How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Kaushik Your Own Question

Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4037
Experience:  MD Psychiatry
9385906
Type Your Mental Health Question Here...
Dr. Kaushik is online now
A new question is answered every 9 seconds

heres hoping again...I have been suicidally depressed for

Customer Question

here's hoping again...I have been suicidally depressed for over five years now-hospitalisations 3 suicide attempts 1 by hypothermia and 2 by paracetomol overdoses but unfortunately I am still here-I take lamotrogine 25mg bd and aripiprazole 10mg marne...everything has been tried in my case and I am DESPERATE for an answer-Dr. Brims suggested ECT but I have been turned down for that...
Submitted: 11 months ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 11 months ago.
Greetings !

Welcome to the site.

I am Dr. Kaushik and i am a psychiatrist and i believe i can help you with your query.

I am sorry to learn about your long standing condition and i empathize with you.

Well i agree that ECT could have been a plausible approach to treat your condition but if that is not possible then i am mentioning below 2 very effective treatment options that you might not have tried so far.

1) 'California Rocket Fuel' that is a term used for combination of 2 anti depressants namely Effexor ( venlafaxine ) at dose of 37.5 -- 150 mg / day and Remeron ( mirtazapine ) at dose of 15-45 mg / day.

This 2 drug combination is usually used in treatment resistant cases of depression which does not respond to other drugs.

2) TMS ( Transcranial Magnetic Stimulation ) -- This is a new treatment modality of treating depression where in a magnetic field is created over the head and through it nerve cells of the brain are stimulated to treat depression.

Kindly see below to gain more information about this.

http://www.mayoclinic.com/health/transcranial-magnetic-stimulation/MY00185

So i have mentioned to you two alternative options both of which are very good and worth trying so you shall discuss them with your doctor and try them one after the other or still better will be to try both of them together which shall bring you results which no other treatment so far has been able to provide you.

I hope this helps.

Wish you all the best.

Please kindly leave a Positive rating if you are satisfied with the answer as only then will i be credited for my service.

If there is any further assistance needed please feel free to ask using the reply button.

Regards.
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4037
Experience: MD Psychiatry
Dr. Kaushik and other Mental Health Specialists are ready to help you
Customer: replied 11 months ago.

The doctors I have don't want to prescribe anti-depressants because my underlying diagnosis is bipolar disorder-how can I persuade them do you suppose?

Expert:  Dr. Kaushik replied 11 months ago.
Greetings !

Well with due respect to whosoever is treating you. he. must have known that use of an anti depressant is not contraindicated in bipolar disorder otherwise how is he going to treat tell depressive phase of bipolar disorder, you have been suffering from bipolar depression which warrants use of an anti depressant to counter it and if no anti depressant has been used so far then the use of California rocket fuel should be reserved for later. and. as of now an ssri. anti depressant like either lexapro (escitalopram) at dose of 10 mg /day shall be started so as to counter the depressive cognition and to make this addition more safe for the comfort of your doctor in terms of preventing manic episode you may ask the doctor to up the dose of either lamotrigine to 50 mg twice a day or aripiprazole to 20 mg,/day either of which will counter the use of anti depressant and balance it out so as to prevent manic episode if that is what your doctor dreads.

You shall discuss this with your doctor in as many words and hopefully he will see logic and reason  in this,

Regards
Customer: replied 11 months ago.

I have seen a psychiatrist in hospital after I have taken another paracetomol overdose and they have flatly refused to consider either California rocket fuel or TNS - what more can I say to the psychiatrists to persuade them do you think?

Expert:  Dr. Kaushik replied 11 months ago.
Greetings !

Well actually the circumstances in which you requested for California rocket fuel and TMS could be held responsible for outright refusal of the psychiatrists to acknowledge and comply with your requests for he same.

You shall agree with me that presenting yourself with a drug overdose and then seeking such treatment changes may not come across as an ideal way to deal with your prescribing psychiatrist since the psychiatrist will be doubly vary of your intentions after your such precarious actions.

So I reckon that you should try to follow the psychiatrist' s advice judiciously and invest your energy and time to become a committed and obedient patient so as to reinstate trust of his in you all over again which has been unfortunately tarnished by your impulsive potentially dangerous actions. Once you are able to win your psychiatrist' s trust then it will be much easier for you to convince him to get the changes in your drug regime done as per desires or at least your psychiatrist will be more open to he idea of listening to your views which at he moment he banishes away .

I hope this makes sense to you and gives you a direction to move in.

Wish you all he best.

Regards.

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/Dr.Keane/2013-8-20_204325_drkeane.64x64.jpg Dr. Keane's Avatar

    Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
  • http://ww2.justanswer.com/uploads/RE/resolutions66/2011-1-17_05728_IMG8202smilingeditedforJustAnswer.64x64.jpg Elliott, LPCC, NCC's Avatar

    Elliott, LPCC, NCC

    Psychotherapist

    Satisfied Customers:

    5024
    35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
  • http://ww2.justanswer.com/uploads/formybunch/2010-12-06_191055_img_0975.jpg Kate McCoy, M.Ed, NBCC, LPC's Avatar

    Kate McCoy, M.Ed, NBCC, LPC

    Therapist

    Satisfied Customers:

    3733
    Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
  • http://ww2.justanswer.com/uploads/DR/DrAkiraOlsen/2012-2-20_746_AkiraADpicmain.64x64.jpg Dr. Olsen's Avatar

    Dr. Olsen

    Psychologist

    Satisfied Customers:

    2336
    PsyD Psychologist
  • http://ww2.justanswer.com/uploads/norriem/2009-5-27_134249_nm.jpg Norman M.'s Avatar

    Norman M.

    Psychotherapist

    Satisfied Customers:

    2193
    UK trained in hypnotherapy, counselling and psychotherapy and have been in private practice. ADHP(NC), DEHP(NC), UKCP Registered and ECP.
  • http://ww2.justanswer.com/uploads/PsychologyProf/2010-07-15_171248_logos060400409.jpg Dr. Michael's Avatar

    Dr. Michael

    Psychologist

    Satisfied Customers:

    2177
    Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
  • http://ww2.justanswer.com/uploads/KURTEMMERLING/2010-07-23_215531_just_ask_picture1.jpg Steven Olsen's Avatar

    Steven Olsen

    Therapist

    Satisfied Customers:

    1727
    More than twenty years of expertise in counseling, psychological diagnosis and education