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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4020
Experience:  MD Psychiatry
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My 57 year old wife of 7 years has had periods of deppression

Resolved Question:

My 57 year old wife of 7 years has had periods of deppression over the last 10-12 years. Her doctor has prescribed Lexipro from time to time to help out. About 6 months ago she was going through a time of bazaar behavior-painting messages on the wall, dumping vitamins out on the table and throwing the bottle away....lots of strange stuff. She saw a note from a basketball official at a training camop I went to and mistakenly interpreted it as something from another woman and called 911.   The end result was her going to a psyciatrist who noty only gave her lexipro but geodon as well. At firt 20mg geodon and 10mg lexipro. The one thing I noticed was she stopped smilling and laughing and this lady smiles and laughs a lot--or used to. She decided to stop taking the geodon after 2 or 3 months but was unable to sleep that night and the next day ran back to the psyciatrist for more geodon--he gives it to her for free.    This story has evolved into a horrible place but I'm out od space.
Submitted: 5 years ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 5 years ago.
Hi there,

Welcome to Just answer !

I can understand your frustration as you are watching your wife suffer like this as a quiet spectator , and i agree with you to some extent that the drugs your wife has been placed on right now are not helping her , plus may even be causing some side effects , but i will also let you know that although the attitude of her psychiatrist is very unprofessional , but he has placed her on 1 anti depressant that is lexapro ( escitalopram ) and 1 antipsychotic that is Geodon ( ziprasidone ) which i feel are right mediations for her present condition , but as of now these medicatins are not acting effectively and are even causing side effects , as mentioned by you , so , in all i am with you on this , that her present teatment regime needs to be reviewed and to be changed for more effective drugs with least side effects . Also , i am not a big fan of geodon , as it has not been as effective as other antipsychotics such as risperidone or quetiapine or olanzapine.

So, first of all i believe your wife is presently suffering from Major depression with psychotic features or Psychotic depression , as her painting of walls , other bizarre behaviour indicate towards a psychotic picture , which has developed with an underlying long standing Major depression.

So, i suggest she nees to be placed on 1 anti depressant , 1 antipsychotic , 1 mood stabilizer and started on psychotherapy ( counseling in lay terms). I know , her psychiatrist has already placed on 1 anti depressant ( lexapro) and 1 anti psychotic ( geodon) since 6 months or so , but , they have not been effective , as your wife's symptoms have deteriorated rather improving . So, i mention below the regime that needs to be discussed with her present psychiatrist or a new psychiatrist if her present psychiatrist is not forthcoming and keeps on being hard to approach.And , the present drugs need to be stopped before starting the regime i am mentioning below .

1) 1 Anti depressant such as EFFEXOR XR , which is to be given as a single daily dose in morning , it has a long duration of action , works well through out the day and has less side effects also.

2) 1 Anti psychotic such as Risperdal or Seroquel or zyprexa , any one of the three to be chosen and let your psychiatrist decide on the dose and time of intake.

3) 1 MOOD STABILIZER such as Lithium or valpraote , again the one out of the two chosen needs to be decided on dose and time of intake by the doctor , i will suggest a low dose for the chosen mood stabilizer .

4) Psychotherapy or counseling needs to be started for your wife by a clinical psychologist , but this should be started after her psychotic features have been controlled , with the above mentioned medications , that means , after roughly 2-3 months . THE BEST psychotherapy for depression is Cognitive behavioural therapy (CBT).

The regime mentioned above needs to be maintained for atleast 6-8 months , and i am quite sure your wife will respond to it well and all her symptoms will be subsided.

So , i suggest you either discuss this treatment regime with her present psychatrist or since this psychiatrist is not cooperative and receptive to suggestions , you shall convince your wife to seek a new psychiatrist and discuss this regime with him/ her.

I wish your wife rapid recovery to the best of health

I hope my answer serves your query according to your satisfaction.

PLease press the ACCEPT button if you are satisfied with the answer as only then will i be credited for my service.

Regards..
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4020
Experience: MD Psychiatry
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