Your ECG and heart ultrasound are normal. At 21, chest pain that changes with upper body movement and is linked to heartburn and burping is highly unlikely to be angina. Instead, it points toward acid reflux or muscle strain, which anxiety can worsen. Your medications, including paroxetine (Paxidep), propranolol, and clonazepam, are helping manage your anxiety. Please discuss these symptoms with your doctor to explore reflux or musculoskeletal care. Gradually incorporating light activity and a balanced diet will also gently address your cholesterol.

Paxidep CR 25 (containing paroxetine) and Dejac T (containing dapoxetine and tadalafil) are highly effective at helping control and delay ejaculation. While they are excellent for managing premature ejaculation and associated involuntary leakage by regulating certain chemical signals in your body, they act as treatments rather than a permanent 'cure.' They work best alongside lifestyle adjustments and pelvic exercises. Since these are prescription medications, it is very important to use them exactly as directed by your doctor to ensure your safety and the best results.

Yes, your weight loss of 10 kg over eight months is highly likely a combined effect. Transitioning from paroxetine (Paxidep CR), which often causes weight retention, to desvenlafaxine (D-Veniz), which is much more weight-neutral, frequently leads to shedding those extra pounds. When you combine this medication switch with your positive dietary changes, it creates a powerful, healthy synergy. A gradual weight loss of about 1.2 kg per month is safe and wonderful for your overall health. Please share this positive update with your doctor at your next visit.

Difficulty sleeping can still occur in Major Depressive Disorder, especially early in treatment, because medicines like Paroxetine and Lithium may take 2-4 weeks (or longer) to show full benefit, and factors like anxiety, stress, irregular sleep habits, or medication timing can also affect sleep. Clonazepam can help short-term but may not always be enough or suitable long-term, so the best approach is to continue medicines as prescribed, maintain good sleep hygiene (fixed sleep time, avoiding screens/caffeine at night, relaxing bedtime routine), and follow up with your psychiatrist to review doses or adjust treatment if needed. They may modify timing, change medications, or add therapy like counselling (CBT), which is very effective; do not stop or change medicines on your own, as proper adjustment and patience usually lead to improvement.

ISince you are already taking paroxetine and propranolol, some helpful next steps might include adjusting the timing or dosage of your propranolol under your doctor's guidance, as a slightly different dose might offer better relief. Alternatively, exploring targeted cognitive behavioral therapy (CBT), specifically exposure therapy, can be incredibly effective when combined with your medication. Please discuss these options with your doctor to find a personalized adjustment that helps you feel more comfortable and confident.

It is very common to feel anxious about these concerns, but please be reassured they are highly treatable. Releasing semen quickly (premature ejaculation) and involuntary leakage are often managed with lifestyle changes, pelvic exercises, and medications. Paxidep CR 25 (containing paroxetine) and Dejac T (containing dapoxetine and tadalafil) are commonly prescribed to help delay ejaculation and improve control. However, they manage symptoms rather than provide a permanent 'cure.' Before starting, a doctor should perform a physical exam and basic tests (like urine tests) to rule out infections or hormonal issues. This ensures your treatment is safe and tailored to you.