Suggest Alternative Treatment For Drug Resistant Depression

Posted on Sat, 18 Jul 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 18 Jul 2015 Answered on

Tue, 4 Aug 2015 Last reviewed on

Question : I am suffering from treatment resistant depression. I have tried many different meds prescribed by a XXXXXXX Clinic psychiatrist. I have also had Electro Shock Therapy. I have read Dr. Weil's books but still have not been able to rise above this ailment. Is it possible to schedule an appt. With Dr. Weil? I live in Ohio but would would be willing to go to Arizona to meet with him. I am becoming desperate. I have also seen an integrative med doctor at the XXXXXXX Clinic but do not feel I am getting the help I need. Can you help me? If I can not see Dr. Weil is there some one near lorain/Cleveland Ohio that you can recommend?
Thank you
XXXXXXX XXXX

Answered by Dr. Dr. Chintan Solanki (42 minutes later)

Brief Answer:
let me know about your medicines details

Detailed Answer:
Hello XXXXXXX

Thanks for writing to us.

I can understand your concern.

You are already aware that you are suffering from treatment resistant depression. And you have taken already ECT. So it seems really difficult to treat.

-But still let me know about your medicines details (dose and duration) which you have taken in past or taking at present. I can throw some light on treatment aspect. And please mention if you have any physical problem.

- Please mention brief details about your depression that how it started and what are the stress factors there?

I am sorry that appointment with Dr. Weil with help of this website is not possible.
I am not aware about any psychiatrist there in Ohio personally but I can provide one site from which you may get good psychiatrist.
Check below link:

http://www.healthgrades.com/provider-search-directory/search?q=Psychiatrist&prof.type=provider&search.type=PracticingSpecialty&entityCode=PS802&method=rollup+specialty&loc=Cleveland%2C+OH&pt=41.504749%2C+-81.69072&isNeighborhood=false&locType=%7Cstate%7Ccity&locIsSolrCity=

You can modify search according to your need.

I will be happy to help further.

Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Chintan Solanki (1 hour later)

35 years ago, nine moths after my second child was born I had my first episode of depression. It. Took a few years to find the right doc and medicine. I took Zoloft successfully for 20 years and did great. I decided to try to go off the Zoloft 2 years ago. With the help of my PCP I very slowly withdrew. I had a medical scare at that time and became very nervous and upset. The scare turned out to be nothing, but I could not shake the anxiety and depressive symptom of feelings of unreality that came with it. I had those same symptoms the first time around. Since that time I have taken Effexor, Welbutrin, Latuda, and Luvox. All meds were titatrated to the highest dose I could tolerate or until it appeared it wasn't helping. I am now on 10 mg of Lexapro titrating to 20 mg in a few days. I take Klonipin .5 mg once or twice a day. I hate to take it and try not to when I can. I have no physical problems and am in good health. I exercise about 4 times a week. Swimming and walking. I do breathing exercises that Dr. Weil recommends and have just started guided imagery. I am desperate and don't understand why I am not getting better. I am also an RN.

Answered by Dr. Dr. Chintan Solanki (12 hours later)

Brief Answer:
Other medicines are still there, it is not likely treatment resistant

Detailed Answer:
Hi,

Thanks for information and sorry for delayed response.

Resistant depression is diagnosed when 3 drugs from different groups are used together and response is not seen.

Positive points in your history are that your physical health is good and your depression was responding to zoloft.

There are still other medicines which are quite effective but not used in your case like mirtazapine/desvenlafaxne, drug from tricyclic anti depressant(imipramine), lithium/lamotrigine, thyroid/B12 supplements after serum level and quetiapine/aripirazole.

Along with combination of medicines psychotherapy- specifically cognitive behavior therapy(CBT) is useful.

I also recommend to read book 'Feeling Good' by XXXXXXX burns.

Discuss above aspect with your current/new treating doctor and add something to lexapro.

Hope this answer will be helpful.

Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Chintan Solanki (8 hours later)

Thank you, Your response has made me feel much more hopeful. What would you suggest adding to Lexapro. What about XXXXXXX e supplement? It is funny that you mention the book Feeling Good by XXXXXXX Burns, I just started reading it yesterday!
Thank you again.
XXXX

Answered by Dr. Dr. Chintan Solanki (2 hours later)

Brief Answer:
mirtazapine, desvenlafaxine or imipramine

Detailed Answer:
Hi XXXXXXX

Thanks for follow up.

If you do not have sleep disturbance, I prefer Desvenlafaxine.

If you have sleep disturbance I prefer Mirtazapine.

Considering age of 63 and if you do not have any physical problem like hypertension or diabetes I like to use imipramine alone.

It is really a good coincidence about Feeling Good.

If still any query there, I will be happy to answer. If not, you can close the discussion and if feasible give your feedback and rating so I can improve my service. In future you can contact me directly on this site if you wish with this link:
http://bit.ly/drchintansolanki
by clicking on 'Ask me a question' on same page.

All the best and take care.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar