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Suggest medication for depression

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Posted on Wed, 25 Nov 2015
Question: Thank you for answering my previous questions.
What is the antidepressant you prescribe? I am wondering if Cymbalta is right for me at this time. Previously I had been on Effexor for approximately 8-9 years.
Thank you
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Answered by Dr. Alexander H. Sheppe (1 hour later)
Brief Answer:
Consultation

Detailed Answer:
Thank you very much for reaching out and using my direct service. I now consider you my private patient, and will do everything in my power to help you!

You're most welcome regarding answering your previous questions. I feel like I have a good grasp on the basics of your situation, and hope to come to understand your story even better.

Antidepressants can require a lot of finesse. There are more than 15 to choose from. I always take a careful look at the particular type of depression from which the person is suffering, as well as the side effect profile of each antidepressant, and choose one that fits the person best.

It sounds like Effexor was useful for you for many years. Effexor belongs to the SNRI class of antidepressants. These are also used to treat chronic pain, and are thought to be a bit more "activating" than other antidepressants, meaning they are good for use in people for whom fatigue is a significant symptom. Cymbalta is the other main SNRI antidepressant. It actually makes good sense for you to try Cymbalta, because of your previous good response to Effexor -- often antidepressants in the same class are of similar efficacy for people, so if Effexor worked before, Cymbalta may work now. When I think through the many antidepressant options, I don't believe there is a more obvious or obviously superior choice of antidepressant for you. I think Cymbalta is your best bet.

This can be frustrating, because it can take up to 8 weeks for antidepressants to work. This is a long wait to see effects. Another option to consider is ECT, or electroconvulsive therapy. This involves being placed under general anesthesia and being delivered an electric impulse that induces a brief seizure. You repeat this process around 8-10 times over a few weeks. This is the most effective treatment we have in psychiatry, with over 90% success in treating depression, with no long-term side effects, and it works quickly, within a few weeks. This is a more dramatic measure, but it is an option especially for older people if your depression is becoming insufferable.

For now, I recommend sticking with the Cymbalta. Give it some time to work. I do think it's the appropriate choice for you.

Dr. Sheppe
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2238 Questions

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Suggest medication for depression

Brief Answer: Consultation Detailed Answer: Thank you very much for reaching out and using my direct service. I now consider you my private patient, and will do everything in my power to help you! You're most welcome regarding answering your previous questions. I feel like I have a good grasp on the basics of your situation, and hope to come to understand your story even better. Antidepressants can require a lot of finesse. There are more than 15 to choose from. I always take a careful look at the particular type of depression from which the person is suffering, as well as the side effect profile of each antidepressant, and choose one that fits the person best. It sounds like Effexor was useful for you for many years. Effexor belongs to the SNRI class of antidepressants. These are also used to treat chronic pain, and are thought to be a bit more "activating" than other antidepressants, meaning they are good for use in people for whom fatigue is a significant symptom. Cymbalta is the other main SNRI antidepressant. It actually makes good sense for you to try Cymbalta, because of your previous good response to Effexor -- often antidepressants in the same class are of similar efficacy for people, so if Effexor worked before, Cymbalta may work now. When I think through the many antidepressant options, I don't believe there is a more obvious or obviously superior choice of antidepressant for you. I think Cymbalta is your best bet. This can be frustrating, because it can take up to 8 weeks for antidepressants to work. This is a long wait to see effects. Another option to consider is ECT, or electroconvulsive therapy. This involves being placed under general anesthesia and being delivered an electric impulse that induces a brief seizure. You repeat this process around 8-10 times over a few weeks. This is the most effective treatment we have in psychiatry, with over 90% success in treating depression, with no long-term side effects, and it works quickly, within a few weeks. This is a more dramatic measure, but it is an option especially for older people if your depression is becoming insufferable. For now, I recommend sticking with the Cymbalta. Give it some time to work. I do think it's the appropriate choice for you. Dr. Sheppe