Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

1. This is severe major depressive disorder. This is absolutely not ADHD.

2. I would immediately discontinue all benzodiazepines, as these are making her depression worse, and will lead to addiction. I would also immediately discontinue all stimulants, as this is not ADHD, and stimulants worsen anxiety.

3. The adverse effects include worsening depression, worsening anxiety, addiction, dependence, and withdrawal. They cannot be used long term. I would stop all stimulants and benzodiazepines.

4. This is an insufficient antidepressant regimen. She needs to be on at least one SSRI (i.e. escitalopram, fluoxetine, sertraline), plus at least 450mg of Wellbutrin daily. Her depression will not improve until her antidepressant regimen is increased significantly.

5. I would stop dexedrine immediately, as noted above.

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