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Dr. K
Dr. K, Psychiatrist
Category: Mental Health
Satisfied Customers: 358
Experience:  15 years clinical experience in all areas of psychiatry. Holistic and practical approach.
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I have been taking antidepressants for 15 years. I take Venlafaxine

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I have been taking antidepressants for 15 years. I take Venlafaxine 75 mg tabs, two in the AM. I also take lithium carb 300 mg each as an enhancer, one in AM and one in PM. I am not bipolor. My depression is pretty well under control. My psychiatrist retired 5 years ago. My current family practioner wants me to increase my lithium to three pills per day. She says my lithium level is low. I know that once a year I always had a lithium test but somehow I had the impression it was associated with some organ (kidneys liver??). Do most people take antidepressants for life? I would like to slowly get off the lithium and get off the venlafaxine later on.

Tell your family doctor that just because the level is low doesn't mean the dose needs to be increased. We treat patients...not lab tests. If you feel like you're doing well overall with the current dose, there is no need to increase it. You can also remind your family doctor that you're not bipolar, and low lose lithium is used to boost the effect of antidepressants in patients with unipolar or "regular" depression.


Some people need these meds for life and some don't. If you've had 3 episodes of severe depression, there is a 90% chance that you will have another one...and staying on medications could prevent a recurrence.


I understand the desire to be off meds...the best way to try it is very slowly lower the dose of one med at a time...and do it at a time when there are no major stressors. If you lower a med and then have a major stress, it will be hard to know if you are feeling worse because of the lower dose.


Also, consider this: although I agree with the idea of not taking too much medicine, some people also do worse if they take too little. If you are tolerating the meds well with no major side effects, you may want to consider just staying on them.


I do for most of patients try a gradual dose reduction; this means once they are stable for at least 6-12 months we slower lower the dose of one med at a time to see how they do. I usually don't lower the dose any quicker than every 1-3 months to play it safe.

Let me know if you need more clarification. Take care.

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