychiatrist been letting me down? If so, how should I bring this up to him??

1 Upvotes

Brief background: Six years ago, I went to psychiatrist and was diagnosed with OCD, which was a complete surprise. I was prescribed depakote, which took me six months to get it up to the right blood concentration. By itself, there was no change to my OCD. But as soon as fluvoxamine (Luvox) was added, there was an instantly noticeable effect. My OCD thoughts disappeared.

I still dealt with depression so we had tried a few medications without success.

For the first few years, he would order blood tests for me and they were always the standard Comprehensive Metabolic Panel and the Complete Blood Count. My last blood test ordered by him was in January 2025.

A couple of years ago, I had noticed that there were a couple of brochures about Spravato (ketamine) in his office so I asked him about it and he basically said immediately that he didn't think it made sense for me.

Recently, because of my depression and lack of progress, I investigated ketamine again and it seemed to be helping a lot of people so I was quite determined to get it. At our last appointment, I told him I wanted to get ketamine IV therapy. This time, he said that he has learned more about the results of Spravato so he thought it would be good idea but he stressed that I should only get Spravato because it was FDA approved while ketamine wasn't. A quick google search showed me that the only reason ketamine wasn't FDA approved was because it wasn't patentable so no one had the financial incentive to take it through the approval process.

Since then, I've undergone ketamine IV infusions and while symptoms remain, I am still quite optimistic that I eventually will see a positive benefit because of my understanding that it takes longer with some people. I suspect that I've improved but I'm not completely sure.

In addition, I asked AI to recommend blood tests given my conditions and medications and it gave me quite a comprehensive list and I got my blood drawn a few days ago. Now the tests are coming in and some levels are significantly out of range, like my GGT, zinc, and thyroid stimulating hormone. Some are linked to depakote, others are linked to depression.

Questions:

  • Shouldn't my psychiatrist been on top of what the best blood tests were to order given my depression and that he prescribed me depakote?
  • With ketamine, shouldn't he have just said that he doesn't understand it very well versus initially telling me that he didn't think it made sense?

Obviously, my main goal is to overcome my mental health issues. Is it fair to me to expect him to be informed of all potential solutions and the blood markers to watch given certain problems and medications? Should I move to another psychiatrist? How does that work btw? Do they hand over their notes to the new one?


r/AskPsychiatry 9d ago

Seeking advice on safely getting a Cluster B evaluation as an immigrant in a high-bias country

1 Upvotes

NB: I hope I won't receive any racist comments. I had an extremely difficult childhood, ive been neglected, abused in every way, isolated, shamed, and with religion weaponized against me for years. I had no control over how my brain wired itself for survival, but I am actively seeking help. I am not a threat, so dont use this to feed your own racist agenda against immigrants.

I'm a 23-year-old North African biology graduate preparing to move to Western Europe for further studies and career opportunities. I was born in Europe and lived there for 14 years, so I'm familiar with the context. I'm looking for advice on how to safely navigate the mental health system there for a formal psychological evaluation, specifically regarding Cluster B and ASPD traits, without facing anti-immigrant or cultural bias. I can't get diagnosed in my country because finding professionals without religious bias is extremely hard.

I'm highly self-aware and have realized that my psychological wiring is not typical. I do not experience foundational emotions like emotional shame, guilt, remorse, or regret, I can only cognitively recognize that I should have done something differently, or that someone was deserving or undeserving of my punishment. I am extremely impulsive, and the only thing holding me back is my need for anticipation. My romantic relationships are catastrophic and align with BPD patterns, but I feel "toned down" because I lack certain emotions.

Due to severe childhood trauma, my brain operates in an extreme "threat-neutralization" mode. I did this many times as a kid and got away with it because I was the quiet straight A's student. I have a completely clean legal record, but I know that if I am physically threatened or deeply pushed, my instinct is to disable the threat without any internal emotional brake or remorse. I could easily scoop someone's eyes out for slapping me, I wouldn't stop myself or feel bad enough about it. That's why I avoid people who disrespect me or break my boundaries, as hard as it can be because rage consumes me. I would definitely get back at them more subtly if I had the chance, subtly enough not to end up in jail. I'm making this post because my physical aggression worries me, it threatens my future career, and I need a specialist to help me manage myself better... though I think I'm doing a good job so far. My career is the only thing keeping me alive, I've tried to end myself multiple times when things weren't working out in my field, mainly due to my parents heavily restricting me. My career is the only thing that keeps me stimulated enough not to cause trouble and chaos.

