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khagihara
khagihara, Doctor
Category: Mental Health
Satisfied Customers: 6587
Experience:  Trained in multiple medical fields for many years
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I am a 45 year old female who has suffered with depression

Customer Question

Good evening
I am a 45 year old female who has suffered with depression most of my adult life. I am also addicted to nicotine. I take 100 mg serep every evening. I also have a disorder with food. Sometimes food binges. I am therefore 20 kg overweight. I loose and put it back on. I have struggled with this most my adult life. I have read up a little about nicotine addiction and it affects dopamine . So I am guessing food must affect it too. Is there any advise you could give me . I am not a happy girl and am exhausted from having to motivate myself daily. I have recently tried to give up nicoretts gum. But have not managed. I have tried to be sensibly slim and have not managed. Can you advise me please. Much thanks Crystal
Submitted: 4 months ago.
Category: Mental Health
Customer: replied 4 months ago.
Please try emailing to the following email address.***@******.***
Customer: replied 4 months ago.
Thankyou
Expert:  khagihara replied 4 months ago.

Is serep correct spelling? What medications & treatments have you tried so far?

Customer: replied 4 months ago.
Serdep is sertaline 100 mg. I have nuzak, cilift.
Customer: replied 4 months ago.
I don't want to call it's to expensive.
Expert:  khagihara replied 4 months ago.

They are same kind of antidepressants called SSRI. n choosing a new antidepressant for patients who fail a selective serotonin reuptake inhibitor (SSRI), our general order of preference is serotonin-norepinephrine reuptake inhibitors, atypical antidepressants, tricyclics, and monoamine oxidase inhibitors. For patients with mild to moderate major depression who obtain little symptom relief despite repeated (eg, one to three) antidepressant switches, we suggest augmentation with a second medication and/or psychotherapy as second-line treatment, rather than additional trials of antidepressant monotherapy. In choosing an adjunctive drug, our general order of preference is second-generation antipsychotics, lithium, triiodothyronine, and a second antidepressant from a different class. However, it is reasonable to use these drugs in a different sequence. Among second-generation antipsychotics, our general order of preference is aripiprazole, quetiapine, risperidone, and olanzapine.

Patients with mild to moderate major depression who obtain definite symptom relief that is not satisfactory despite augmentation with different drugs (eg, two to four) should switch antidepressants as second-line treatment. Patients who do not respond satisfactorily to several (eg, three to nine) courses of first- and second-line treatments should receive repetitive transcranial magnetic stimulation as third-line treatment.

For patients with treatment resistant depression that is mild to moderate and is not responsive to first-, second-, and third-line treatments, other augmentation options include omega-3 fatty acids, folate, S-adenosyl methionine, or pramipexole.

Although electroconvulsive therapy (ECT) is usually reserved for severely depressed patients, it is a reasonable option for patients with moderate depression who are resistant to first-, second-, and third-line treatments.

Expert:  khagihara replied 4 months ago.

We recommend that smokers be managed with a combination of behavioral support and pharmacologic therapy. The combination of counseling and pharmacologic treatment can produce higher quit rates than either one alone. The first-line pharmacologic therapies for smoking cessation include nicotine replacement therapy (NRT), varenticine, and bupropion. In patients who are unable to quit with first-line therapy, we suggest adding another of the first-line therapies or nortriptyline for combination pharmacologic therapy or considering the use of nortriptyline monotherapy as second-line options

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