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Dr. Vikas
Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2253
Experience:  MBBS ; M.D Psychiatry, MS. Health Informatics
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I'm a 44 female who's had depression throughout my life,

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I'm a 44 female who's had depression throughout my life, however it has never been quite this long and deep (almost debilitating). I am on Paxil 20 (higher dose does not help) and Abilify 2mg. I can't seem to tolerate other ssris or ssnis, but feel the need for another med. I'm am afraid to try lamictal with it's potential side effects and dependency. Please help!

Hi! You know, to give you the best answer, I think I should ask you a few questions first that will help define the problem and the situation.

The first question is about Viibryd. It is an SSRI but it's new, relatively. Has it been prescribed for you in the past?

Secondly, Abilify is prescribed most frequently for mood disorders like Bipolar Disorder. Is that a possibility here in your situation rather than just depression?

Another question in depression that's hard to relieve is trauma: Was there trauma or abuse in your childhood? What about alcohol or dysfunction in your family when you were growing up?

Have you also had psychotherapy?

Are you getting any treatment right now? If so, what type? How is it going?

If not, when was the last treatment? What type of treatment was it? Was it helpful?

Any extra information that will help, feel free to share.

I see you are offline at this time and I may be logged off until later tonight (US time) before you reply, but go ahead and reply to these questions and I’ll answer as soon as I log on again. Okay?

Dr. Mark

Customer: replied 4 years ago.

I've heard of Vybrid, but just didn't feel like dealing with another ssri. As far as I know I am not bipolar, the abilify was added on a few years ago because my paxil stopped working. I am currently seeing a psychiatrist occasionally, no psychotherapy currently, though I've have had psychotherapy in my 20's.

Customer: replied 4 years ago.
Relist: Incomplete answer.

I don't think Lamictal can be useful in your case considering the diagnosis of unipolar depression.

In your case, there are two very good alternatives to augment the current antidepressant Paxil.

You can discuss with your doctor about trying a combination of Paxil with Wellbutrin (Bupropion) if you are also having symptoms such as fatigue, lack of energy, poor concentration, sleepiness or Paxil with Mirtazapine (Remeron) if you are having insomnia in addition to depression.

Bupropion and Mirtazapine are not SNRI and act as a very good augmenting agent with a SSRI antidepressant like Paxil to augment its effect. These medicines may also counteract the sexual or gastrointestinal side effects if any due to Paxil.

If you have any other query please feel free to ask further.

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Kind regards

Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2253
Experience: MBBS ; M.D Psychiatry, MS. Health Informatics
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