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Ask Dr. Kaushik Your Own Question
Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4642
Experience:  MD Psychiatry
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I am totally lost. I have had lot of abdominal surgery done

Customer Question

i am totally lost.
I have had lot of abdominal surgery done over the last few year and it stillnot right.
but I have been very depressed with this and have physical let myself go.
I am totally afraid to go out side my house.
I don't some day get out of bed.
I just don't know what to do.
I have tried over the year antidressants,and doctors and psychic and councillors,i get better for a while and but this this time it is worse than ever.
I physical want to get better,but I just don't have the energy to walk out the door I have made appts and then cancel them on the day as I too scared to take the step out
I have tried many time but I seem to be stuck in a totally rut.
Submitted: 11 months ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 11 months ago.


Welcome to the site.

Please tell me what all anti depressants have you tried so far and mention the medications that you are currently taking ?


Customer: replied 11 months ago.

i am currently taking nothing.

as my gp has taken me off everything for over 2years

as nothing seem to help after trying so many for over 30years,and inhospital treatment as well.

Expert:  Dr. Kaushik replied 11 months ago.

Thanks for the inputs.

Well, i can suggest you some very good anti depressant medications in combination which are used to manage Depression which is difficult to treat. Some good examples are as mentioned below.

1) Effexor XR ( Venlafaxine extended release ) at dose of 37.5 - 75 mg / day + Remeron ( Mirtazapine ) at dose of 15-45 mg/ day.


2) Lexapro ( Escitalopram ) at dose of 10-20 mg/ day + Lamictal ( Lamotrigine ) at dose of 25-100 mg / day. + Modafinil / provigil at dose of 50-100 mg/ day

In addition to any one of these two drug combinations, you will have to seek CBT ( Cognitive Behavior Therapy ) as a specialized therapy from a clinical psychologist to learn coping skills and strategies.

-- If for some reason you try and fail to reap benefits from any of these options then i would suggest that you may discuss the option of ECT ( Electro-convulsive Therapy ) UNDER THE SUPERVISION OF A Psychiatrist , this is also called as Shock Therapy in colloquial terms and it is consdiered to be very effective and safe option for treating Intractable or treatment resistant depression.

-- rTMS ( Transcranial Magnetic Stimulation ) which comes as a recent advancement in terms of managing treatment resistant Depressive cases, where in through magnetic stimulation one tends to counter depression, it requires the supervision and guidance of a psychiatrist. Kindly see the link below to learn more about this choice of treatment.

So kindly all of these options with your GP and if possible involve a psychiatrist to take a decision on the treatment modality that you will like to choose from the list mentioned.

I hope this helps.

Wish you all the best.

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