Thanks for the follow-up question.
I have gone through the new medicines that you have mentioned. Its unfortunate that you failed to discuss about the sexual issues. You could have asked your doctor to give you some separate time to discuas certain things confidentially.
Anyways, you are still on sertraline and this can keep your sexual problems ongoing. Desvenlafaxine if available could be a better antidepressant as it has no sexual side effects. Further pramipexole which I had discussed with you previously is a good option and should be seriously considered. It will help your amotivation and also help with your problems with sexual desire and sexual function. For my patients i start them on 0.125mg twice a day and then increase it to 0.25 mg thrice a day. I would sincerely request you to discuss this medication with your psychiatrist.
Dr. Srikanth Reddy MD
Patient replied :
I know you would be upset with me but i have started taking the medication pramipex .I took the medicine .125mg for twice a day for two weeks.It was out of my sheer desperation that i had to take the medicine as my next appointment with my doctor is after a month....I have noticed positive changes in my sexual health......the only concern that now remains prominent is lethargy....istill feel a lot of letahrgy while i wake up...i wish to do exercise to remain fit for which i would request if could get certain nutritional supplement....which gives me energy to workout....my weight currently is 125 kgs...and that is also bothering me ......doctor please do not get irate...as you have helped me and i would keep you posted with anything and everything that is new in my life releated to my disease or persona; life.....when should i increase the dose of pramipex ....????
Normally the next step should be to increase the dosage to 0.25mg twice a day. This will take care of the a motivation and reduced energy as well. Other way of controlling the problem of reduced energy is by taking Tab. Modafinil 100mg in the morning.
However let me make it clear that we are not supposed to prescribe you any medicines and the medicines that you are taking are not over the counter medicines and you should take them only after discussing with your primary treating psychiatrist.
Patient replied :
i consulted my doctor ..he refused taking pramipex...
my current dosage...
adesam 100 mg arip 20 mg pacitane 20 mg morning
quitipin 400 mg serta 50 mg and arip 20 mg at night...
please suggest what to do...as my current weight is increasing and my sexual problem recurs every time i feel im fit.....my sleep is increasing with every passing day and i feel low energy every morning i wake up...i tried discussing these symptoms with my doc but he feels these are lesser value but according to me they are a hindrance in my life...
pls suggets me a medicine to take....
Kindly note this consult is almost over 6 months old now and hence will be closed by the system.
We keep our consults open not more than a month or till 2 follow ups are over, whichever is earlier.
Kindly initiate a new consult to consult the same specialist.