Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Somatic Symptoms Of Depression
Question: Hi. I have a 28 yo daughter who was diagnosed with depression when 20 and has been taking Effexor xr 75mgs since that time which seems to maintain her relatively well. In July 2014 she had a 2 week low period & was hit by a bout of flu at the same time, with body & headaches aches & unrelenting tiredness. After 2 weeks the flu disappeared & she was left with a severe back aches for which she sought assistance from GP, he recommended physio which she had without success. . She then also developed hip pain - GP had general blood tests done which returned normal. He then recommended cortisone injections which she declined. She has since had unsuccessful treatments by osteopath, naturopath, masseur, physio etc. It is now 8 months since the pain started and now involves headaches and fatigue. She is at a loss as what to do next. She loves Her jobs (part time yoga teacher & part time Red Cross store manager), but it is starting to affect them whereby she has to leave early in pain and with an overwhelming need to sleep. This in turn seems to be making her feel, as she calls it, down. She says it doesn't feel the same as when she is depressed, just unable get her body to go on. Resting doesn't always help either. She says the worst pain seems to come when laying down. Would appreciate your thoughts on this and where to go from here.
Brief Answer:
Increase in dose of effexor may help
Detailed Answer:
Hello,
Thanks for using healthcaremagic.
I read your query and understand your concerns.
Since every test is found normal and no other ailment is able to explain her symptoms, it is possible that she has developed somatic symptoms of depression. These are characterized by multiple pains, fatigue and weakness among others. I am assuming this because these are common symptoms after a patients is depressed and remains so for years.
I must agree that she is well maintained on 75 mg effexor but it is possible that the low dose may not be able to prevent development of somatic symptoms as we know 75 mg is minimum possible effective dose for effexor in depression.
In my view talk to her psychitriat to either enroll her for psychotherapy or to increase the dose of effexor. Both option have potential to work for her.
I hope this helps you .
Thanks and regards
Dr Ashok Kumar
Increase in dose of effexor may help
Detailed Answer:
Hello,
Thanks for using healthcaremagic.
I read your query and understand your concerns.
Since every test is found normal and no other ailment is able to explain her symptoms, it is possible that she has developed somatic symptoms of depression. These are characterized by multiple pains, fatigue and weakness among others. I am assuming this because these are common symptoms after a patients is depressed and remains so for years.
I must agree that she is well maintained on 75 mg effexor but it is possible that the low dose may not be able to prevent development of somatic symptoms as we know 75 mg is minimum possible effective dose for effexor in depression.
In my view talk to her psychitriat to either enroll her for psychotherapy or to increase the dose of effexor. Both option have potential to work for her.
I hope this helps you .
Thanks and regards
Dr Ashok Kumar
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank you. I have a feeling she will not be happy with this as, although she knows she cant go off them (has tried in the past), she hates them and doesn't like the thought of increasing. she is quite concerned re the effects of having children. she is intelligent & has done all the research re this. I will put it to her and see what happens. Thank you once again.
sorry meant to ask - so you don't think that the flu, where her body aches and pains seem to have been initiated (sometimes quite debilitating) have had any thing to do with her current aches? It seems that her body has been thrown out of whack since then. Her current pains are hip, which has subsided since massage, shoulders and headaches.
sorry meant to ask - so you don't think that the flu, where her body aches and pains seem to have been initiated (sometimes quite debilitating) have had any thing to do with her current aches? It seems that her body has been thrown out of whack since then. Her current pains are hip, which has subsided since massage, shoulders and headaches.
Brief Answer:
I am almost certain
Detailed Answer:
Hello,
Thanks for reverting back to me.
I understand her resistance but when there is no other option, increasing the dose of medication or supplementing it with other molecule is required. The other option is psychotherapy which appears to be an effective alternative for her considering the duration of illness and her thought process.
I am almost certain that her current symptomatology is not due to flu as she has widespread pain which cannot be explained on the involvement of single system. Above it there is no condition which remains so after eight months of simple flu.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards
I am almost certain
Detailed Answer:
Hello,
Thanks for reverting back to me.
I understand her resistance but when there is no other option, increasing the dose of medication or supplementing it with other molecule is required. The other option is psychotherapy which appears to be an effective alternative for her considering the duration of illness and her thought process.
I am almost certain that her current symptomatology is not due to flu as she has widespread pain which cannot be explained on the involvement of single system. Above it there is no condition which remains so after eight months of simple flu.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
