Your brain MRI was normal. The upper body swaying and pulsing feelings can sometimes stem from inner ear (vestibular) issues, neck muscle tension, or heightened autonomic sensitivity. Since escitalopram (Nexito), piracetam (Cognitam), and vitamins haven't fully resolved this, your next best step is to consult an otoneurologist (an ENT specializing in balance) or a cardiologist for a thorough blood pressure and heart rate evaluation. Gentle vestibular rehabilitation therapy may also help.

Your current regimen includes Nexito (escitalopram), Toficalm (tofisopam), and Lonazep (clonazepam) as needed. Since you are still experiencing constant worry, your current doses may need adjustment, or we may need to explore therapy options like Cognitive Behavioral Therapy (CBT), which is highly effective for health anxiety. Please do not alter your doses on your own. I strongly recommend scheduling a follow-up with your psychiatrist so they can safely tailor your treatment plan to help you find better relief.

Regarding your medications, escitalopram and clonazepam can be helpful for anxiety, but they require careful management in your situation. For bipolar depression, escitalopram must typically be paired with a mood stabilizer to prevent triggering manic episodes. Additionally, because you recently discontinued substance use, clonazepam?which can be habit-forming?should be used with close medical supervision. I highly recommend discussing these details with your psychiatrist to tailor a safe, supportive plan that protects your recovery and effectively manages your symptoms.

You are currently taking Nexito 5 (escitalopram), which is a starting dose. It can take a few weeks to become fully effective, and sometimes an adjustment is needed to better control these anxiety-related symptoms. Please do not change your dose on your own. I highly recommend discussing these experiences with your prescribing doctor. They can safely evaluate your progress, reassure you about these physical sensations, and adjust your treatment plan to help you feel much better.

Since escitalopram (Nexito) and the Ayurvedic syrup Supragy didn?t provide full relief, it simply means this specific approach wasn't the right fit for your body. Everyone's brain chemistry is unique. Finding the right treatment?whether it's a different class of medication, psychotherapy, or a combination?can take time. Please consult a psychiatrist to safely explore these alternative options.

I strongly advise against self-initiating lamotrigine. Lamotrigine requires a very gradual, carefully supervised dose increase to prevent rare but serious skin reactions. While you are currently taking escitalopram (Nexito) and clonazepam (Clonotril), your body is also still adjusting to stopping your previous substances. Safely introducing any new medication requires a doctor's evaluation. Please reach out to your prescribing doctor or psychiatrist; they can safely guide you on whether lamotrigine is right for you and how to start it safely.