HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

Suggest Treatment For Severe Anxiety And Depression

Posted on Mon, 12 Jun 2017

Question: Hi I am 65 with no medical issues except anxiety/depression. I had been taking Pristiq, felt very good but was unable to sexually function. Unable to get and keep an erections. It was a challenge to master-bate. When I turned 65 the government pays for prescriptions. I reviewed a number of antidepressants and their side effects and felt that Wellbutrin was very conservative on weight gain, and actually improved ones sexual concerns. After about 3 weeks I noticed I was becoming very depressed and while certainly no thoughts of harming myself it does make me feel that now I am older my time is near. I made an appointment with my MD however it was a few weeks out. I discussed this with my pharmacist and he agreed I could doubt the 150 mg to 300mg safely until I could see my MD. I did so for about 1 week while I had to be out of the city on a business meeting. Now I am back and will see my MD tomorrow. I am looking for a antidepressant that will work but not cause depressing weight gain and will not destroy my sexual activity. I know I will get more guidance tomorrow but I would like to get an opinion from another MD. A specialist . I should note that I recently lost two good friends in April and had to travel to Hong Kong to deal with my best buddies affairs. This defiantly affected my thinking and mood, I believe that the doubling up did not improve the situation at all and I returned to one a day. I am lost....can you help
Thanks XXXXXXX

Answered by Dr. Dr. Ashok Kumar Choudhary (1 hour later)

Brief Answer:
I think pristiq can be increased

Detailed Answer:
Dear XXXXXXX
Thanks for using Healthcaremagic.

I read your query and understand your concerns.

From the available description I feel that pristiq should be increased as it was effective to deal with your depression but lost its efficacy after start of bupropion. This happens because there is some antagonism between serotonin blockage by pristiq and antagonistic effect by Bupropion.

I consider increased dose of pristiq as better option as sexual side effects can be tackled with same wellbutrin of 150 or 300 mg or pramipexole 0.25-0.75 mg per day.

Among the antidepressants the next better option is agomelatine if it is available in your country.

I hope this helps you.
Feel free to write back to me if you have more questions.
Thanks and regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Ashok Kumar Choudhary (12 hours later)

have you any experience with an antidepressant with the product name vilazodone?
Thanks XXXXXXX

Answered by Dr. Dr. Ashok Kumar Choudhary (11 minutes later)

Brief Answer:
Follow up

Detailed Answer:
Dear XXXXXXX
Thanks for follow up.

I have used vilazodone in around 20-30 patients of depression and can answer your questions if any.

Thanks again.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Prasad