Question: Dr. Bienenfeld, I would like to know which antidepressants/anxiety medications you believe most helpful to your patients. I am a 67-year-old college professor, and I love my job. My personal life has become stressful. My only sibling, (brother) died of pancreatic cancer last year, and now I'm the one dealing with our mother, who is in hospice care out of town, not in imminent danger of passing away. She has always had a difficult personality, and despite my very best efforts, she is highly critical and suspicious with me. Moreover my husband, a wonderful retired teacher, has some serious health problems, and he is exhausted most of the time. I want to be strong for him. I did suffer a clinical depression back in 1985, and in the 25+ years since then, things have been pretty stable.
I am on 50 mg. of Pristiq. I also take 30 mg. of temazepam at bedtime.
My other meds are: Lomotil (for colitis w/ diarrhea, long-standing) 1 tab 3 times a day
Atenolol (50 mg. once a day for migraine prevention) If I get a migraine, which is seldom, I take Relpax, 40 mg.
I take Simvastatin for lowering cholesterol
I take Elmiron (only for the last 5 months) to help prevent UTIs (& interstitial cystitis)
I'm feeling sad and anxious (much of it related to mother). Not sure which meds to keep or change, or ??? School starts in a month, and I need to be stabilized. My primary care doc is competent but very scared to prescribe meds related to my symptoms. What would you suggest?

Thank you. I have only been on Pristiq for 6 months. Before that I was on generic Lexapro, 20 milligrams a day. But I did some research and found that several SSRIs contribute to UrinaryTract infections, urinary urge and frequency. So I chose Pristiq.
One friend suggested Cymalta. My daughter is taking low=dose Prozac. She is an attorney. Another friend has benefitted from Zoloft, though I worry about a headache since I do have migraines, though not often.
What could I take to decrease the anxiety part of my symptoms (besides faith and exercise)?I think there may be some confusion. 25 years ago I was on Deseryl during clinical depression episode. I am on Pristiq now, but only for the past 6 months. Before that I was on Celexa for a few years and then generic Lexapro, 20 mg. But I started to have urinary tract infections, so I asked my neurologist if Icould try Pristiq.
I can continue and increase Pristiq (as you suggest) during this stressful time in my life, but should I consider Zoloft? Cymbalta?
Also, what would help with anxiety? You didn't mention that in your answer.

And how does one find out her genetic need for a certain anti-depressant?

Thank you so much for the clarification. Last questions: I took an 8-week course of Entocort for colitis, which I stopped 2 weeks ago. Also, I am still wondering if Elmiron (prescribed to prevent urinary tract problems) has an effect on emotional stability.

I'm so glad I asked you about Enterocort. How long after discontinuation of that drug would the effects wear off? It's been about 20 days.