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On citalopram, mirtazapine and clonazepam for depression. Still very depressed. Suggest?

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hi I am on citalopram3 times daily 20mg each mirtazapine45 mg 1 time a day andclonazepam 4 times a day .5 each for depression could that be too much as I still am very depressed most of time and have been on this medication for over 5 yrs
Posted Sun, 18 Aug 2013 in Depression
Answered by Dr. Nehal Shah 2 hours later
Hi,Thanks for using healthcare magic.

I have gone through your history.
Citalopram and mirtaazepine are good, potent antdepressant agents with usual dose range is 20-80 mg and 15-45 mg respectively.
Clonazepam is good anti anxiety drug with dose range of 0.5mg to 4mg per day.
You do not have improvement still, the reasons might be one of following.

1. Presence of other psychiatric illness like bipolar mood disorder, obsessions etc,

2. Use of substances like nicotine, alcohol if any
3. Presence of lonstading, continuous stresser
4. Physical illness like thyroid dysfunction, depression.

You should consult your psychiatrist to find out the cause of non improvement. Treatment would be directed as per cause.

You may get benefit by psychotherapy, stress management, yoga, meditation and breathing exercise.

I hope i have addressed your concern.

Feel free to revert to me in case if you have further query.
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