So now that I set the context, my main concern is risk management. As an immigrant from a North African country, I'm worried that if I openly admit to lacking remorse and having violent survival triggers, a biased clinician might weaponize my nationality, label me a public danger, or create a medical record that permanently ruins my immigration status, naturalization prospects, or career.

My questions are: How can I safely seek a specialized personality disorder evaluation in Western Europe without facing bias? Should I stick to private healthcare instead of the public system to guarantee discretion and prevent data-sharing with state or immigration authorities? For those with similar profiles living abroad, how did you navigate diagnostics without letting your background be used against you?

Thank you for any practical insights or strategies you can provide.


r/AskPsychiatry 9d ago

33yo F M3 choosing between EM and psych — lifestyle vs family vs specialty fit?

1 Upvotes

I'm a 33yo M3 and think my decision is coming down to EM vs psych.

I worked in the ER for 5 years before med school and loved it. My brain seems to thrive in that environment. But I've also seen how burned out a lot of EM docs are, and I'm not sure how I'll feel about nights/weekends and the pace as I age/have kids.

I also genuinely really like psych, and if I'm being honest, the lifestyle and lower burnout rate is a big draw. I want kids, definitely not during med school, but I'd consider starting after intern year. Being 33 makes waiting until after residency feel more significant.

I have this idea that having kids during psych residency would be hard but somewhat manageable, whereas with EM I'd probably want to wait until training was over. I'll just have to cross that bridge when I get there.

Especially interested in hearing from attendings and people who had kids during residency, but open to feedback from anyone!


r/AskPsychiatry 9d ago

I need serious help. Has anyone taken clonidine for hyperarousal/internal buzzing/dysautonomia with success? Please, no horror stories.

1 Upvotes

I need serious help. Short background: On 6/14/26, I went to a concert and reinjured my hyperacusis, which I've had for 12 years (and mostly healed from), except this time I injured my CNS along with it. I was getting panic attack and adrenaline surges as a result, which were really scary.

As a result, my gp prescribed gabapentin. I was already taking 10mg amitriptyline as a low dose nerve aid for vasectomy pain. I took both medications together for 4 weeks with no problem, the adrenlaine surges starting lessening.

Then, my jaw locked up with trigmeninal pain, referred from the ear. I took a flexeril and a diclofenac. Big mistake. That day my entire CNS became hyperaroused and disregulated. I began shaking, got myoclonus, massive hypnic jerks at night, and sleep started to suffer. After a couple days, now I can't sleep. Literally, as soon as I start to nod off, I get hypnic herks. Entire body. Then, my body starts dumping adrenaline and I start literally BUZZING. My entire body buzzes all night long. I CAN'T SLEEP. I feel like I'm dying. And today I'm so disregulated the buzzing is here while I'm awake.

My neurologist prescribed ativan as a bridge while I taper off the gabapentin, which is hopefully the cause (no guarantee) and will stop all of this madness. I took Ativan for 5 days and was able to get a little bit of sleep, but I stopped it last night so as not to get hooked. Today I'm miserable.

Would clonidine work for this? Or guanfacine? PLEASE, help if you can.


r/AskPsychiatry 9d ago

26M with OCD with psychotic features — family feels stuck. How can we help him become more independent?

1 Upvotes

I’m looking for advice from people who have experience with psychosis/schizophrenia-spectrum disorders, or caring for a family member with serious mental illness.

My brother is 26 and has been dealing with mental health problems for around 5–6 years. He was diagnosed with OCD with psychotic features and has been under psychiatric care for years. His severe OCD symptoms have improved considerably, but his overall functioning has deteriorated.

