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Doctor Rao
Doctor Rao, Doctor
Category: Mental Health
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Experience:  MBBS,MD,DPM,MRCPsych
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Hi Dr I was first diagnosed with major depression in 2005 and

Resolved Question:

Hi Dr I was first diagnosed with major depression in 2005 and was given trepiline. It worked wonders for me. I stopped taking it when relocated to a new town. After some few months I experienced the numbness of the left hand and low moods again. I went to see one of the psychiatrist in that town. She gave me cipralex and some other antidepressant and sleeping tablets because I struggle with sleep. Now all these worked for a while, then I stopped. I went to see her again when i got depressed she gave me some antidepressants. I relocated again and experenced extreme tiredness, that numbness, irritability, sleeplessness and fear. The psychiatrist I went to said it is anxiety. She gave me seroquel and cipralex. That did a trick for a while. Currently I'm not on any medication because I feel they are not helping me. I want to go back to trepilin. I told the previous psychiatrist that trepiline worked for me but they said it is an old drug. I want to try it again I was taking 3 tablets at night. What should I do should I ask the Dr to give me trepiline even if it is an old drug because it was working for me. I was on these other antidepressants for two years but they never helped. Nothing has ever worked for me like trepiline. Please help
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. G. replied 1 year ago.
I think requesting the medication that worked for you is the right thing to do. More than likely, the new psychiatrist needs your old records to see that the medication worked. If you find that you are not getting anywhere with this new psychiatrist then you might want to go to someone who will try the treatment that has worked for you. I would definitely stress to your psychiatrist the effectiveness of the meds you took. A last ditch effort might be for your old psychiatrist to talk to the new one.
Customer: replied 1 year ago.


Thanks Dr. I don't have the contacts of my old Psychiatrist anymore. Last time I talked to him he said I should check myself to a hospital and explain to them my history. That was in 2006 when I felt that depression is coming back. I was thinking of going to a normal GP to ask for a prescription of treipiline.

Customer: replied 1 year ago.
Relist: Answer came too late.
Expert:  Doctor Rao replied 1 year ago.
Hi It must be difficult for you.

I would briefly mention what we look in a person when looking at the cause as it is important to treat the problem.

I want you to understand the Depression and anxiety model. We generally look in to Depression by three factors.
1. Predisposing factors (the factors that might make you vulnerable, example, family history of depression Etc)

2.Precipitating factors (the factors that might bring the illness to surface Ex-alcohol or drug abuse,financial or relationship problems or any deaths in Te family)

3.Perpetuating factors (The factors that might maintain the illness, ex-ongoing Psychosocial problems,financial problems,other physical illnesses like diabetes, Hypertension or other chronic medical conditions)

If you are having any unaddressed/ongoing perpetuating factors we need to be mindful that the effectiveness of antidepressants would be partial.So, if you have it is important to look in to addressing them or minimizing their effect if possible.

Now coming to the question in specific, Please note that Trepiline although people consider it as a old fashioned antidepressant still very effective and efficient in treating depression. This is still one of the common medication used by neurologists for neuropathic pains,anxiety and depression by psychiatrists in some countries.

The advantage of Trepeline is because of the effects on anxiety and sedation to help sleep along with low mood.

Another important thing is there has been some research evidence available that if a person responded to an antidepressant int he past or if a family member responded to particular antidepressant the person might respond to it better.So, you can request a trial of Trepiline especially as two antidepressants failed to sustain the benefits after that.
I hope that will help, if not then you can discuss with your Doctor about Wellbutrin as it is also effective against depression and anxiety.

If there are no constraints with time or resources please also consider psychological therapies like Cognitive behavioral therapy (CBT) as the best evidence so far is for the combination of medications and CBT.

If you find the answer helpful,please provide positive feedback.

Thank you.


Doctor Rao, Doctor
Category: Mental Health
Satisfied Customers: 641
Experience: MBBS,MD,DPM,MRCPsych
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Doctor Rao
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