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Hello, Can You Suggest Alternatives For Depression Sufferers Who Have

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Posted on Sun, 11 Nov 2018
Question: Hello,
Can you suggest alternatives for depression sufferers who have experienced serotonin syndrome?

After having adverse reactions to several different SSRIs medication, and some other serotonin base medication (amitriptyline, mirtazapine etc), include several natural supplement like 5-HTP, St. John's wort, noni etc.

And after recently genetic testing has been indicate that I have genetic predisposition for low MAO – A enzyme (rs6323 MAOA R297, (--) TT allele,) and that my problem could be relate to serotonin syndrome,

Is there any available test to proof serotonin syndrome?

Does antidepressant medication effecting just norepinephrine and dopamine can be better in my case
Medication like
Desipramine (Norpramin)
Rboxetine

Or you are advising some other option or approach in respect of serotonin syndrome in case that depression need to be treate

Now i am only on clonazepam 0.5 mg. But this med does not working well for depression and anxity in my case
Thanks
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (3 hours later)
Brief Answer:
Yes there are alternatives

Detailed Answer:
Hello,
Thanks for using Healthcaremagic.

I read your query and understand your concerns.

From the available description and genetic testing reports it is very clear that non serotonin based medications will make a better choice for treatment of anxiety and depression in your case.

The options available are as follows
Tianeptine
Bupropion
Opipramol
Reboxetine
Low dose antipsychotics such as quetiapine and lurasidone


Unfortunately there are no gold standard tests to confirm serotonin syndrome other than the clinical suspicion and supporting tests such as serotonin metabolites in urine.


I do not think desipramine is an option as it has potential serotonergic properties alike amitryptiline which you tried in the past.

I hope this helps you.
Feel free to write back to me if you have more questions.
Thanks and regards.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr. Ashok Kumar Choudhary

Psychiatrist

Practicing since :2000

Answered : 3354 Questions

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Hello, Can You Suggest Alternatives For Depression Sufferers Who Have

Brief Answer: Yes there are alternatives Detailed Answer: Hello, Thanks for using Healthcaremagic. I read your query and understand your concerns. From the available description and genetic testing reports it is very clear that non serotonin based medications will make a better choice for treatment of anxiety and depression in your case. The options available are as follows Tianeptine Bupropion Opipramol Reboxetine Low dose antipsychotics such as quetiapine and lurasidone Unfortunately there are no gold standard tests to confirm serotonin syndrome other than the clinical suspicion and supporting tests such as serotonin metabolites in urine. I do not think desipramine is an option as it has potential serotonergic properties alike amitryptiline which you tried in the past. I hope this helps you. Feel free to write back to me if you have more questions. Thanks and regards.