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Ask Dr. Ed Wilfong Your Own Question

Dr. Ed Wilfong
Dr. Ed Wilfong, Psychologist
Category: Mental Health
Satisfied Customers: 1528
Experience:  Twenty-five years treating all ages; Specialities: psychopharmacology & diagnosis, MMPI-2, testing.
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My 22-year-old son was diagnosed with severe Tourettes synd

Resolved Question:

My 22-year-old son was diagnosed with severe Tourette's syndrome and depression when he was very young. He has been having a great deal of trouble with his depression lately - I'm even thinking that he might be bi-polar. He also has some sleep disorders that have been tied to his TS. He sees a psychiatrist once every three months for medicine management. At this time he is on the highest doses possible of Effexor and Abilify. His psychiatrist has drastically cut back on his patient load due to responsibilities at his hospital. What is your suggestion for our next step? His depression is getting worse and worse. It seems as if he is either in a really good mood or he is so down nothing helps
Submitted: 7 years ago.
Category: Mental Health
Expert:  Dr. Ed Wilfong replied 7 years ago.
Yes, see if he will try something other than abilify. It is often ineffective with TS. The effexor is for depression and anxiety only. If he move him to something like seroquel it should help if he is bipolar and with TS (stay on effexor with it). Also, if he has been on effexor for a long time, he may want to try another antidepressant as they can lose effectiveness over time (year +). If on only 75mg, may want to just increse to 150-225mg.

Edited by Dr. Ed Wilfong on 3/2/2010 at 1:00 AM EST
Customer: replied 7 years ago.
He is actually taking 300 mg of Effexor. Do you think counseling would also be important, or is it more about getting him on the right medication?
Expert:  Dr. Ed Wilfong replied 7 years ago.
I think replacing the abilify is important, but mostly for tourettes. If 300mg of effexor is not adequate, it may not be working any longer.
All research shows that for depression, counseling plus medication is more effective than either alone. Having the added burden of TS to deal with, I would think it to be very important. If I had to choose, I would pick the medication, but I would hate to do that. Both is so much better.
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