Question: My MD prescribed escitalopram 5 mg for mild depression. Prior use of certraline-type antidepressant, trazodome (spelling?) made me feel very strange (zombie-like). I haven't begun taking the escitalopram yet and am hesitant. Any advice? Thanks!

Dear Dr. Ditah:
Thank you for your answer. It's surprising to learn that Trazodone is used to treat schizophrenia and psychotic disorders since this was never my situation. Neither (as far as I know) did my mood and personality need stabilization or modulation. My primary care MD at the time prescribed it as a sleep aid!
Living in southern New England, I have managed mild Seasonal Affective Disorder (SAD) by working at getting as much sunlight as possible along with regular 2- to 3-mile walks. However, this year the fatigue that seemed to accompany SAD lasted beyond the winter season until the present, so I recently consulted an emergency room consulting MD at a local walk-in clinic. The MD said this could be Chronic Fatigue Syndrome and recommended a complete evaluation to rule out other problems that could produce these symptoms.
I did this, and the examining Physician's Assistant (PA) performed a fairly good examination, including taking urine sample which came back negative for whatever it was taken for. Also, a blood sample will be taken later this week for analysis. However, the PA also believed that I am depressed and thus prescribed the Escitalopram, which (as I said above) I am inclined to resist in favor of continuing behavioral consultation, more exercise, etc. In the past I had also taken half-capsules of St. John's Wort for about a year but discontinued it when I read somewhere that it could cause confusion.
Finally, I did consult a psychotherapist, who was of the strong opinion that this is depression, which in my case causes more fatigue in the morning and seems to subside by afternoon after activities. My body seems to benefit from a good 2 or 3-hour outside workout like raking lawns, lawnmowing, etec. She urged me to start taking the Escitalopram, so today I took the first tablet.
I'm really very healthy and have taken no significant amounts of meds (except for antibiotics for Lyme disease in the past). Thus, although I do complain about morning fatigue which may be a major symptom of depression, I resist taking medicines like this for such long periods of time unless nothing else works.
I'd certainly be interested in your comments on this lengthy report. Thank you very much!

Thank you very much, Dr. Ditah. Will do.