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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10547
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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Ive been diagnosed with ptsd anxiety and manic depression i

Customer Question

ive been diagnosed with ptsd anxiety and manic depression i am currently taking 3 medications just to try and function daily ive been on same meds for 8 yrs now there not working anymore ive told my doctor he just increase dosage now im maxed out on some im really suffering please help me
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.
*This website DOES NOT constitute treatment and only provides information and advice. For treatment (therapy and/or medications) you must go to a licensed professional in your area. Please note that anything said here is not private or confidential, as this is a public forum.
Hello, I am so sorry that you are struggling with these symptoms of your PTSD and Bipolar Disorder (formerly called Manic Depression), I cannot imagine how difficult this is for you. I would like to ask you a few questions to get a better idea of what you are looking for, so that I can better assist you.
1. You mention that you are looking for help, but what exactly do you require help with? Are you looking for alternative medication ideas, treatment ideas, etc...?
2. What medications and doses are you currently using? And what previous medications and doses have you tried before?
3. You stated that you have currently been on your medication regimen for 8 years and they are not working anymore, when they were working did they alleviate your symptoms completely?
4. Are you currently undergoing any form of therapy in combination with your medication regimen?
Customer: replied 1 year ago.

yes they did work abilify 15 mg trazadone 150 mg zoloft 200 mg zanex 0.5 three times daily is there any other drug combos that might help me ive been having more than usual suicidal thoughts

Expert:  Dr. Z replied 1 year ago.
Thank you, ***** ***** tell me is the Trazodone used as a sleep aid medication (do you usually take it at night before going to bed)? Or are you using that to treat your anxiety and depression?
Expert:  Dr. Z replied 1 year ago.
Thank you for your responses as that helps me to better understand your situation. So your Zoloft is definitely at the highest dose, so switching to another antidepressant would be prudent in this case. Suitable antidepressants with great effectiveness are Lexapro and Remeron. Your doctor would have to gradually taper you off the Zoloft (typically reducing by 25mg every 7-14 days) and introduce and increase the other antidepressant. Also I want you to know that you have not maxed out on Abilify yet, as the maximum dose for Abilify is 30mg, so your doctor should consider increasing the Abilify to 20mg and then possibly increase upwards to 30mg after 2 weeks on 20mg/day. The Abilify increase should help to reduce these suicidal thoughts fairly fast. If your doctor does not want to increase the Abilify than switching to another atypical antipsychotic would be helpful; Latuda, Seroquel, or Geodon should be considered as all of these have great properties in treating depressive symptoms and preventing Mania as well. The Xanax can also be increased if your anxiety is very problematic, but I caution this because Xanax is a Controlled Substance and very physically addictive, so an increase will just cause more of an addiction. Or your doctor can consider switching you to Klonopin which is just as effective as the Xanax in terms of potency, and has a much longer half-life, so you only need to take it twice a day instead of 3 times a day. This may provide a greater 24/day coverage than the Xanax.
As for the Trazodone, I am not sure if you are using this as a sleep aid medication or as a treatment for your depressive/anxiety symptoms, so when you can get back to me on that, I would be happy to include that in my analysis of your medication regimen.
I hope this answers your questions and gives you some guidance on this issue. I truly wish you all the best and I hope that any future changes to your medication regimen lessen your symptoms. Please let me know if you have any questions or concerns as I am happy to assist and support you regarding this issue.
*If you are satisfied with my answer, I would appreciate it if you can provide me with a positive rating so that I can receive credit for helping you today. Thank you

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