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Suggest Treatment For Severe Depression
Question: Respected docter
I am sufering from major depression . I was taking 18 to 20 tablets of alprax per day in divided doses for the past 2 yrs. I was hospitalised on 1st september and after detoxification and oral medication was discharge on 22 sep. 2014. The medicine prescribed after discharged was arpizol 10 mg at night, ciplar 40 mg twice a day, toficalm 100 mg twice a day, quetipine 100 mg at night now I am feeling very very hypo,slowed movements difficulty in speaking with others social phobia difficulty in waking up and getting ready for the day. Please suggest me best medicine treat my depression and symptoms
I am sufering from major depression . I was taking 18 to 20 tablets of alprax per day in divided doses for the past 2 yrs. I was hospitalised on 1st september and after detoxification and oral medication was discharge on 22 sep. 2014. The medicine prescribed after discharged was arpizol 10 mg at night, ciplar 40 mg twice a day, toficalm 100 mg twice a day, quetipine 100 mg at night now I am feeling very very hypo,slowed movements difficulty in speaking with others social phobia difficulty in waking up and getting ready for the day. Please suggest me best medicine treat my depression and symptoms
Brief Answer:
Desvenlafaxine or escitalopram with etizolam
Detailed Answer:
Hello,
Thanks for writing to us again.
You are taking arpizol(an antipsychotic medicine useful for depression), quetipine (an antipsychotic medicine useful for depression), ciplar(anti anxiety), toficalm(anti anxiety). So among these no one is specific antidepressant medicine. You mentioned paxidep in column but not in your question. If you are taking it, it is an specific antidepressant from SSRI group.
In my opinion if you are taking paxidep up to 25 mg and still no improvement, medicines from other than SSRI should be added. Options are Bupropion(buron xl), desvenlafexine(d-veniz) or imipramine(depsonil).
For choosing the medicines, your detailed history of depressive symptoms, your physical check up, past history of medicines taken and discussion about all options I narrated are required. You can ask about these alternatives to your treating doctor.
If I were your treating doctor I will start with desvenlafexine 50 mg probably.
If no SSRI/paxidep is taken, I would like to start with escitaloparm(nexito) 10mg in your case.
Simultaneous psychotherapy/behaviour therapy also can help.
If you are ok with toficalm I would suggest continue. If not I would like to replace it with etizolam(etirest)0.5 mg in morning and noon for initial symptomatic relief.
Please discuss regarding these with your psychiatrist.
Hope I have answered your query. I will be happy to answer further question.
regards,
Dr.Chintan Solanki.
Desvenlafaxine or escitalopram with etizolam
Detailed Answer:
Hello,
Thanks for writing to us again.
You are taking arpizol(an antipsychotic medicine useful for depression), quetipine (an antipsychotic medicine useful for depression), ciplar(anti anxiety), toficalm(anti anxiety). So among these no one is specific antidepressant medicine. You mentioned paxidep in column but not in your question. If you are taking it, it is an specific antidepressant from SSRI group.
In my opinion if you are taking paxidep up to 25 mg and still no improvement, medicines from other than SSRI should be added. Options are Bupropion(buron xl), desvenlafexine(d-veniz) or imipramine(depsonil).
For choosing the medicines, your detailed history of depressive symptoms, your physical check up, past history of medicines taken and discussion about all options I narrated are required. You can ask about these alternatives to your treating doctor.
If I were your treating doctor I will start with desvenlafexine 50 mg probably.
If no SSRI/paxidep is taken, I would like to start with escitaloparm(nexito) 10mg in your case.
Simultaneous psychotherapy/behaviour therapy also can help.
If you are ok with toficalm I would suggest continue. If not I would like to replace it with etizolam(etirest)0.5 mg in morning and noon for initial symptomatic relief.
Please discuss regarding these with your psychiatrist.
Hope I have answered your query. I will be happy to answer further question.
regards,
Dr.Chintan Solanki.
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Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Answered by
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