
Sir, I Have Been Taking Different Antidepressants From 1992 And

At present I am taking Zosert 100mg morning and 100 mg at evening from last about 2 years but still I faced many episodes of depression( no happiness, not interested in going to shop, not want to talk with anybody and remains silent all the time in my bedroom and not sleeping well).
On 22.05.2018 my doctor prescribed me Lamitor OD 100 mg to take at night including above zosert and I was feeling well to some extent for about three months and again I was depressed as mentioned above.
Then I met my doctor on 09/11/2018 and he prescribed me Bupron XL 150 to take after breakfast including above Zosert and Lamitor but again my position is same as mentioned above.
Now I am fed of these medicines because I feel I will be never happy again.
In view of the above information kindly advise me in detail what to do.
With regards,
Khurshid (16/11/18)

At present I am taking Zosert 100mg morning and 100 mg at evening from last about 2 years but still I faced many episodes of depression( no happiness, not interested in going to shop, not want to talk with anybody and remains silent all the time in my bedroom and not sleeping well).
On 22.05.2018 my doctor prescribed me Lamitor OD 100 mg to take at night including above zosert and I was feeling well to some extent for about three months and again I was depressed as mentioned above.
Then I met my doctor on 09/11/2018 and he prescribed me Bupron XL 150 to take after breakfast including above Zosert and Lamitor but again my position is same as mentioned above.
Now I am fed of these medicines because I feel I will be never happy again.
In view of the above information kindly advise me in detail what to do.
With regards,
Khurshid (16/11/18)
Consultation
Detailed Answer:
Dear Khurshid,
Thanks for using Healthcaremagic.
I read your query and understand your concerns.
From the available description it is almost clear that you are suffering with recurrent depressive disorder a kind of depressive disorder with poor response with antidepressant if prescribed alone.
Having said this I feel augmenting with other medications should be best strategy. The second choice is combining different antidepressants which has been already done over the last six months.
Considering the fact that you have sleep disturbance and low energy I feel dropping lamitor will be right thing to do after consulting your doctor.
Regarding the first choice the available options include antipsychotics, mood stabiliser or thyroxine.
Although the choice is determined after consideration of multiple factors I often consider either quetiapine (25-150mg) or olanzapine (2.5-7.5mg) (both antipsychotics) or lithium (300-900mg- mood stabilizer).
Regarding the second choice I feel Bupropion is an option which can be continued albeight at higher dose (300mg per day). This is potent antidepressant which prevents many of the side effects of Zosert and also helps in increasing the energy level and daytime activity.
I also like to inform you that any antidepressant prescription takes time to show effects. Since bupropion (Bupron XL) was added just one week back waiting for few more days will be appropriate to observe positive effects.
I hope this answers you.
Feel free to write back to me if you have more questions.
Thanks and regards.

Consultation
Detailed Answer:
Dear Khurshid,
Thanks for using Healthcaremagic.
I read your query and understand your concerns.
From the available description it is almost clear that you are suffering with recurrent depressive disorder a kind of depressive disorder with poor response with antidepressant if prescribed alone.
Having said this I feel augmenting with other medications should be best strategy. The second choice is combining different antidepressants which has been already done over the last six months.
Considering the fact that you have sleep disturbance and low energy I feel dropping lamitor will be right thing to do after consulting your doctor.
Regarding the first choice the available options include antipsychotics, mood stabiliser or thyroxine.
Although the choice is determined after consideration of multiple factors I often consider either quetiapine (25-150mg) or olanzapine (2.5-7.5mg) (both antipsychotics) or lithium (300-900mg- mood stabilizer).
Regarding the second choice I feel Bupropion is an option which can be continued albeight at higher dose (300mg per day). This is potent antidepressant which prevents many of the side effects of Zosert and also helps in increasing the energy level and daytime activity.
I also like to inform you that any antidepressant prescription takes time to show effects. Since bupropion (Bupron XL) was added just one week back waiting for few more days will be appropriate to observe positive effects.
I hope this answers you.
Feel free to write back to me if you have more questions.
Thanks and regards.


I WANT YOUR ADVISE/CLARIFICATION FOR BELOW MENTIONED POINTS IN EASY WORDS AS I AM NOT MUCH EDUCATED.FOR YOUR FURTHER INFORMATION I WAS A CHAIN SMOKER BUT I GAVE UP SMOKING FROM MARCH 2017
1. CAN I TAKE ZOSERT 200MG ONE TIME DAILY FOR MUCH EFFECTIVENESS, IS THERE ANY OTHER ANITDEPRESENT MORE EFFECTIVE/BRAND THAN ZOSERT
2. YOUR SUGGESTION IS TO DROP LAMITOR WHY ? IS IT NOT A MOOD STABLIZER ? SUGGEST ONE ALTERNATE MEDICINE . ARE YOU SUGGESTING ME TO TAKE ANTIPSYCHOTICS OR MOOD STABLIZER OR BOTH
3. CAN I WITHDRAW ALL MEDICINES BECAUSE I FEEL THEY ARE NOT EFFECTIVE ON ME.
WITH REGARDS,
KHURSHID

