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Re: Mitch and others, I am at my wits end. » nmk

Posted by Jumpy on January 5, 2003, at 13:33:58

In reply to Mitch and others, I am at my wits end., posted by nmk on January 5, 2003, at 11:28:54


> I just don't know what to do at this point and am hoping anyone can offer some suggestions? Thanks in advance.
>
> Nicole

Hey Nicole,

First, anyone in your family suffer from mental illness? If so, do they take medication? What has been the most effective medication for them? (Response often runs in families)

Second, have you maximized you dose of zoloft ... tapered up to 200 to 250 mg?

Third, have you every tried a tricyclic AD such as Pamelor? It is great for depression, anxiety to some degree, and can help with insomnia.

Fourth, if you got your anxiety under control, maybe with a small dose of a long acting benzo like klonopin or tranxene, you could simply add wellbutrin to the zoloft. This would allow you to avoid tapering off zoloft and tapering up on a new AD.

Fifth, have you had a routine medical exam and blood work to rule out medical cause of depression and anxiety?

When someone has not responded to 2 meds at full dose from different classes, some may call this treatment resistant depression. No one really knows what the next best step is for these people (switch, augment, allow current trial to persist longer). STAR*D study is going to answer the question to what to do with treatment resistant depression. Until then, it is just guess work.

Hope this helps.

Jumpy


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URL: http://www.dr-bob.org/babble/20021230/msgs/134613.html