Sir my daughter is having 16 years and was affected from depression from 28 months back. We consulted doctors and started tab" nexito" at a dose of 5 mg and elevated upto 20 mg in due course. We reduced the dosage and finally came to a 5 mg at an interval of almost one week. By this time we she was almost 75% ok. After some time she again started problems and on consultation with another doctor it was told that the stoppage of medicine made the problem and he again started nexito. Up to 10 mg level she was comfortable. But doctor asked for elevating the dosage upto 20 mg. While at 15 mg itself she was finding very uncomfortable and at 20 mg it is very difficult to manage. She is having a weight of 62 kgs. We are having doubt regarding the optimum dosage. Whether we need a dosage of 20 mg or can we reduce the same. She restarted taking medicine regularly for last two months and dosage of 20 mg from last one week. Please give clarification regarding this. Child is also undergoing counselling sessions in an interval of one week.

Dr. Vikas PrabhavPsychiatrist9yrs exp

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Dear sir, the dose of nexito at 20 mg is considered within the safe dosage limit. The problems associated with dose increased normally last around a week to ten days till the body adjusts to it. She should feel better after that period. However if your daughter is finding it difficult to tolerate it, please talk to your psychiatrist about it. My wishes for a quick recovery, she will get better soon. 

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Dr. Saul PereiraPsychologist48yrs exp

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Once your child has reached optimum dose, she has to maintain it for some time depending on her doctor and symptoms. You should never monitor her medicine but leave it to the doctor always. Once the brain becomes used to the optimum, only then does the doctor get into the teaser dose to gently and gradually coax the brain to produce the lessened dose. Any amateur attempt to reduce or increase the dosage is fraught with danger and reactions. I also recommend that the counseling sessions increase to daily sessions for at least 21 days and then you could gradually wean her off the sessions. In the meantime please help her do the following sincerely because she could resolve the problem better with good cooperation: have a good night?s sleep, have a good breakfast of more proteins, meditate often, remain free of stress, eat a lot of fiber, nuts, avocado, exercise regularly, eat dark chocolate, do yoga meditation exercises, spend time in nature or gardening, etc. I suggest you do the opposite of what this depression makes you feel like doing (actually, not doing): you will need to fight this condition. You must become active; stay upright during the daylight time; meet people; never sleep during the day, wake up by 6 am every day, play some active games, especially contact games, do physical exercises, talk to people and join some social clubs, attend yoga classes etc. Watch sitcoms on tv or comedies and cheer yourself up. Go for excursions in groups, for outings, camps, conferences, and religious conventions. Get a pet dog and spend time training it, exercising it and relating to it. Expose yourself to some sunlight every day, at least, 30 minutes but not in the scorching heat. Whatever happens, please incorporate these three important adaptations in your life: always be responsible, be respectful, and be functional. If you did these three, lots of things will go well in life. Please pray and have faith in god to alleviate your sufferings. Don?t wait for others to help. Use your own motivation, which might be at its lowest, but persevere and win this battle. Above all to be really happy, you need to live in love and for love. Learn all about emotions and how to handle them and that will get you out of the depression rather easily and quickly. A counselor is there only to facilitate you, all the hard word must come from you, and your cooperation with that person is very critical for your success. Be positive every day and learn to be contented with what you have. Do some left brain exercises: it is the happy brain. Here are a few suggestions: shut your left nostril and breathe, move your eyes from right to left and vice versa for at least half a minute at a time, and do calisthenic exercises with some form of counting, regularly. Whatever happens please cooperate with the therapy and do not discontinue until the condition is completely resolved.  

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Dr. Sushil Kumar SompurPsychiatrist15yrs exp

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It is great to hear that your daughter is also going through counseling sessions for the therapy of her depression along with medications. I believe she is on appropriate medications and it can be augmented. If you believe she is able to tolerate only 10 mg of nexito and has residual symptoms another class or category of anti depressants can be used. However more information is needed as pointed out. We encourage you to use a private consultation to find out how you are able to manage your daughter's depression better. Look forward to hearing from you. If you need help with booking an appointment online with me on this website either text, an appointment for a confidential and private consultation you may do so by contacting the help desk of Lybrate.  

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