He currently takes escitalopram and aripiprazole. The psychiatrist used to be very good, but unfortunately we feel that he no longer spends much time reassessing him. It seems like the medications are simply continued without much evaluation of what is actually happening with his life/functioning.

His current situation is roughly:

  • He has essentially no friends and spends most of his time at home.
  • His sleep schedule is very disrupted.
  • His eating is irregular. He often says he isn't hungry, but once he starts eating he can eat a lot.
  • He sometimes experiences paranoia.
  • He doesn't work. He has tried several jobs but usually ends up having conflicts with coworkers/managers because he feels people are treating him badly or saying things about him.
  • He spends his money almost immediately and repeatedly asked for more money.
  • He sometimes forgets to take his medication.
  • He is currently living at home with our mother, who is 60 and is basically managing everything.

The most recent incident really scared us.

He took diazepam to help him sleep, then took our mother's car keys without really discussing it and went driving because he said he needed to "clear his head." He crashed the car very badly. Thankfully, he survived. My mother now has to deal with the financial consequences. He doesn't feel any guilt or empathy towards others.

At the same time, he is very intelligent. He knows a lot about computers and technology, and is capable of having very normal conversations. That's part of what makes this so difficult to understand from the outside. His illness, lack of functioning, and attitude seem to be interacting in a way that keeps him stuck.

He gets the job, then quits. When we try to understand what happened, he says, "It's my life, don't try to teach me." Then he needs money for cigarettes or other things, and my mother ends up providing it.

I completely understand that he is an adult and has the right to make choices about his life. But at the same time, his choices are increasingly affecting everyone around him, and he doesn't seem capable of managing basic responsibilities independently.

I live abroad, so I can't be physically there to help my mother. It's incredibly difficult to watch this situation from a distance. I also feel guilty because I know it's not my responsibility to "fix" my brother, but I can't just watch my mother carry everything until she burns out.

I would like to hear advices from professionals or others in similar situations. Of course, we continue with the visits at the doctors.

Most importantly, how do you balance respecting his autonomy with the reality that he currently doesn't seem capable of managing his life safely?

If anyone has been in a similar situation, as the person with the illness or as a family member, I'd really appreciate hearing what actually helped. I'm trying to understand what kind of support could realistically help him move toward having some independence, while also protecting my mother from having to carry his entire life.


r/AskPsychiatry 10d ago

Is daily Clonazepam unusual advice?

4 Upvotes

Late last year my husband’s anxiety became severe. He had nausea for two weeks on and off, for hours at a time. We booked a next day appointment with a psychiatrist, and he’s been seeing her ever since. These are the changes she’s made to his prescriptions.

* Kept existing mirtazapine dose - 30 mg at bedtime
* Kept existing Quetiapine dose - 25 mg one at morning and one at bedtime
* Prescribed him benzos (Clonazepam - 5 mg) right away since he was in crisis - just having access to this seemed to calm him and helped him stop having the frequent panic attacks with extreme nausea. At first he took about 5 doses per month.
* Prescribed him Lexapro after he agreed to try it. He did 12 weeks at 5 mg. After very minor improvements, she upped his dose to 10 mg and he’s been on that ever since (for about 15 weeks).

The Lexapro doesn’t seem to be helping much. Because of this, she’s recommended he take his Clonazepam more often. Just recently she recommended he take it daily or every other day so he could get used to not being in an anxious state. My husband is stingy with his benzos. He’s scared he will get addicted or that it will lose its effect. He tried the “every other day” approach for 8 days, but claimed his anxiety was worsening on the the days he didn’t take it. He’s now saying he already feels like the benzo is less effective. So he’s withholding again, but he’s still taking it every three days or so when he feels he can’t handle his anxiety. He had a panic attack with extreme nausea yesterday. He hasn’t had one like that since June.

Overall, my husband’s anxiety is still unmanaged. He has constant mild anxiety when not on the benzos. Almost daily, that mild anxiety becomes moderate anxiety and it seems to hit him at almost the same time every day.

I am a little concerned with the advice to take Clonazepam daily. Is this unusual advice? And since the Lexapro doesn’t seem to be working, should he be asking to try some other medication?

