instruction: hello doctor for someone suffering from anxiety ocd intrusive thoughts this person was on my of cipralex for quite a few years then about months began a change of medicines about 7 in this time finally this person was given 25 my fluvoxamine first days everything was fine then anxiety attacks started as of last night dose went up to 50 my result is the person is feeling calmer however they feel very disconnected and cannot do anything cannot concentrate cannot think or analyse things I forgot to say that when they started fuvloxamine they stopped the drops of cipralex we do not know what to do tonight whether to stop this fluvoxamine and go back to cipralex or whether to keep going and maybe these side effects will stop if so how long aproximately we are very confused and cannot get hold of the psychiatrist that prescribed this please if some doctor there is an expert on these meds and there side effects that could help us a lot of these medicines and maybe all give strange and serious side effects that are not listed by the pharma companies
output: hello I can understand your concern as you have mentioned that the patient is feeling better with this medication I would suggest you to continue 50 my fluvoxamine for atleast another to days and see if they feel okay fluvoxamine has a sedative effect and that is why the patient is feeling all these symptoms of not being able to concentrate or do anything etc I would suggest you to take the medicine before sleeping 50 my is actually a low dose so you should not be worried continue same dose for a few days and see if body adjusts sometimes if anxiety is under control with fluvoxamine some medicine can be added to prevent the side effects secondly you have not mentioned details of the patients age etc I would suggest you that if possible patient should start therapy as well medications and therapy when combined give faster results take care of yourself