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Suggest Treatment For Seasonal Depression

Posted on Fri, 11 Jul 2014

Question: I have what I believe is seasonal effective disorder, only it's during the warmer months rather than the cold winter months. I find myself depressed, unambitious, even hopeless. My therapists have offered nothing to offer except Xanax, and all that does it make me more tired. It's so sad to dread summer, which I do, starting around March every year. Can you help me?

Answered by Dr. Sunil Gupta (1 hour later)

Brief Answer:
Please see details below

Detailed Answer:
Hi,

I read your query and can understand your concern. If your depression is happening at the same time of a year every time, it can be termed as a seasonal affective disorder.

Frankly, xanax will not do anything for your depression except for decreasing your anxiety and if you continue taking it for longer periods of time, it might be possible that you become dependent on it.

You should talk to your psychiatrist regarding starting starting an anti-depressant, something like sertraline or escitalopram. And in your case, since you have had multiple episodes, I would recommend that the treatment be continued regularly if you respond well to that drug.

I do hope I was able to answer your query. Please feel free to ask any further questions that you might have.

Best wishes for a speedy recovery,

Dr. Sunil Gupta

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

Follow up: Dr. Sunil Gupta (3 hours later)

I've been taking sertraline and lithium for 15 years. They help other moods, but not the SAD.

Answered by Dr. Sunil Gupta (23 minutes later)

Brief Answer:
Please see details below

Detailed Answer:
Hi,

Thanks for following up. I am glad to know that you are already on treatment. However, I would have liked to know the doses of the medications that you have been taking.

Since, you are already on medications, I would consider two options. If the dose is not adequate, increase the dose. If the dose is adequate enough, consider alternate medicine or augment your medications. The other option that I would consider in you case can be lamotrigine. It can be effective in recurrent depressive disorders if lithium and sertraline at adequate dose is not helping.

I would like to know the current lithium level to ascertain that lithium levels are within therapeutic limits. I would have also liked to get thyroid profile investigated (T3. T4, and TSH) as many times, hypothyroidism is associated with long term lithium intake and also cause mood symptoms itself.

You can discuss these options with your psychiatrist and take steps accordingly.

I do hope that the above information was helpful. Please don't hesitate to ask any more questions that you might have.

Best wishes,

Dr. Sunil Gupta

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

Follow up: Dr. Sunil Gupta (16 hours later)

I take 100 mg of Lithium 3x/day, and two 100mg and two 50mg a day.

Answered by Dr. Sunil Gupta (3 hours later)

Brief Answer:
Please find details below

Detailed Answer:
Hi,

Thanks for following up. You are already on more than adequate dose of sertraline. For lithium, I would suggest a serum lithium level. The recommended level for lithium is .6 to 1 mEq/L. If the level comes to be low, the dose of lithium can be increased further.

If the levels are adequate, I would definitely recommend lamotrigine. The sarting dose is 25 mg/day and can be increased to 200 mg/day gradually depending upon response. In addition, the thyroid profile would be needed as I said in my last reply.

Please do ask any further queries that you might have. If you have none, please close the answer and rate the answer.

I do hope that you recover very soon from your symptoms. Best wishes.

Dr. Sunil Gupta

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