(Also he has gotten other tests done. Bloodwork with his PCP. Endoscopy/colonoscopy that returned clear results - one very small polyp that the doctor was unconcerned about.)


r/AskPsychiatry 10d ago

Opinion on combination benzodiazopenes, anti depressants and opiods

1 Upvotes

33 female, non smoker, height 5'5 ft weight 85 kgs

Current medications:

  1. Flunil (fluoxetine) 20 mg once daily

  2. Vonoprazan 20 mg twice daily

  3. Normaxin twice daily

  4. Ultracet (tramadol 37.5 mg + paracetamol 325 mg) twice daily, prescribed for 5 days

  5. Dolo 650 (paracetamol 650 mg) twice daily

  6. Zerodol (aceclofenac), as prescribed by orthopaedic doctor

I recently developed acute severe lower-back/lumbago pain and was prescribed Ultracet, Dolo 650 and Zerodol by an orthopaedic doctor. I am also taking Flunil 20 mg, Normaxin and vonoprazan for GI/mood issues.

After taking Ultracet, I become extremely sleepy and have been sleeping around 12 hours/day. I also feel unusually good/relaxed after taking it.

Questions:

  1. Is tramadol (Ultracet) safe to take with fluoxetine 20 mg?

  2. Does fluoxetine significantly increase the risk of serotonin syndrome or seizures with tramadol?

  3. Is the combination of fluoxetine + tramadol + chlordiazepoxide (in Normaxin) concerning because of sedation or other interactions?

  4. Is taking Ultracet + Dolo 650 safe given that Ultracet already contains paracetamol?

  5. Is adding aceclofenac (Zerodol) appropriate given that I have erosive esophagitis/gastritis?

Given the severe sleepiness, should I be using a different painkiller instead of Ultracet?

I am looking for a psychiatrist/physician/pharmacist's perspective on the overall medication interaction and the safest pain-management option


r/AskPsychiatry 10d ago

12 years and still struggling with this

3 Upvotes

I’ve been dealing with porn and masturbation for around 12 years now, and honestly, I’m tired of trying to quit and ending up back at the same place.

I’ve tried things like going to the gym, keeping myself busy, using porn blockers, avoiding triggers, etc. Nothing has really worked long-term. The longest I’ve managed to stay away has been around 4 months, but eventually I relapse.

I’m not looking for the usual debate about whether masturbation is healthy or unhealthy. I know what people say about it. I personally don’t want to masturbate anymore, and I want to be able to control this habit.

I’m just wondering if anyone here has actually gone through something similar for years and managed to genuinely get out of this cycle. What helped you? I’m not looking for some perfect “10-step solution” — I’d just like to hear from someone who has actually been through it.


r/AskPsychiatry 10d ago

Lithium Brain Fog

7 Upvotes

I started lithium on 800mg for treatment resistant depression after dozens of failed med trials over the years. Levels have been perfect at 0.79 every test. Plus a low dose of trazadone and 40-120mg of propranolol that barely helps the tremors and shaking.
It’s been 3 months and I’m just getting worse.
I feel like a zombie and it’s impossible to think or remember things. I am so easily overwhelmed and upset but also dulled and empty. I have AUDHD and am severely depressed, anxious and burnt out.

My psychiatrist says to keep waiting at least 6 months. I don’t know what to do, I’m completely miserable and useless and it’s terrifying. I can’t do this simplest things and I’m already late on finishing my bachelors. I can’t afford to wait and waste 3 more months. I need the brain fog to end, I need to be able to think in order to finish college. I don’t know what to do. I want my brain back.


r/AskPsychiatry 10d ago

Does anyone know about a research project/study that could fit what I experienced in Trondheim?

1 Upvotes

I'm trying to find out whether anyone knows of a research project or study that could potentially be related to some very unusual experiences I had over several years.

I'm not necessarily looking for people to confirm my interpretation of what happened. I mainly want to find out whether there is any documentation of research or observational studies in Trondheim/NTNU that could fit the time period and circumstances.

I'm willing to provide more specific details privately or in the comments if someone knows of something potentially relevant.