I WANT YOUR ADVISE/CLARIFICATION FOR BELOW MENTIONED POINTS IN EASY WORDS AS I AM NOT MUCH EDUCATED.FOR YOUR FURTHER INFORMATION I WAS A CHAIN SMOKER BUT I GAVE UP SMOKING FROM MARCH 2017
1. CAN I TAKE ZOSERT 200MG ONE TIME DAILY FOR MUCH EFFECTIVENESS, IS THERE ANY OTHER ANITDEPRESENT MORE EFFECTIVE/BRAND THAN ZOSERT
2. YOUR SUGGESTION IS TO DROP LAMITOR WHY ? IS IT NOT A MOOD STABLIZER ? SUGGEST ONE ALTERNATE MEDICINE . ARE YOU SUGGESTING ME TO TAKE ANTIPSYCHOTICS OR MOOD STABLIZER OR BOTH
3. CAN I WITHDRAW ALL MEDICINES BECAUSE I FEEL THEY ARE NOT EFFECTIVE ON ME.
WITH REGARDS,
KHURSHID
Follow up
Detailed Answer:
Dear Khurshid,
Thanks for follow up and sorry for delayed reply.
1. Regarding zosert it is ok to take full dose at a time as half life (frequency deciding factor in medications) is beyond 24 hours. The Daxid is brand which is available in XXXXXXX at almost similar price of zosert and probably better placed in compare to Zosert.
2. Regarding Lamitor, I like to make it clear that it is good medication for bipolar depression but for unipolar depression (as in your case) not much superior to any of the other mood stabilisers. However Lithium and Sodium valproate are more safer in compare to lamitor.
Adding one medicine at a time is better strategy rather than number of different medications.
3. I think this is not a well placed strategy and you are likely to encounter withdrawal effects.
I must acknowledge that the above statements are for general information and any change in medications should be made after consulting your doctor, who is better placed to recommend appropriate medication.
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 my future patients.
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.

Follow up
Detailed Answer:
Dear Khurshid,
Thanks for follow up and sorry for delayed reply.
1. Regarding zosert it is ok to take full dose at a time as half life (frequency deciding factor in medications) is beyond 24 hours. The Daxid is brand which is available in XXXXXXX at almost similar price of zosert and probably better placed in compare to Zosert.
2. Regarding Lamitor, I like to make it clear that it is good medication for bipolar depression but for unipolar depression (as in your case) not much superior to any of the other mood stabilisers. However Lithium and Sodium valproate are more safer in compare to lamitor.
Adding one medicine at a time is better strategy rather than number of different medications.
3. I think this is not a well placed strategy and you are likely to encounter withdrawal effects.
I must acknowledge that the above statements are for general information and any change in medications should be made after consulting your doctor, who is better placed to recommend appropriate medication.
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 my future patients.
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.


1. Is it better/effective to take zosert 200 or Daxid 200 daily one time after breakfast
or Zosert 100 or Daxid 100 daily two times after breakfast and zosert/Daxid 100 after dinner
2. Kindly tell me what is unipolar depression?
With regards

1. Is it better/effective to take zosert 200 or Daxid 200 daily one time after breakfast
or Zosert 100 or Daxid 100 daily two times after breakfast and zosert/Daxid 100 after dinner
2. Kindly tell me what is unipolar depression?
With regards
Follow up
Detailed Answer:
Dear khurshid,
Thanks for follow up.
Zosert can be taken in either way and is neither is superior or inferior to another. You take it in divided dosage or at the same time, effect will be similar.
Unipolar depression is equal to what is known as depression in common language. When the depression is part of bipolar disorder it is called bipolar depression.
I hope this answers you further.
Thanks and regards.

Follow up
Detailed Answer:
Dear khurshid,
Thanks for follow up.
Zosert can be taken in either way and is neither is superior or inferior to another. You take it in divided dosage or at the same time, effect will be similar.
Unipolar depression is equal to what is known as depression in common language. When the depression is part of bipolar disorder it is called bipolar depression.
I hope this answers you further.
Thanks and regards.


I AM SUFFERING FROM DRY MOUTH / THROUGHT AFTER I START BUPRON 150MG.KINDLY ADVISE ME HOW TO DEAL IT
WITH HIGH REGARDS

I AM SUFFERING FROM DRY MOUTH / THROUGHT AFTER I START BUPRON 150MG.KINDLY ADVISE ME HOW TO DEAL IT
WITH HIGH REGARDS
Follow up
Detailed Answer:
Dear Khurshid,
Thanks for reverting back to me.
For the dry mouth it is advisable to sip water as frequent as possible. However there is chance that with improvement in your depressive symptoms the dry mouth side effect will decrease over time.
I hope this helps you.
Thanks and regards.

Follow up
Detailed Answer:
Dear Khurshid,
Thanks for reverting back to me.
For the dry mouth it is advisable to sip water as frequent as possible. However there is chance that with improvement in your depressive symptoms the dry mouth side effect will decrease over time.
I hope this helps you.
Thanks and regards.

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