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Suggest Treatment For Depression
Question: Hello
I have asked you repeatedly about my daughter XXXXXXX who was an elite ice dancer but is taking a break because she suffers from depression and phobia-she is afraid to train and compete and suffers from panic attackes 4-5 times per week.
The doctors never real use psychiatrists and rely upon psychiatric nurses to prescribe. I tried talking to the nurse but she seemed to fight my every idea.
Now she has recommended pharmcogenetic testing to find the right drug for her. Sounds good Does it work?
Also afraid of the combination she now has my daughter on; 100 mg Zoloft; 5 mg Abilify and Klonopin up to 3 times per day
I have asked you repeatedly about my daughter XXXXXXX who was an elite ice dancer but is taking a break because she suffers from depression and phobia-she is afraid to train and compete and suffers from panic attackes 4-5 times per week.
The doctors never real use psychiatrists and rely upon psychiatric nurses to prescribe. I tried talking to the nurse but she seemed to fight my every idea.
Now she has recommended pharmcogenetic testing to find the right drug for her. Sounds good Does it work?
Also afraid of the combination she now has my daughter on; 100 mg Zoloft; 5 mg Abilify and Klonopin up to 3 times per day
Brief Answer:
Private Consultation
Detailed Answer:
Hello XXXXXXX and thank you for using my private service. I consider your daughter my private patient, and will do everything I can to help.
First, your question about genetic testing. Genetic testing has in the last several years become very useful for determining how an individual's metabolism affects levels of the drug in the system. This is very important, because if for example your daughter is a rapid metabolizer of Zoloft, she may need higher doses to achieve the desired effect.
I highly recommend genetic testing in her case. I recommend using GeneSight - I have no financial stake whatsoever with them, I simply find their testing the most useful in my practice.
Second, your question about your daughter's medication regimen. This regimen seems reasonable to me. As I mentioned in my previous answer, I would recommend increasing her Zoloft to 150mg, and then in 2 weeks increasing again to 200mg.
Klonopin is excellent for anxiety while the antidepressant is taking time to kick in. But I would caution against Klonopin use for more than 2-3 months as you can develop dependence on it.
Please feel free to ask any followup questions that come to mind.
Dr. Sheppe
Private Consultation
Detailed Answer:
Hello XXXXXXX and thank you for using my private service. I consider your daughter my private patient, and will do everything I can to help.
First, your question about genetic testing. Genetic testing has in the last several years become very useful for determining how an individual's metabolism affects levels of the drug in the system. This is very important, because if for example your daughter is a rapid metabolizer of Zoloft, she may need higher doses to achieve the desired effect.
I highly recommend genetic testing in her case. I recommend using GeneSight - I have no financial stake whatsoever with them, I simply find their testing the most useful in my practice.
Second, your question about your daughter's medication regimen. This regimen seems reasonable to me. As I mentioned in my previous answer, I would recommend increasing her Zoloft to 150mg, and then in 2 weeks increasing again to 200mg.
Klonopin is excellent for anxiety while the antidepressant is taking time to kick in. But I would caution against Klonopin use for more than 2-3 months as you can develop dependence on it.
Please feel free to ask any followup questions that come to mind.
Dr. Sheppe
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Brief Answer:
Private Followup
Detailed Answer:
Here is a link to the answer to this question on GeneSight's website. They can help any provider order a testing kit and get the sample to them. It's actually pretty easy, all things considered!
https://genesight.com/talking-to-your-healthcare-provider/
Dr. Sheppe
Private Followup
Detailed Answer:
Here is a link to the answer to this question on GeneSight's website. They can help any provider order a testing kit and get the sample to them. It's actually pretty easy, all things considered!
https://genesight.com/talking-to-your-healthcare-provider/
Dr. Sheppe
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
How can I find a doctor in my area that uses Genesight to get the testing done?
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