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.

You should consult your doctor or psychiatrist to review your treatment, as your current medications are not improving your depression. Do not stop or change them on your own. Your doctor may adjust your dose, change your medication, or recommend adding psychological therapies, such as cognitive behavioural therapy, to help manage your symptoms and improve your quality of life.

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.

Sometimes, doctors recommend increasing the dose to 37.5 mg to ensure you reach a fully therapeutic level that prevents symptoms from returning and provides long-term stability for both your anxiety and irritable bowel syndrome. While you are feeling good now, a slightly higher dose can sometimes offer more complete, lasting relief. However, your comfort is very important. I highly recommend discussing your positive progress and any concerns about side effects with your doctor before making any changes.

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.

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.