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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 8999
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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I was diagnosed with EBV a little over a year ago. I am having

Customer Question

I was diagnosed with EBV a little over a year ago. I am having major depression and the medicine that was prescribed for me is Viibryd 40 mg and paxil 40 mg. I have no energy and am sad all the time. I am 66 years old and retired last year and have not been able to do anything except stay around home because I do not feel good. Are there other meds out there that might be more helpful. Any advise is appreciated. Thank you.
Submitted: 10 months ago.
Category: Neurology
Expert:  Dr. Frank replied 10 months ago.
Hello. You are on a fairly high dose of two SSRI medications. There are other medications that can be used in addition to the SSRI medications. Rather than use two separate anti-depressants, depending on your symptoms, you use one and add another class of agent, a atypical antipsychotic medication, to balance the tiredness/fatigue that can come with high doses of SSRI medications. The ones most commonly used are Seroquel (quetiapine) or Abilify (aripiprazole), both at a very low dose. The two medications, an SSRI and the atypical antipsychotic work synergistically together to provide some energy, while increasing mood and affect. So that would be my medication suggestion, to ask your psychiatrist. Alternatively, there are now new non-pharmacologic treatments. One is TMS, or transcranial magnetic stimulation. I will attach a webpage on a center where TMS is done for resistant depression. Please get back to me if you have questions on this, and I will reply by chat line here. I can also call you if you wish to discuss this on the phone, I will put out the phone option box. JA charges extra, but if you want to speak on the phone, that is an option. Otherwise, if satisfied with this answer, please remember to rate this service by clicking on the rating stars, as that is how I am compensated for this work thanks *****
Expert:  Dr. Frank replied 10 months ago.
http://www.hopkinsmedicine.org/psychiatry/specialty_areas/brain_stimulation/tms/ Here is a webpage from Johns Hopkins in Baltimore, these sites are spreading across the country, because it is effective without medication side effects. Dr Frank