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Ask Dr. Sophie ::Neurology & Psychiat...
Dr. Sophie ::Neurology & Psychiatry
Dr. Sophie ::Neurology & Psychiatry, Doctor
Category: Mental Health
Satisfied Customers: 2951
Experience:  Neurology and Psychiatry
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What exactly is Treatment-Resistant Depression I have major

Customer Question

What exactly is Treatment-Resistant Depression? I have major depression. My olny child, Danny age 17 at the time of his death, 4 years ago, distroyed me. I have taken Effxor XR 300 mg daily, Wellbutrin 75 mg daily (both morning) at night I take Seroquel 200 mg to 400 mg, Sonata 10 mg twice at night and Lunesta 3 mg. My depresstion right now 4 years later is no better than it was the day my son died.
Submitted: 7 years ago.
Category: Mental Health
Expert:  Dr. Sophie ::Neurology & Psychiatry replied 7 years ago.
First, I am sorry to hear your only child is gone and the grieving would never truly end for any mom in this tragic situation.

A psychiatrist may call it "abnormal grieving" since there are 5 described stages to grieving: Denial, Anger, Bargaining, Depression and Acceptance. Most people go through the 5 stages. In such tragic event as losing one's child, there is no set time on how long the grieving should last, however, most doctors would agree that grieving lasting more than one year and/or never reaching "acceptance" stage is concerning.

Other than the deep feeling of loss, there can be other reasons for your treatment-resistant depression such as an underlying health problem or another diagnosis that has not been identified. Health problems that may lead to refractory depression include thyroid disease, anemia, heart problems, chronic pain and anxiety. Other mental health diagnoses which may make depression difficult to treat are certain forms of bipolar disorder, panic disorder or post-traumatic stress disorder.

With treatment-resistant depression, typical pharmacologic therapy doesn't help a lot or does not help at all and symptoms like feeling sad, hopeless and disinterested in activities continue. Treatment-resistant depression generally requires trying many types of treatments to find out what works.

You have probably seen a psychiatrist who has prescribed the current therapies, and you may also benefit from seeing a psychologist or other mental health counselor. I would strongly suggest psychotherapy in addition to finding best antidepressant medication.

Sometimes the pharmacologic therapy does not work is because of what your body does with the antidepressant(s) and specifically the metabolism in your liver by so called cytochrome P450. The genotyping test can help predict whether your body can or can't process the drug and may help pinpoint which antidepressant may be better for you. This type of test may be available in a university setting.

Dr. Sophie ::Neurology & Psychiatry and other Mental Health Specialists are ready to help you
Customer: replied 7 years ago.
I accept your information, It is very helpful. If you would please tell me where I could go to get the cytochrome P450 Tet done. I live in Alabama but willing to travel within the U.S. Thank You again.
Expert:  Dr. Sophie ::Neurology & Psychiatry replied 7 years ago.
You are welcome, I am glad I could help.

I do not have a specific list of laboratories that do this testing, but you may inquire with Athena Diagnostics (, a major university medical center in your area or Mayo Clinic.

Best wishes.

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