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Suggest Treatment For Depression
Question: Hello. This is XXXX. I must have hit the wrong button and the screen went away. At any rate I will start again. I had a discussion with Dr. XXXXXXX 3 or 4 days ago about my trying to find a good antidepressant.
I was on Wellbutrin for 2 years and really did not receive any great success. The depression was getting worst due to lives problems with being 71 and having friends pass away, but that should not have kept my positive attitude from working well.
I was on Effexor for 3 years and it worked well for me until it started to cause urinary retention very seriously. I was getting up 8-10 times in the night and after months of that I was no very happy.
I went to a Urologist who gave Flo ease or I think it is Tamsulsin and that didn't help so I tried cranberry pills and that helped, but the best advise he gave me was to stop the Effexor. The problem went away, but so did the Effexor, so I started Wellbutrin.
After trying a few others; the last being Zoloft, which cause terrible constipation plus other negative side effects.
The doctor I have been seeing for 15 years agreed to Prisquit and said it was similar to Effexor and may not cause Urinary retention. I took my first pill yesterday at 2:00 PM as that was when I filled the script and within 30 minutes began to feel a pleasant change which I recognized as a good sign. The starting dose was 50mgs and I didn't get up in the night except twice, so I was encouraged.I woke up this morning somewhat happy and took the 2nd pill at 7:00am. The script read once a day in morning and the dose was 50mgs. I felt fine and had 3-4 cups of coffee, which I have been doing for several years and took 2 15mgs of oxycodone, which I have been on for chronic back pain. I have cut down 80% since I have a knee replacement and can see with the help of the Prisquit I can get off them in a couple of months.
The downside of the morning was the onset of some depression after a small feeling of well being had started to kick in so I was quite disappointed. I know the pill says it takes 2 weeks to fully work and that the dose can be higher, but I am wondering why it worked so well yesterday and bottomed out this morning.
Now I am questioning the other pills I am taking. For sleep the doctor has given me 45 mgs of remeron at night, but that doesn't work anymore so I added 3 5mgs of Valium which usually helps me fall asleep. So I have Remeron and Valium at night and the Oxycodone in the morning. Between the pills and the coffee could one or more of them be keeping the Prisquit from working? I know this is a long question, but now you have all the details. Any help would be appreciated. XXXX
I was on Wellbutrin for 2 years and really did not receive any great success. The depression was getting worst due to lives problems with being 71 and having friends pass away, but that should not have kept my positive attitude from working well.
I was on Effexor for 3 years and it worked well for me until it started to cause urinary retention very seriously. I was getting up 8-10 times in the night and after months of that I was no very happy.
I went to a Urologist who gave Flo ease or I think it is Tamsulsin and that didn't help so I tried cranberry pills and that helped, but the best advise he gave me was to stop the Effexor. The problem went away, but so did the Effexor, so I started Wellbutrin.
After trying a few others; the last being Zoloft, which cause terrible constipation plus other negative side effects.
The doctor I have been seeing for 15 years agreed to Prisquit and said it was similar to Effexor and may not cause Urinary retention. I took my first pill yesterday at 2:00 PM as that was when I filled the script and within 30 minutes began to feel a pleasant change which I recognized as a good sign. The starting dose was 50mgs and I didn't get up in the night except twice, so I was encouraged.I woke up this morning somewhat happy and took the 2nd pill at 7:00am. The script read once a day in morning and the dose was 50mgs. I felt fine and had 3-4 cups of coffee, which I have been doing for several years and took 2 15mgs of oxycodone, which I have been on for chronic back pain. I have cut down 80% since I have a knee replacement and can see with the help of the Prisquit I can get off them in a couple of months.
The downside of the morning was the onset of some depression after a small feeling of well being had started to kick in so I was quite disappointed. I know the pill says it takes 2 weeks to fully work and that the dose can be higher, but I am wondering why it worked so well yesterday and bottomed out this morning.
