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Suggest Treatment For Severe Anxiety And Depression
Question: I have no sense of emotions, either happy or sad. Nothing interests me. I have been dealing with depression for most of my life but have never had this feeling or lack of feeling. I am on several psychotic drugs but don't feel that they are the cause because I have switched medications many times and still have the same response. Life seems meaningless. I am not suicidal. I am under pschiatric care with the same doctor for the last 4 years. Which way do I turn?
Brief Answer:
I think there is need to look for vascular reasons
Detailed Answer:
Hello,
Thanks for using Healthcaremagic.
I read your query and understand your concerns.
From the available description it appears that you are dealing with apathy which is well known symptom (manifestation) of depression. The second most common cause for apathy is vascular reason which is often found among middle aged and older age adults.
I have suspicion of apathy due to vascular reasons due to following reasons
1. Recent onset of apathy while the depression was present for long time
2. Your age
3. failure to respond to standard antidepressants
4. Absence of other symptoms of depression
Regarding further action I recommend two things
First I think there is need for brain imaging (CT/MRI)
Second ask your doctor to consider prescription of modafinil. This is one which is quite helpful in apathy and we can hope that it will help you in overcoming these issues.
I hope this assists you.
If you have more questions I will be glad to assist you further.
If you do not have more questions, please close the discussion and if possible rate the answer for my future patients.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.
I think there is need to look for vascular reasons
Detailed Answer:
Hello,
Thanks for using Healthcaremagic.
I read your query and understand your concerns.
From the available description it appears that you are dealing with apathy which is well known symptom (manifestation) of depression. The second most common cause for apathy is vascular reason which is often found among middle aged and older age adults.
I have suspicion of apathy due to vascular reasons due to following reasons
1. Recent onset of apathy while the depression was present for long time
2. Your age
3. failure to respond to standard antidepressants
4. Absence of other symptoms of depression
Regarding further action I recommend two things
First I think there is need for brain imaging (CT/MRI)
Second ask your doctor to consider prescription of modafinil. This is one which is quite helpful in apathy and we can hope that it will help you in overcoming these issues.
I hope this assists you.
If you have more questions I will be glad to assist you further.
If you do not have more questions, please close the discussion and if possible rate the answer for my future patients.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I had brain imaging done in the past and no problems were found. I was tested about a year ago and about 3 years ago. It sounds like the only solution is medication which has yet to be tried. Should I try getting off of some of the medication I am on?
Brief Answer:
What are the current medications you are taking
Detailed Answer:
Hello,
Thanks for reverting back to me.
I am glad to know that brain imaging studies were fine and there is no evidence in favor of vascular aetiology.
Now regarding the next step of action I feel using medication for apathy will be the better option. The medications include Modafinil and Armodafinil.
I am not sure what medication you are currently taking so it will be wrong to state anything without knowing medications. As you've sated the medications are unlikely cause for your above said symptoms but still I like to review your medication whether any of them contributes to apathy symptoms.
I'd request you to post the medication details.
Thanks again.
What are the current medications you are taking
Detailed Answer:
Hello,
Thanks for reverting back to me.
I am glad to know that brain imaging studies were fine and there is no evidence in favor of vascular aetiology.
Now regarding the next step of action I feel using medication for apathy will be the better option. The medications include Modafinil and Armodafinil.
I am not sure what medication you are currently taking so it will be wrong to state anything without knowing medications. As you've sated the medications are unlikely cause for your above said symptoms but still I like to review your medication whether any of them contributes to apathy symptoms.
I'd request you to post the medication details.
Thanks again.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
prescriptions currently taking:
1 20 mg Simvastatin
1 .4 mg Tamsulosin
2 100 mg zoloft
25 mg Diazepam
2-3 Quetiapine
1 2 mg tablet Rexulti
1 30 mg tablet Buspar
I feel like I am on too much stuff and it is not helping me.
1 20 mg Simvastatin
1 .4 mg Tamsulosin
2 100 mg zoloft
25 mg Diazepam
2-3 Quetiapine
1 2 mg tablet Rexulti
1 30 mg tablet Buspar
I feel like I am on too much stuff and it is not helping me.
Brief Answer:
I think Diazepam can be reduced
Detailed Answer:
Hello,
Thanks again.
I do not see any irrational medication as per available history when it comes to antidepressants and antipsychotics. It seems that your psychiatrist have taken a very calculated decision before making a prescription.
Having said that, I feel Diazepam can be reduced if possible as there is little role of benzodiazepines in current situation except sleep.
I'd request you to discuss two things with your psychiatrist on next appointment -
1. Reduction of the dose of Diazepam
2. Add on Modafinil.
I hope this answers you.
If you have more questions I will be glad to assist you further.
If you do not have more questions, please close the discussion and if possible rate the answer for my future patients.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.
I think Diazepam can be reduced
Detailed Answer:
Hello,
Thanks again.
I do not see any irrational medication as per available history when it comes to antidepressants and antipsychotics. It seems that your psychiatrist have taken a very calculated decision before making a prescription.
Having said that, I feel Diazepam can be reduced if possible as there is little role of benzodiazepines in current situation except sleep.
I'd request you to discuss two things with your psychiatrist on next appointment -
1. Reduction of the dose of Diazepam
2. Add on Modafinil.
I hope this answers you.
If you have more questions I will be glad to assist you further.
If you do not have more questions, please close the discussion and if possible rate the answer for my future patients.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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