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Suggest Treatment For Severe Depression
Question: I am suffering from my third major bout with depression. I a m male 50 with a good supportive family but a very pressure packed job. Cymblta helped me for many years. It quit working 6 months ago and I have tried wellbutrin, pristiq, and now effexor xr with no success. I had a gene test that ruled out using ssri meds and recommended adding deplin which I have. sure sI try all natural supplements instead of anti depressanats. lastly, 30 years ago my birst episode was helped greatly by elavil.
Brief Answer:
I think TCA should be preferred
Detailed Answer:
Dear XXXX,
Thanks for using Healthcaremagic.
I read your query and understand your concerns.
Considering the history of good response with elavil and cymbalta in the past I am of the opinion that whatever we try the medicine should act on both serotonin and norepinephrine receptors. This is because the early response informs us about what may act.
I am of the opinion that nortryptiline or desipramine will be better option over elavil and other TCA medications because of less severe side effect profile and better tolerability.
I do not think you need to lose hope as good response in the past clearly indicates that you will overcome this depressive episode in couple of weeks.
I hope this answers you.
If you have more questions feel free to write back to me.
Thanks and regards.
I think TCA should be preferred
Detailed Answer:
Dear XXXX,
Thanks for using Healthcaremagic.
I read your query and understand your concerns.
Considering the history of good response with elavil and cymbalta in the past I am of the opinion that whatever we try the medicine should act on both serotonin and norepinephrine receptors. This is because the early response informs us about what may act.
I am of the opinion that nortryptiline or desipramine will be better option over elavil and other TCA medications because of less severe side effect profile and better tolerability.
I do not think you need to lose hope as good response in the past clearly indicates that you will overcome this depressive episode in couple of weeks.
I hope this answers you.
If you have more questions feel free to write back to me.
Thanks and regards.
Above answer was peer-reviewed by :
Dr. Raju A.T
Would you think maybe after ten years of cymbalta I have fooled my body into a lack of seratonin production. Should I consider supplements like 5 htp to boost the levels in the brain? Any other possible supplements other than the dealing which I take
Brief Answer:
Follow up
Detailed Answer:
Hello,
Thanks for follow up.
I do not think anything can be responsible for low serotonin in your body other than the unknown reasons. The science despite substantial advancement an not explain many of the things in regard to depression and same is applicable to your question.
I am not sure whether it fooled your boy or not but I am sure that cymbalta helped for a long time. We can say that it is no more effective does not mean that it caused any deterioration in functioning.
I do not find any harm with use of nutritional supplements. 5HTPn is one and the second most preferred in the list is S Adenosyl methionine. Another thing which I commonly use in my patients is vitamin D supplements.
I must acknowledge that they are not the product to treat the depression but they may help the prescription medications.
I hope this helps you further.
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:
Hello,
Thanks for follow up.
I do not think anything can be responsible for low serotonin in your body other than the unknown reasons. The science despite substantial advancement an not explain many of the things in regard to depression and same is applicable to your question.
I am not sure whether it fooled your boy or not but I am sure that cymbalta helped for a long time. We can say that it is no more effective does not mean that it caused any deterioration in functioning.
I do not find any harm with use of nutritional supplements. 5HTPn is one and the second most preferred in the list is S Adenosyl methionine. Another thing which I commonly use in my patients is vitamin D supplements.
I must acknowledge that they are not the product to treat the depression but they may help the prescription medications.
I hope this helps you further.
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.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I sincerely promise to close this thread and give you a glowing review. I am trying to mentally figure out how cymbalta has quit but that in your opinion a tricyclics attacking the same receptors might work. Can you shed some basic knowledge on why you feel this will work. This might be a job for you but I am trying anything to regain my personality back. Life is a battle at the moment. Sincerely. XXXXXXX
Brief Answer:
Follow up
Detailed Answer:
Dear XXXXXXX
Thanks for follow up.
As communicated earlier there is no definite cause for this but it is postulated that there is upregulatuon of receptor where cymbalta works due to unknown reasons.
However it has been found that same receptor responds to other molecules in normal fashion. This is the reason I said TCA should work despite absence of action by cymbalta.
I hope this clarifies.
Thanks and regards.
Follow up
Detailed Answer:
Dear XXXXXXX
Thanks for follow up.
As communicated earlier there is no definite cause for this but it is postulated that there is upregulatuon of receptor where cymbalta works due to unknown reasons.
However it has been found that same receptor responds to other molecules in normal fashion. This is the reason I said TCA should work despite absence of action by cymbalta.
I hope this clarifies.
Thanks and regards.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Remy Koshy
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