On Cymbalta And Diagnosed With ADHD. The Current Antidepressants Are Not Working. Suggest The Correct Treatment?
please help me doctor, and please let this be the proper treatment and data, help, advice, everything that will bring me back into the happy, playful, energetic . funny person i was so long ago please dr ..?? please. much sincerity XXXX XXXXXXX
Its a long and patient way ahead..
Detailed Answer:
Hello,
Thanks for choosing health care magic for posting your query.
I have gone through your question in detail and I can understand what you are going through.
There are basically three issues which are bothering.
1) Chronic depressive disorder.
2) Drug dependence.
3) Poor psycho social support.
We will try to address the issues one after other. The depressive disorder certainly needs to kinds of treatment. Firstly medications especially SSRI. Unfortunately cymbalta (duloxetine) is not a very popular and effective antidepressant. These days the first line medications are either one of these; venlafaxine,escitalopram, fluoxetine or bupropion. These drugs are very effective for depression. If the depression still doesn't respond then either lithium, olanzapine or quetiapine can be added to one of the antidepressants from the above list. Cymbalta is agood drug as well but it comes very down the list. Probably you can discuss with your psychiatrist regarding change of your antidepressant. Along with antidepressant change you can discuss with your psychiatrist about starting you on cognitive behavioural therapy. These therapies aument the medications and helping in the resolving of the issues. Especially with ongoing stress or like in your case, CBT can be useful.
Regarding your second problem of your drug abuse, i understand that you are doing well on methadone treatment. Ones your depression gets treated, the drug abuse problem will be lot easier to handle. Some motivational interviews along with your CBT will be good for you.
Lastly regarding the poor psycho social support, its difficult to manage all this alone. Especially with 2 kids with you, you would love to have some support. Why not try a new relationship. Probably someone who is sober and understanding who knows your situation well. If such support is not viable then your CBt therapist can be a good person to vent out your feelings.
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.
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bit.ly/dr-srikanth-reddy
Wish you good health,
Kind regards
Dr. Srikanth Reddy M.D.