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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4643
Experience:  MD Psychiatry
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I have been diagnosed with Major Depressive disorder by my

Customer Question

I have been diagnosed with Major Depressive disorder by my psychiatrist with Kaiser. I am in my fourth episode in 30 years now brought on by my son leaving for college, divorcing my wife of 27 years and the sale of my home. I was on Lexapro for 7 and it pooped out. They tried Prozac for 2 months with no improvement, then put me on 40mg of Cymbalta with very limited effect, then 60mg to which I have responded to for the last 5 months, but I have noticed increased anxiety as of late. In addition, I still have suicidal iterations daily, and those too seem to be on the increase the last couple of weeks. I have asked to try Wellbutrin in addition to my Cymbalta which I will begin this week. My question is twofold: should I still be having suicidal iterations at all if I am stable, and in your opinion, would i be better off upping my dose of Cymbalta, rather than trying the Wellbutrin, trying both or trying a different medication altogether
Submitted: 9 months ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 9 months ago.
Welcome to the site.
I am a Psychiatrist and I believe I can help you with your query.
Well, had you been completely stable then the ideas of self harm or suicide would not be bothering you on and off, so the fact that you still have thoughts of self harm indicate that your Depression is still present and it gets flared up on and off, most likely due to overwhelming stress.
Now as far as your drug regime is concerned, increasing dose of cymbalta beyond 60 mg / day will be of little consequence or use , if any since beyond this dose the likelihood of further improvement in symptoms is bleak. Secondly, better than adding wellbutrin to assist cymbalta in dealing with depression, a much better move will be to add a mood stabilizer drug such as depakote or lamictal, any one of these two if added in once a day dose would give cymbalta the much required assistance and kick to deal with depression more efficiently.
So kindly discuss these options with your doctor , hopefully he will see reason in this suggestion and he may bring about this change for your own good.
I hope this helps.
Wish you all the best.
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