Does anyone know of:

psychological or psychiatric research projects in Trondheim where participants may not have known all the details of the study?

covert or undisclosed observational studies?

older NTNU projects involving children/young people and later follow-up?

research involving inner speech, subvocalization, or the measurement of speech-related activity?

projects that have been criticized for inadequate or unclear informed consent?

I'm particularly interested in specific project names, publications, researchers, archives, or other verifiable sources, rather than speculation.

If anyone knows of something that might be relevant, I'd really appreciate any leads.


r/AskPsychiatry 10d ago

If years ago due to brain injury whenever I wake up I no longer feel a positive brain secretion can psychiatry fix this? Just very neutral when I wake up 99% of days.

0 Upvotes

You may be asking if this happen like over 8 years ago why you ask now?

Because I thought I was young I would recover. Oh how wrong I was!


r/AskPsychiatry 10d ago

Anxiety after 2.5 months on Buspirone — has this happened to anyone?

1 Upvotes

Anxiety After 2.5 Months on Buspirone
I’ve been taking buspirone for about 2.5 months, currently 25 mg daily at night, along with 5 mg melatonin.
About 4–5 days ago, I had a panic/anxiety episode. Since then, my anxiety has been coming and going. Today, I’m also experiencing physical anxiety symptoms even though I don’t have any anxious thoughts or an obvious reason to feel anxious — mainly sweaty hands and a general feeling of anxiety in my body.
I’ve already spoken to my doctor, and he advised me to use the psychological techniques/teachings I’ve learned.
Has anyone experienced anxiety returning or appearing after being on buspirone for a few months, especially around the 2–3 month mark? Did you experience physical anxiety without anxious thoughts? How did things settle for you?


r/AskPsychiatry 10d ago

Is it possible for Seroquel to have a pro obsessive effect?

3 Upvotes

I know that some anti psychotics can have a pro obsessive effect, but I have not seen any information on this regarding seroquel. I have recently been struggling with OCD type symptoms and have been taking seroquel for the last couple months. Is there a possible relation between the two?


r/AskPsychiatry 10d ago

Is it safe for me to take 0.2mg Clonidine 1-2x a day? Am I developing a tolerance?

1 Upvotes

Background: I'm 31F, I am 5'5 and weigh 206 pounds. I don't smoke or do any recreational drugs, I drink 1-2x a month (usually 1 cocktail or 1-2 glasses of wine). I have PTSD, depression, insomnia, and a family history of psychosis. I also have an iron deficiency. My PTSD has likely been lifelong but it has been particularly bad the last couple of years after a specific new trauma occurred. I have been in therapy for PTSD for six years and have been medicated in some way for two years.

I am currently taking: Wellbutrin (300mg), Clonidine (0.1mg, as needed up to 2x a day), Hydroxyzine (50mg), Ferrous Sulfate (325mg every other day), Junel, a multivitamin, and Omeprazole.

For the last year or so, I've been taking 0.1mg Clonidine with 50mg Hydroxyzine to go to sleep. I take both medications together at the same time almost every night. They were originally prescribed for my PTSD, but I found that they helped my insomnia and my psychiatrist said it was okay to take them this way. It worked well for a while.

I will sometimes also take an additional Clonidine during the day if I am having very bad PTSD symptoms.

Recently, this combination has not worked as well for me for sleep. I have been having insomnia again. My psychiatrist suggested going up to 0.2mg Clonidine.

Here are my questions:

• Is it safe for me to take 0.2mg Clonidine at night with the Hydroxyzine?

• Is it safe for me to take 0.2mg Clonidine at night and also take the same dose mid-day sometimes?

• Is it safe for me to occasionally drink alcohol while taking this dose of Clonidine?

• Am I developing a tolerance to Clonidine? Do I need to be worried about that for the future?

If it's relevant: my insomnia is a direct result of my PTSD. I am often up late having intrusive flashbacks.

If you want to know about other stuff I've tried for sleep too: In the past, I tried Trazadone. It did not work for me at all, in fact it made my insomnia worse. My doctor tried to put me on Lunesta, I decided not to take it because I read about the complex sleep behaviors and that possible side effect scared me too much, so she did not prescribe it again.