Posted by yxibow on May 22, 2006, at 16:02:10
In reply to Treatment-Resistant Depression - Please Help, posted by aturtle16 on May 22, 2006, at 14:18:59
> Hi everybody, I am new to psycho-babble. I believe I have treatment-resistant depression, as I have tried 4 different SSRI's + Wellbutrin (which made me worse)and see no difference...still having severe symptoms of depression. My pdoc is getting aggravated at me because I'm not responding (currently on 30 mg of Lexapro daily). He hasn't suggested shock therapy YET, but I don't want it anyway as I've heard horror stories about its side effects. I go to psychotherapy, too, but it doesn't seem to have an effect, either. Does anyone have any suggestions?
That's not the end of the road by any stretch -- there are as mentioned still all the tricyclics (TCAs), tetracyclics (Remeron) which is actually a fairly powerful antidepressant, there are 5 true SSRIs (lexapro is a metabolite of Celexa), so there's one you probably havent tried (Luvox ?). There are even odd old antidepressants like Amoxapine (an old idea that is comparable to Symbyax) and Trazodone (and Serzone though you have to watch your liver). There's neuroleptic augmentation of SSRIs. There are the SSNRIs Effexor and Cymbalta (which has shown some good results in those who didnt respond to others).
I don't think he's getting aggravated at you -- if he is getting aggravated at you, there's something else going on between the two of you or he's not being the patient doctor that you need. But that is just my opinion.
And I'm sure I've forgotten a few more, not to mention MAOIs, which have their own pitfalls, but there's a whole soup of them above which I would try before that or ECT.- cheers
Jay
poster:yxibow
thread:646927
URL: http://www.dr-bob.org/babble/20060520/msgs/646958.html