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Suggest Treatment For Depression
Question: My insurance quit paying for mental health. I need refills of buproprion and trazodone and maybe anything else the Dr. might suggest in addition to the buproprion. My question is how much does this consultation cost, because I don't have the $150 to $200 it costs around here. I have no interest in life. While I am not suicidal, I really don't find any enjoyment in Life. I have no energy, am apathetic and lethargic. For instance I go home on a Friday and nearly every weekend I don't leave the house. I tend to do nothing except watch TV and even then probably can't tell anyone what I watched. I haven't taken an actual shower since January, I take "spit baths" in the sink in order to go to work. I used to have things I liked to do, but now it is just too much trouble and takes energy and "want to" which I just don't have. I have known I was on my last refill for over a month and have not called anyone for any kind of appointment. Can you help me?
Thanks, XXXXXXX
Thanks, XXXXXXX
Brief Answer:
Detail required
Detailed Answer:
Hi dear,
Thank you for your query.
I understand your concern but i would like more detail for proper diagnosis and treatment.
First of all since when you have such problem and in what dose you are taking medication which you described?
Is there any benefit from these medication?
I would also like to know that whether your illness affects your work and relation with family and friends.
From your history you are suffering from major depressive disorder probably and need proper treatment.
If you are in my clinic i would start with SSRi like escitalopram 10 mg and SOS benzodiazepins for sleep disturbance.
Is there any past history and family history about psychiatric disorder?
Never take any medication without consultation.
Awaiting your response.
Thank you
Detail required
Detailed Answer:
Hi dear,
Thank you for your query.
I understand your concern but i would like more detail for proper diagnosis and treatment.
First of all since when you have such problem and in what dose you are taking medication which you described?
Is there any benefit from these medication?
I would also like to know that whether your illness affects your work and relation with family and friends.
From your history you are suffering from major depressive disorder probably and need proper treatment.
If you are in my clinic i would start with SSRi like escitalopram 10 mg and SOS benzodiazepins for sleep disturbance.
Is there any past history and family history about psychiatric disorder?
Never take any medication without consultation.
Awaiting your response.
Thank you
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
The trazodone works well and I sleep without being hungover. I do not want to change that. I was prescribed 100 mg which I sometimes cut in half. The wellbutrin is 300mg XL and I would like to keep taking it or maybe increase it since I don't gain weight and it at least is keeping me at work. I was taking 80 mg of Prozac. I do not believe that the minimum low dosage of any medication is going to do me any good.
Elavil was prescribed for my Dad although he never took much of it and never refilled it. No other mental health issues in my family.
So maybe add something to the welbutrin or increase it and keep the trazodone. I have probably been depressed for many years but have only been taking medication since 2005 except for following the birth of my second child when I took Triavil 2/10 for a month or so. I seldom see my son or grandchildren who live here in town. And seldom talk to my youngest son in VA. He is flying me out to VA at Christmas but I may yet cancel it because it seems like too much trouble. I have two welbutrin 300mg XL left.
Elavil was prescribed for my Dad although he never took much of it and never refilled it. No other mental health issues in my family.
So maybe add something to the welbutrin or increase it and keep the trazodone. I have probably been depressed for many years but have only been taking medication since 2005 except for following the birth of my second child when I took Triavil 2/10 for a month or so. I seldom see my son or grandchildren who live here in town. And seldom talk to my youngest son in VA. He is flying me out to VA at Christmas but I may yet cancel it because it seems like too much trouble. I have two welbutrin 300mg XL left.
Brief Answer:
Need to change medication
Detailed Answer:
Hi dear,
As you are well with trazadone no need to change it but for depression you need to change medication because you already on 300 mg of buproion which is maximum dose for that medication.
80 mg of fluoxetine is quite high dose and mostly used in obsessive compulsive disorder, so in depression you need to take other SSRI like escitalopram up to 20 mg or sertraline up to 200 mg which are more potent.
And you can add medication like lithium or arpiparazole to augment anti depressant effect.
Discuss with psychiatrist about that.
Thank you
Need to change medication
Detailed Answer:
Hi dear,
As you are well with trazadone no need to change it but for depression you need to change medication because you already on 300 mg of buproion which is maximum dose for that medication.
80 mg of fluoxetine is quite high dose and mostly used in obsessive compulsive disorder, so in depression you need to take other SSRI like escitalopram up to 20 mg or sertraline up to 200 mg which are more potent.
And you can add medication like lithium or arpiparazole to augment anti depressant effect.
Discuss with psychiatrist about that.
Thank you
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
I can not afford a psychiatrist. I was under the impression that you would prescribe at least a refill if not a change.
As far as the flouxetine goes, we started at 20 mg and worked up to 100mg before dropping back to 80 mg. At this time I cannot remember why we dropped it.
It seems like my system does not process medications the same as other people. It always seems that I need a higher dose than others to get the same effect. And that is in all medications. And Dr's always start conservatively and we work our way up.
As far as the flouxetine goes, we started at 20 mg and worked up to 100mg before dropping back to 80 mg. At this time I cannot remember why we dropped it.
It seems like my system does not process medications the same as other people. It always seems that I need a higher dose than others to get the same effect. And that is in all medications. And Dr's always start conservatively and we work our way up.
Brief Answer:
you need to consult psychiatrist for prescription
Detailed Answer:
Hi dear,
For prescription you need to consult psychiatrist and after complete history and mental status examination psychiatrist prescribed you medication.
Without seeing a patient no one prescribed medication. Moreover these are prescribed medications.
Everybody has different system and so process of medication is different in different individual.
That is the reason why we start with lower dose and increase gradually.
Thank you
you need to consult psychiatrist for prescription
Detailed Answer:
Hi dear,
For prescription you need to consult psychiatrist and after complete history and mental status examination psychiatrist prescribed you medication.
Without seeing a patient no one prescribed medication. Moreover these are prescribed medications.
Everybody has different system and so process of medication is different in different individual.
That is the reason why we start with lower dose and increase gradually.
Thank you
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
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