Now I am questioning the other pills I am taking. For sleep the doctor has given me 45 mgs of remeron at night, but that doesn't work anymore so I added 3 5mgs of Valium which usually helps me fall asleep. So I have Remeron and Valium at night and the Oxycodone in the morning. Between the pills and the coffee could one or more of them be keeping the Prisquit from working? I know this is a long question, but now you have all the details. Any help would be appreciated. XXXX
Brief Answer:
CBT needed
Detailed Answer:
Hi XXXXXXX it is very very unfortunate that you are having all these problems. But, I definitely appreciate the fact that the information you gave was detailed and chronological.
Now, regarding your problem, I think changing so many medications one after another either for effectiveness or for side effects and still relying on medication only for depression for more than a decade, is not a wise option.
And another thing is, you were suddenly switched from Effexor (Venlafaxine) to completely unrelated Bupropion and then again to Sertraline. Then again Venlafaxine and then to its derivative Desvenlafaxine. It also surprised me that Venlafaxine was effective for you, whereas its active metabolite Desvenlafaxine (Pristiq) was not effective.
Whatever the reason may be for all these, I think you most importantly need Cognitive Beviour therapy for your problem. Unless the thought process is rationalised and the process of development of irrational assuptions are interfered with, no medicine can cure major depressive disorder.
You should talk to your local psychiatrist so that he/she can arrange for the same or consult a clinical psychologist or counsellor at the earliest to have this therapy.
For the time being, please continue with Pristiq (it is as effective as Effexor) and the other medications you are having. Please also avoid keeping yourself aloof from others and feeling worthless.
1.Go outdoors & interact with people.
2. Start helping those who are in need, even if you don't know them (this will create a "feel good"/satisfaction within you).
3. Make a chart of your daily thought and work chronologically and give them pleasure ratings(1-least pleasurable, 6-most pleasurable). Add them by the end of the week and avoid those thoughts and tasks with lowest pleasure rating.
Finally, I would again tell you that you are a wonderful writer and be proud of yourself.
If you have any further questions, please write back.
If you are satisfied with the answer, please close the thread and rate my answer.
Regards,
Dr. Kaushik
CBT needed
Detailed Answer:
Hi XXXXXXX it is very very unfortunate that you are having all these problems. But, I definitely appreciate the fact that the information you gave was detailed and chronological.
Now, regarding your problem, I think changing so many medications one after another either for effectiveness or for side effects and still relying on medication only for depression for more than a decade, is not a wise option.
And another thing is, you were suddenly switched from Effexor (Venlafaxine) to completely unrelated Bupropion and then again to Sertraline. Then again Venlafaxine and then to its derivative Desvenlafaxine. It also surprised me that Venlafaxine was effective for you, whereas its active metabolite Desvenlafaxine (Pristiq) was not effective.
Whatever the reason may be for all these, I think you most importantly need Cognitive Beviour therapy for your problem. Unless the thought process is rationalised and the process of development of irrational assuptions are interfered with, no medicine can cure major depressive disorder.
You should talk to your local psychiatrist so that he/she can arrange for the same or consult a clinical psychologist or counsellor at the earliest to have this therapy.
For the time being, please continue with Pristiq (it is as effective as Effexor) and the other medications you are having. Please also avoid keeping yourself aloof from others and feeling worthless.
1.Go outdoors & interact with people.
2. Start helping those who are in need, even if you don't know them (this will create a "feel good"/satisfaction within you).
3. Make a chart of your daily thought and work chronologically and give them pleasure ratings(1-least pleasurable, 6-most pleasurable). Add them by the end of the week and avoid those thoughts and tasks with lowest pleasure rating.
Finally, I would again tell you that you are a wonderful writer and be proud of yourself.
If you have any further questions, please write back.
If you are satisfied with the answer, please close the thread and rate my answer.
Regards,
Dr. Kaushik
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Answered by
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