Suggest Treatment For Severe Depression, Inattention, Poor Concentration And Fatigue

Posted on Sat, 11 Mar 2017

Question: I have been being treated for severe, recurring depression for 3 years. My Kaiser psychiatrist has me on Lexapro (20 mg) 1x a day and Xanax (.50mg) 3x a day. The program no longer seems to be working. I am developing narcolepsy and a bad ability not to focus or get tasks done. And my depression at times seems to be worsening. My brother ( a USC trained anesthesiologist) believes I am actually in a part of the ADD spectrum that would best be treated with Adderall. NOT the meds I am currently taking?
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Answered by Dr. Alexander H. Sheppe (3 hours later)

Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

Severe depression can mimic symptoms of ADHD -- inattention, poor concentration, and daytime fatigue are all actually symptoms of undertreated depression. I would not prescribe Adderall in this case because it wouldn't help with the underlying problem, which is the depression. I would recommend either increasing the Lexapro dose to 25mg or 30mg daily, or considering switching to a different antidepressant such as Zoloft, Effexor, or Pristiq.

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