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Asking for second opinion
Hi dear doctors, I have been on medicine for more than a year. I am a type 1 diabetic for 12 years. My weight has also increased to 100kgs. My medicines are Mirtaz 7.5, Nexito 20, Lamitor od 100, Sizodon LS (risperidone) And Oxetol 150. I feel that I am having alot of medicines that is why asking for a second opinion. The psychiatrist described MAD but I feel they have given medicines on the basis of symptoms and they don't know what exactly I am facing. Even after taking mirtaz at 8:30 pm, I wake up at night and my sleep is in pieces (this has happened 2 times), My memory is also deteriorating. When I wake up at night even after taking medicines, I take extra mirtazapine and Lorazepam. I feel Please advice.
Answers (8)
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I want to acknowledge how much courage it takes to voice these struggles. Often, we treat mental health as a matter of 'willpower,' but as a psychiatrist, I can tell you that what you are experiencing has a real biological and neurological basis.
Your brain, like any other organ, can sometimes struggle to maintain balance under stress. Seeking treatment isn't a sign of failure; it’s a proactive medical decision to regain your quality of life. We can work together to understand the 'why' behind these feelings and find a structured path back to your baseline. You don't have to navigate this alone.
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Hey, i understand too many medications, make the patient feel tired of taking them, we will be needing the full history of the patient, so that medications can be optimised to the minimum number
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Medications must be reviewed along with medications for physical illness
On the basis of present symptoms medications must be optimised
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"Hi there, I understand that seeking help can feel overwhelming, but you’ve already taken the first brave step. I can guide you with a clear treatment plan tailored just for you, so you can feel better and regain control over your life. You can reach me directly on WhatsApp for quick support on seven zero eight two zero two two zero six two."
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Hi.. will need further history regarding the same to advise appropriately. Consult online for treatment
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Please consult.
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Dr. Seujee Goswami
Psychiatrist
13 yrs exp
Bangalore
Hello,
It is understandable to seek a second opinion when you feel unsure about your treatment, especially when multiple medications are involved.
You are currently on a combination of antidepressant, mood stabilizer, antipsychotic, and sleep-related medications. Sometimes such combinations are used when symptoms are complex, but concerns like weight gain, sleep fragmentation, memory issues, and diabetes management definitely deserve careful review.
Waking at night and taking extra doses of mirtazapine or lorazepam without medical guidance is not advisable, as this can affect memory, sleep architecture, and overall stability.
Given your history of Type 1 diabetes and significant weight gain, it would be important to review:
• Whether all current medications are still necessary
• Possible metabolic side effects
• Whether sleep disturbance is medication-related or illness-related
• Whether the diagnosis and treatment plan need reassessment
A structured re-evaluation by a psychiatrist (preferably with complete past records) would help clarify the long-term plan.
Next Steps
• Do not increase or add doses on your own.
• Book a comprehensive review appointment with a psychiatrist and carry all previous prescriptions and reports.
• Request a clear explanation of diagnosis, treatment goals, and duration of each medication.
Health Tips
• Polypharmacy sometimes becomes necessary, but periodic medication rationalization is important.
• Diabetes and psychiatric medications require coordinated monitoring of weight, sugars, and metabolic parameters.
• Memory concerns should always be evaluated rather than ignored.
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Dr. Indraja Sharma
Psychiatrist
7 yrs exp
Kota
You are on multiple psychotropics (Escitalopram, Mirtazapine, Lamotrigine, Risperidone, Oxcarbazepine) along with diabetes — this definitely needs a structured review.
Key concerns:
• Polypharmacy
• Weight gain (likely risperidone + mirtazapine contributing)
• Memory issues (can be due to risperidone, benzodiazepines, poor sleep)
• Fragmented sleep
• Self-adjusting doses (extra mirtazapine + lorazepam) – not advisable
What to do:
1. Full diagnostic reassessment (Is it MAD alone? Bipolar spectrum? Anxiety?)
2. Rationalize medications — reduce unnecessary overlap.
3. Avoid taking extra doses at night.
4. Review diabetes control (high sugars can worsen sleep & cognition).
5. Consider CBT for insomnia instead of increasing sedatives.
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