Hello doctor, I am 28 years old with height 5'8", weight 120 kg, and married. I have been suffering from anxiety and depression for the past 12 years. One day I was driving to college and suddenly got a panic attack all of a sudden for the first time. I was really scared and thought I would die. I thought there was something wrong with my brain, so I had thousands of tests and then brain MRI. All was perfect. During that time, I weighed 80 kg. I was so scared that I was totally on the bed for two years. I gained 40 kg in a year by eating all day. I was scared, fearful, and depressed. I tried lots of medicines, but nothing helped. Then a GP suggested me Cipralex and Xanax 1 mg twice a day. Things started getting a little better. Then I decided to lose weight. I lost 55 kg in two years. At that time I was almost 20 years old. I left the university because I was not able to focus. My father is an industrialist, so I joined him and worked very well for three years. When I was 23 years, I was better enough to make friends. I used to hangout and started taking alcohol weekly. I started enjoying alcohol, and the effects of Cipralex were going away with time. After a year or so, I went into depression mode again. Then I consulted a pschiatrist and he put me on Wellbutrin XL 300 mg, Seroxat CR 25 mg, Xanan 1 mg thrice a day and Rivotril thrice a day. After a few weeks the honeymoon period of Wellbutrin kicked in and the life changed. I was focused and powerful. I just did whatever I wanted to. I started earning money. I mean my dad was happy from my work so he used to give me enough to enjoy life. I became an alcoholic. I got married two years back and have a son now. I used to drink all day long even in the breakfast. I build so much tolerance that I would drink two bottles of vodka every day and night, and 15 cans of beer in a day. My weight has again gone back to 120 kg. By the time I increased my Wellbutrin dosage to 600 mg per day on my own to get that honeymoon effect back, but nothing changed. It is now all where it started, lying on my bed, panicked, fearful and depressed for the past 10 days. I left alcohol 10 days back cold turkey. I had an LFT test and the GGT was around 700. I just do not want to die of liver cirrhosis. I also had a CBC test and it was 99 percent normal as well. Hepititus B and C are negative. I had an ultrasound abdomen four months back and at that time, all of the organs were fine except a little fatty liver. Now all I want is to restart my life. I just want that Wellbutrin feeling back. I have build tolerance to Wellbutrin, so it does not work anymore. I just want to restart life. I want to enjoy with my wife and son. I want to go to work the same way I used to when I lost weight. You can understand well. I have increased the dosage of Benzodiazepene all by myself to cope with withdrawl symtoms of alcohol. Currently I am on Wellbutrin Xl 600mg, Seroxat CR 25 mg, Xanan 1 mg four to five times, and Rivotril 0.5 mg four to five times.
Hi. I have gone through your problem and understand your concern. The doses of Wellbutrin (Bupropion) are towards higher side and dose of Seroxat CR (Paroxetine) is towards lower side, while benzodiazepine is also towards higher side, but it can be gradually tapered to lower side. Once the alcohol withdrawal symptoms decrease, you can lower the benzodiazepine doses. Usually I recommend to my client Seroxat CR 50 mg to manage the symptoms of depression. I would suggest to stop alcohol and continue the same medicine. Of course, increase the dose of Seroxat. Regular exercise is very important, and management of alcoholic liver disease has to be considered. Thiamine in doses of 100 mg three times a day and if required Metadoxine can be used. All these are prescription-only drugs, so you need a prescription for the same. For more information consult a psychiatrist online -->