Depression

Supplementing anti-depressants SSRIs

08/09/2008 01:44AM

Question:

I have clinical depression with anxiety treated with Effexor 75 mg and Cytomel .25 mcg for over a year. This helps but not enough as I am still depressed, low energy, lack of concentration, no joy, hard to get started daily, etc. Have tried the full range of SSRIs, most of which cause sleep disturbance of oversleeping or insomnia. I tried and failed increasing the dosage to 150-225 due to sleeplessness. Most other depression/anxiety drugs I have tried over last 15-20 years cause excessive drowsiness or insomnia. What can supplement this medical regime to effectuate its helpfulness. E.g., I have read about deplin. What medical doctor in Cuyahoga County Cleveland Clinic satelite system can help? Thanks.

Answer:

I recommend seeking a consultation from a specialist at Cleveland Clinic (G Tesar, L Pozuelo, to name just 2, but there are plenty of other good ones). Review in detail the doses and durations and effects of past antidepressants trials to identify remaining medication options. Then consider these non-pharmacologic options: cognitive therapy or interpersonal therapy for depression, daily self-management plans, exercise, sleep management, omega-3 supplements, light therapy. And never give up. There are many options. Some will work for you.

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Response by:

Lawson Wulsin, MD
Professor of Psychiatry and Family Medicine
Department of Psychiatry
Department of Family Medicine
College of Medicine
University of Cincinnati