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Ask Dr. Kaushik Your Own Question
Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4661
Experience:  MD Psychiatry
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Here's hoping again...I have been suicidally depressed for

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here's hoping again...I have been suicidally depressed for over five years now-hospitalisations 3 suicide attempts 1 by hypothermia and 2 by paracetomol overdoses but unfortunately I am still here-I take lamotrogine 25mg bd and aripiprazole 10mg marne...everything has been tried in my case and I am DESPERATE for an answer-Dr. Brims suggested ECT but I have been turned down for that...
Greetings !
Welcome to the site.
I am Dr. Kaushik and i am a psychiatrist and i believe i can help you with your query.
I am sorry to learn about your long standing condition and i empathize with you.
Well i agree that ECT could have been a plausible approach to treat your condition but if that is not possible then i am mentioning below 2 very effective treatment options that you might not have tried so far.
1) 'California Rocket Fuel' that is a term used for combination of 2 anti depressants namely Effexor ( venlafaxine ) at dose of 37.5 -- 150 mg / day and Remeron ( mirtazapine ) at dose of 15-45 mg / day.
This 2 drug combination is usually used in treatment resistant cases of depression which does not respond to other drugs.
2) TMS ( Transcranial Magnetic Stimulation ) -- This is a new treatment modality of treating depression where in a magnetic field is created over the head and through it nerve cells of the brain are stimulated to treat depression.
Kindly see below to gain more information about this.
So i have mentioned to you two alternative options both of which are very good and worth trying so you shall discuss them with your doctor and try them one after the other or still better will be to try both of them together which shall bring you results which no other treatment so far has been able to provide you.
I hope this helps.
Wish you all the best.
Please kindly leave a Positive rating if you are satisfied with the answer as only then will i be credited for my service.
If there is any further assistance needed please feel free to ask using the reply button.
Dr. Kaushik and other Mental Health Specialists are ready to help you
Customer: replied 3 years ago.

The doctors I have don't want to prescribe anti-depressants because my underlying diagnosis is bipolar disorder-how can I persuade them do you suppose?

Greetings !
Well with due respect to whosoever is treating you. he. must have known that use of an anti depressant is not contraindicated in bipolar disorder otherwise how is he going to treat tell depressive phase of bipolar disorder, you have been suffering from bipolar depression which warrants use of an anti depressant to counter it and if no anti depressant has been used so far then the use of California rocket fuel should be reserved for later. and. as of now an ssri. anti depressant like either lexapro (escitalopram) at dose of 10 mg /day shall be started so as to counter the depressive cognition and to make this addition more safe for the comfort of your doctor in terms of preventing manic episode you may ask the doctor to up the dose of either lamotrigine to 50 mg twice a day or aripiprazole to 20 mg,/day either of which will counter the use of anti depressant and balance it out so as to prevent manic episode if that is what your doctor dreads.
You shall discuss this with your doctor in as many words and hopefully he will see logic and reason  in this,
Customer: replied 3 years ago.

I have seen a psychiatrist in hospital after I have taken another paracetomol overdose and they have flatly refused to consider either California rocket fuel or TNS - what more can I say to the psychiatrists to persuade them do you think?

Greetings !
Well actually the circumstances in which you requested for California rocket fuel and TMS could be held responsible for outright refusal of the psychiatrists to acknowledge and comply with your requests for he same.
You shall agree with me that presenting yourself with a drug overdose and then seeking such treatment changes may not come across as an ideal way to deal with your prescribing psychiatrist since the psychiatrist will be doubly vary of your intentions after your such precarious actions.
So I reckon that you should try to follow the psychiatrist' s advice judiciously and invest your energy and time to become a committed and obedient patient so as to reinstate trust of his in you all over again which has been unfortunately tarnished by your impulsive potentially dangerous actions. Once you are able to win your psychiatrist' s trust then it will be much easier for you to convince him to get the changes in your drug regime done as per desires or at least your psychiatrist will be more open to he idea of listening to your views which at he moment he banishes away .
I hope this makes sense to you and gives you a direction to move in.
Wish you all he best.