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Suffering from chronic depression. Prescribed Xet CR plus, not working, Parocen CR 25, librium 25. History of diabetes, high BP. Treatment?

my husband is suffering from depression from the last 20 years but last year in june it was a major suggested him xet cr plus 12.5 in the morning and 25 mg at night. he also is a diabetic and also has high blood pressure .all medicines are been taken regularly.but now depression activities have increased and the medicine xet cr plus is also not working.i consulted a doctor and he suggested parocen cr 25 with librium 25 with licabxl and lozeb-2.after taking this doses he is not feeling well please suggest
Asked On : Tue, 17 Jul 2012
Answers:  1 Views:  285
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Psychiatrist 's  Response
Hello and welcome to Healthcare Magic. Thanks for your query.

Though many people respond well to anti-depressant medication, there will be a proportion of people who respond only partially or have a poor response to treatment. The most common reasons for poor treatment response are inadequate dosage or duration of treatment and irregular treatment. If despite regular and adequate treatment there is still poor response or recurrent episodes, then the possibility could be a 'treatment-resistant depression'. Now, don't get alarmed by that word as it does not imply that there is no treatment option available. It just means that these particular proportions of people need a special way of approach and management.

The management approach first involves investigating for any causes for treatment resistance, for example, certain medical causes, like thyroid problems, certain vitamin deficiencies, etc. can be contributory. If so, they have to be detected and treated appropriately. Further treatment options include trying different combination of anti-depressants, augmenting the antidepressant with other psychiatric medication like an anti-psychotic or a mood-stabilizer, thyroxine supplementation, etc. Combining intensive psychological therapies (such as Cognitive Behavioural Therapy - CBT) with medication often gives good results. Sometimes, if medication and psychotherapy fail, Electro-convulsive Therapy (ECT) can also be used as an option. Please have a detailed discussion with your husband's psychiatrist regarding further treatment options.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist
Answered: Wed, 24 Oct 2012
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