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Suggest Right Medication For Depression And Benign Tremors
Question: I need help with finding right fix in an antidepressant. I have been pretty stable on Zoloft 200mg for the past 15 years. I have been told that I have a chemical problem in my brain because I don't have life troubles that lead to depression. After taking primidone prescribed by a neurologist for a benign tremor I immediately became depressed. It is really really bad. They changed me to gabapentil with no improvement. I am off both of those now, but prior to that my GP put me on Wellbutrin. Not really any better.
I have seen a licensed therapist who also indicated that my lifestyle and life situation is stable, so talk therapy doesn't work.
Could the medicines I described above change the way my brain works and I need to go off everything but Zoloft. Is there any hope that my brain will stabilize.
I have seen a licensed therapist who also indicated that my lifestyle and life situation is stable, so talk therapy doesn't work.
Could the medicines I described above change the way my brain works and I need to go off everything but Zoloft. Is there any hope that my brain will stabilize.
Brief Answer:
Yes there is hope of being stable
Detailed Answer:
Hello,
Thanks for using Healthcaremagic.
I read your query and understand your concerns.
As you might be knowing that Primidone is enzyme inducer which clears many of the drugs relatively early including Zoloft. It is possible that with use of Primidone level of zoloft fell below required level and that probably caused the recurrence of depression.
I do not feel changing antidepressant is ideal thing. In my view if you have less than two weeks after discontinuation of primidone wait for few more days.
In case two weeks already crossed after discontinuation of Primidone I will suggest you to go for Effexor which can be started from 37.5 mg and can be increased to 225 mg according to response pattern.
Unfortunately these kinds of disturbances are idisyncratic reactions and can not be predicted precisely. They generally stabilizes in few weeks and in my view there is nothing to worry about stability of mind. They do not cause any permanent change and with achievement of same level of zoloft things are likely to improve.
I hope this helps you.
If you have more questions feel free to write back to me.
Thanks and regards
Yes there is hope of being stable
Detailed Answer:
Hello,
Thanks for using Healthcaremagic.
I read your query and understand your concerns.
As you might be knowing that Primidone is enzyme inducer which clears many of the drugs relatively early including Zoloft. It is possible that with use of Primidone level of zoloft fell below required level and that probably caused the recurrence of depression.
I do not feel changing antidepressant is ideal thing. In my view if you have less than two weeks after discontinuation of primidone wait for few more days.
In case two weeks already crossed after discontinuation of Primidone I will suggest you to go for Effexor which can be started from 37.5 mg and can be increased to 225 mg according to response pattern.
Unfortunately these kinds of disturbances are idisyncratic reactions and can not be predicted precisely. They generally stabilizes in few weeks and in my view there is nothing to worry about stability of mind. They do not cause any permanent change and with achievement of same level of zoloft things are likely to improve.
I hope this helps you.
If you have more questions feel free to write back to me.
Thanks and regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Is gabapentil also an enzyme inducer? I have been off primidone for more than 2 weeks but only about 1 and 1/2 weeks for gabapentil.
Brief Answer:
No gabapentin is not involved
Detailed Answer:
Hello,
Thanks for reverting back to me.
Fortunately gabapentin do not cause any interaction with zoloft and safe.
Considering new information I recommend you to go for effexor for treatment of depression as it has good efficacy.
Another option is to increase the dose of zoloft as it will raise the chemical level to required level in brain. I must acknowledge that zoloft is approved upto 200 mg per day and any dose above 200 mg will be considered off label use.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
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
Wish you great health.
Regards
No gabapentin is not involved
Detailed Answer:
Hello,
Thanks for reverting back to me.
Fortunately gabapentin do not cause any interaction with zoloft and safe.
Considering new information I recommend you to go for effexor for treatment of depression as it has good efficacy.
Another option is to increase the dose of zoloft as it will raise the chemical level to required level in brain. I must acknowledge that zoloft is approved upto 200 mg per day and any dose above 200 mg will be considered off label use.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
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
Wish you great health.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Is that the same as Wellbutrin? How long do you think I would need to stay on Effexor? Would I go off Wellbutrin
Brief Answer:
No they are different
Detailed Answer:
Hello,
Wellbutrin and effexor are entirely different antidepressants. In fact wellbutrin is a weak antidepressant and not of much use except in young men who have certain objectionable side effects.
Yes you need to go off wellbutrin and need to start effexor after talking to your psychiatrist as it is prescription only medication.
We can expect improveent in two to six weeks with effexor that can be continued for maintenance treatment. It is difficult to predict total duration of effexor but it can be said that it will be in months or longer.
Hope this clarifies the situation.
Thanks and regards
No they are different
Detailed Answer:
Hello,
Wellbutrin and effexor are entirely different antidepressants. In fact wellbutrin is a weak antidepressant and not of much use except in young men who have certain objectionable side effects.
Yes you need to go off wellbutrin and need to start effexor after talking to your psychiatrist as it is prescription only medication.
We can expect improveent in two to six weeks with effexor that can be continued for maintenance treatment. It is difficult to predict total duration of effexor but it can be said that it will be in months or longer.
Hope this clarifies the situation.
Thanks and regards
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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