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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Depression At This Stage Be Treated?

My name is Katherine and I am 28, 175cm tall, about 65kg. And from Australia. I have been suffering from major depression for about 5 years. I have tried a few different anti-depressants and I am currently on Effexor 300mg daily, with Seroquel to augment the AD. However, I only take Seroquel on occasion when I cannot sleep, because if I take it during the day it makes me too drowsy. I see a psychologist once a week, but this has made things both better and worse. There are no psychiatrists in my area that my GP is willing to recommend, she doesn't think any will be any good, but there is one 2 1/2 hrs away I can go to. Both my parents died when I was young - my father when I was 5, my mother when I was 16. I developed complicated grief after my mothers death, which ended in more ongoing depression. I went through a lot of trauma after my mother died, because my step-father remarried right away, and had legal rights to everything and basically kicked us out. I went to live with my older sister and was treated quite badly, who was addicted to amphetamines. I was, and still am, quite badly affected by the experience. My questions are, what would be the next steps in treating my depression? It is quite severe. I keep failing uni year after year because I just don't care anymore, about anything. And I feel like nothing works, and I'm never going to get well again. It's been years, and Effexor is the only medication that has had a good effect, but I feel I need to go up in dosage again. I also have quite bad anxiety. I don't want to do a anything like ECT, what are the most effective non-medical therapies? My GP has already mentioned exercise, importance of close relationships etc
Thu, 5 Feb 2015
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Psychiatrist 's  Response
Hello thanks for asking from HCM for your health related queries

I have gone through your query and I can understand your problem. It was very difficult situation in your childhood and this has caused precipitation of depression in you. You are a healthy female with good height and average weight. You are taking Venlafaxine regularly for depression but Quetiapine or Seroquel only on SOS basis for sleep.

First of all I would like to tell you that seroquel is not a drug that can be used exclusively for sleep. The drug has been used in your case to augment the effect of venlafaxine and taking the drug on SOS basis will not serve the purpose. So you should start taking the drug regularly. If the drug is making you drowsy in day time then you can take the drug in evening time only, but regularly as per your prescription.

ECT is the option for severe depression not remitting to drugs so no need to fear from that. If symptoms persist even with these drugs you can go for other augmentation drugs like Lithium or Lamotrigine. These drugs will help to keep away symptoms of resistant depression. Try to forget your bad past and keep trying for your present and future. It is difficult but with efforts you can move past this phase of life.

Cognitive therapy can also help you to remove abnormal faulty distortions.

Thanks, hope this helps you. Visit a psychiatrist for prescription of drugs.
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How Can Depression At This Stage Be Treated?

Hello thanks for asking from HCM for your health related queries I have gone through your query and I can understand your problem. It was very difficult situation in your childhood and this has caused precipitation of depression in you. You are a healthy female with good height and average weight. You are taking Venlafaxine regularly for depression but Quetiapine or Seroquel only on SOS basis for sleep. First of all I would like to tell you that seroquel is not a drug that can be used exclusively for sleep. The drug has been used in your case to augment the effect of venlafaxine and taking the drug on SOS basis will not serve the purpose. So you should start taking the drug regularly. If the drug is making you drowsy in day time then you can take the drug in evening time only, but regularly as per your prescription. ECT is the option for severe depression not remitting to drugs so no need to fear from that. If symptoms persist even with these drugs you can go for other augmentation drugs like Lithium or Lamotrigine. These drugs will help to keep away symptoms of resistant depression. Try to forget your bad past and keep trying for your present and future. It is difficult but with efforts you can move past this phase of life. Cognitive therapy can also help you to remove abnormal faulty distortions. Thanks, hope this helps you. Visit a psychiatrist for prescription of drugs.