HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

I Ve Had Depression For 16 Years And It S

default
Posted on Tue, 6 Oct 2020
Question: I've had depression for 16 years and it's been a degenerative disease. Can anyone CURE me? I only want to talk to psychiatrists. I'm taking 20 m.g.
of Lexapro and 20 m.g. of Fluoksetin Lannaxer. Unofficially, I would say I have a mood disorder and I definitely have a sleep disorder now as
I can literally sleep 12, 20, or even 34 hours and be asleep 95% of the time. The other doctor said I have hypersomnia and most likely narcolepsy.
My aim now is to do Deep Brain Stimulation and to try ketamine since it has been proven to work some. I need an out-of-the-box practical thinker who can come up with some solutions. By the way, I'm also not stupid. I've written 10 books, so maybe, it's an occupational hazard. I really don't want to live until I'm 80 and have spent literally half my life depressed. I don't even think Job went through this and right now, Jesus' 24-hour persecution is looking pretty good to me right now. LOL Answers? I truly think in 30 years modern science will have solved this.
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (2 hours later)
Brief Answer:
Consultation

Detailed Answer:
Hello,
Thanks for using Healthcaremagic.

I read your query and understand your concerns.

First of all I like to inform you that so far there is no cure for depression although multiple options exists for treatment. Although I have limited details about the problems faced by you but the available details indicate it will be better to go for a medication witch hits at least two neurotransmitters such as Pristiq, Duloxetine or Milanacipran.

Considering your sleep disorder, hypersomnia I feel Pristiq should be considered first choice. In case that does not help than the combination of Wellbutrin with pristiq can be considered. Since your current medications only target the serotonin that could be the reason for poor response in regard to long existing depression.

ketamine is excellent choice but it is only approved for treatment resistant depression.

I hope this helps you.
Feel free to write back to me if you have more questions.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Dr. Ashok Kumar Choudhary (36 minutes later)
Thanks Dr. XXXXXXX

I appreciate you shedding some light on this (quite literally). So, in terms of meds, I've always been told to taper off of Lexapro and other pharmaceutical meds. So how would this switch work?

I was having more outbursts before I was taking Fluokestin Lannaxer. It was like my brain was grinding and it was hard to detach from negativity.

So I take how many milligrams of Pristiq? Do I titrate it? Wellbutrin is for what?

I talked to someone and she even recommended amphetamines to some extent. I assume the non-addictive kind if there is such a thing.

My depression is resistant and not fully treatable so yes, I would like to take ketamine. I was going to buy some in a particular country and just use it. I know you don't want to hear that, but after 16 years, I'm kinda desperate.

Anything else?

doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (43 minutes later)
Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for follow up.

The pristiq can be started at 25 mg per day and should be titrated upward slowly while the existing medication (Lexapro) titrated downwards. By this way the withdrawal effects of existing medication as well as interaction between different medications can be avoided without loosing the the effects of medication(if any).

In other words cross titration between Lexapro and Pristiq is right answer at this moment. Following the proper dose build up of prestiq Fluoxetine can be tapered off slowly.

Bupropion is not for the current date and this is indicated if prestiq alone fails to yield results.

Amphetamines are addiction medications and indicated for residual symptoms of medication.

In case you feel that the current set of medications are working well or partially relieving depression I feel modafinil can be added to current regimen of medication.

I hope this helps you further.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Dr. Ashok Kumar Choudhary (24 hours later)
I appreciate the insight and help Dr. XXXXXXX

So you are basically saying my current meds only treat for an insufficient amount of serotonin, and that I should go with meds that affect two neurotransmitters. Is that right?

I'm an XXXXXXX living in Uzbekistan teaching at a university here, and I don't think the pharmacies have Prestiq (Desvenlafaxine) and Wellbutrin (Bupropion). It would be great if you could write me prescriptions for 4-5 months of these pharmaceuticals so I can order them from Canada or the US. The shipping is expensive so that's why I want to go with bulk.

Also, if you could write me a prescription for ketamine that would be great, too? I might be able to use it.

Anything else? During these 6 months of having a COVID-19 quarantine, my mental health has taken a big hit. I can't swim and do some other things that kept me more in balance.

Take care
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (6 hours later)
Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for follow up and requesting for prescription.

I am sorry to inform you that the land of law does not allow me to prescribe controlled medications through the online platform. The in person consultation is the only mode where you can get prescription for Bupropion and Prestiq in XXXXXXX

At the same time I do not feel the pharmacies in Canada or USA will honour my prescription as they are supposed to honour the prescription from a limited area (doctor registration state and country matter for them).

Meantime take care of your mental health by any possible activities such as stretching, meditation, yoga which can be practiced at home.

I hope this helps you.
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 : 3347 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
I Ve Had Depression For 16 Years And It S

Brief Answer: Consultation Detailed Answer: Hello, Thanks for using Healthcaremagic. I read your query and understand your concerns. First of all I like to inform you that so far there is no cure for depression although multiple options exists for treatment. Although I have limited details about the problems faced by you but the available details indicate it will be better to go for a medication witch hits at least two neurotransmitters such as Pristiq, Duloxetine or Milanacipran. Considering your sleep disorder, hypersomnia I feel Pristiq should be considered first choice. In case that does not help than the combination of Wellbutrin with pristiq can be considered. Since your current medications only target the serotonin that could be the reason for poor response in regard to long existing depression. ketamine is excellent choice but it is only approved for treatment resistant depression. I hope this helps you. Feel free to write back to me if you have more questions. Thanks and regards.