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    Second Opinion Clinic

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    Why should anyone seek a second opinion in Psychiatric diagnosis?

    Psychiatric illnesses tend to be long, chronic illness, with multiple acute episodes of increased symptoms.

    many relatives/patients frequently complain of:
    No additional improvement or recovery while being on medication. दवा पर रहने के दौरान कोई अतिरिक्त सुधार नहीं। દવા કરતી વખતે કોઈ વધારાનો સુધારો નથી.
    Control of symptom/s being inadequate लक्षण का नियंत्रण अपर्याप्त होना। લક્ષણનું નિયંત્રણ અપૂરતું છે.
    Multiple medications and their related side effects. एकाधिक दवाएं और उनके संबंधित दुष्प्रभाव। બહુવિધ દવાઓ અને તેનાથી સંબંધિત આડઅસરો.
    Significant increase in the cost of medications. दवाओं की लागत में उल्लेखनीय वृद्धि। દવાઓની કિંમતમાં નોંધપાત્ર વધારો.
    Till how long should we take medications हमें कब तक दवाएं लेनी चाहिए। આપણે દવાઓ ક્યાં સુધી લેવી જોઈએ.
    Improvement is dependent on the continuation of medications. Gains wear off on discontinuation of the medications. सुधार दवाओं की निरंतरता पर निर्भर है। सुधार दवाओं के बंद होने पर रुकते हैं। સુધારણા દવાઓ ચાલુ રાખવા પર આધારિત છે. દવાઓ બંધ કરવા પર લાભ થંભી જાય છે.
    Patient not being able to resume daily activities or being inactive. रोगी दैनिक गतिविधियों को फिर से शुरू नहीं कर पा रहा है। દર્દી દૈનિક પ્રવૃત્તિઓ ફરી શરૂ કરી શકતા નથી.
    This is known as a State Of No Change, also known as “Plateau”.
    Plateau states can occur due to a lot of reasons:
    • Frequent stopping of medications.
    • Insufficient medication dose
    • “TREATMENT RESISTANT ILLNESS”
    • Multiple side effects.
    • Expensive medications

    UNDERSTANDING YOUR ILLNESS

    “Plateau” means a state of balance/stasis.

     

    When there is no change in the symptoms, even on increasing the dose of medications, it is known as a “Plateau State”.

    Residual symptoms can remain in such patients, leading to a poor quality of life.

    E.g. 1.

    Patients with Severe Depression, reports sadness of mood, loss of energy and happiness, irritability, sleep and diet disturbances, suicidal thoughts and behaviors.

    Not all the above-mentioned symptoms respond equally to treatment. Even with adequate treatment, some symptoms might persist.

    Such patients are either known as “Treatment Resistant” with a plateaued response to medications.

    E.g. 2.

    Schizophrenia patients tend to hear multiple “VOICES” as a part of their illness.

    Most of these patients respond to these voices by talking back to them. Medications can significantly reduce the severity of these voices and can help the patient live a near normal life.

    However, around 25% of patients, fail to respond to medications and continue to hear voices, at variable intensity.

    Such patients are known ss “Treatment Resistant” and this phenomenon is known as “Plateau Response”

    This leads to severe impairment and poor quality of life.

    In such cases, there are only two options left:

    • A).

      Increase the dose of medications or the number of medications:

      This can reduce the symptoms, but can also increase the side effect burden, as these medications have to be taken for extended periods of time (Possibly life-long in such cases)

    • B).

      Introduce neurostimulation measures:

      which can significantly reduce the burden of illness, without any additional side effect burden, and without the need for life long sessions.

    UNDERSTANDING THE TREATMENT OPTIONS

    PYRAMID OF EFFECTIVENESS:

    In any field of medicine, including Psychiatry, there are multiple treatment options. These treatment options can be ranked on the basis of their effectiveness and their side-effect profile.

    Which Form of Neurostimulation is better for me?

    The answer to this is specific to every individual.
    There are multiple factors involved in making a decision of which technique of neurostimulation to be applied:

    • Age
    • Duration of illness
    • Symptom Profile
    • Target symptoms
    • Response to medication
    • Other physical illness and medications
    • In some cases, for e.g. suicidality, brief pulse therapy (ECT) is the only option available,
      hence no other form of neurostimulation is offered.

    GET A SECOND OPINION

    The most common feedbacks that we received in our out-patient services was that:

    • “We were unaware about our illness”
    • “No one talked about these treatment options to us”
    • “Can these treatments be done without admissions?”
    • “We always thought that ECT was “SHOCK” treatment”
    • “Is there any way to reduce medications”

    Given this experience, we thought of setting up a second opinion clinic.

    Our aim of creating a dedicated service to help patients who have been suffering from mental illness since a long time was:

    • To help you first understand your illness better.
    • To educate you about the new advances made in the field of Psychiatry, globally
    • To discuss your illness specific issues and help you make a decision on the further course of action.
    • To provide the highest quality of neurostimulation services available anywhere on the planet, at an affordable price.

    We encourage all patients and their care givers, suffering from mental illnesses since a long time, to understand their illness and take more informed decisions about their own health.

    We are always happy to help you.