My sister was first diagnosed with somatic disorder and doctor had prescribed flutop la 90 mg, olzapine 2.5 mg and diva od 500 mg one each per day but even after being fine for almost 6 months she got panic attack once on 2021 jan and after that the divaa od 500 mg was given twice a day for 15 days. From 25th february till july 10 2021 she was again normal but suddenly she has her episode back. She is still on medication one each everyday, what should we do now? My concern is the fluoxetine delayed release tablet 90 mg once a day is safe or not. Or we need to reduce the doses.

Dr. Prof. Jagadeesan M.S.Psychiatrist17yrs exp

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There are better medication combinations which can tried. The above one is also fine if it works well and doesn't cause weight gain. You need to consult a psychiatrist online or on person with further details to decide the course of action. Fluoxetine 90 mg if tolerable and efficacious can be used. Good luck.  

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Dr. Saranya DevanathanPsychiatrist50yrs exp

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Dear lybrate-user, nice to know your concerns for your sister. Please ask her to talk to the doctor about her diagnosis and then prognosis. It may not be somatic disorder or panic disorder. It might be a recurrent depressive disorder or bipolar depression where somatic and panic symptoms occur. She needs to be on long term treatment to prevent future episodes. Since she has frequent episodes, she needs to be on divaa od for many years. The dose, the effect, side effect, etc will be assessed periodically by your doctor. You need to take her to psychiatrist, even when normal. Fluoxetine 90 mg reduces her burden of taking the tablet daily. The side effect will be the same as flutop 20 mg. Is she married? If not are you planning to get her married? Please discuss these issues also with your psychiatrist. All these medicines need a planned pregnancy - not stopping medicines.  

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Dr. P K SukumaranPsychiatrist56yrs exp

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Please continue all these + diva 500 mg 1 0 1 exercise one hour per day your can stabilize their moods with proper treatment, medication, and support. Your patience, love, and understanding can play a significant part in your loved one?s treatment and recovery. Often, just having someone to talk to can make all the difference to their outlook and motivation.  

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