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Dr. Scott
Dr. Scott, Doctor
Category: Mental Health
Satisfied Customers: 819
Experience:  Physician
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My mother is currently taking the following medications for

Customer Question

Hello. My mother is currently taking the following medications for treatment of her depression and anxiety;
JA: How long have you been feeling this way? Have you reached out to anyone about this yet?
Customer: Lamotrigine 25mg
Lorazepam (Ativan) 1mg Anxiety
Vilazodone(Viibriyd) 40mg Depression
Aripiprazole (Abilify) 20mg
Bupropion 200mg x 2 tab
JA: Anything else in your medical history you think the psychologist should know?
Customer: 5 years ago she had what presented as a breakdown and was diagnosed as bipolar. since, it's been treated as depression/anxiety. she is 73 and since stopping working, depression symptoms have worsened. She has for a long time said she thinks of suicide. recently she was being treated only by her gp then went to a psychiatrist - both were giving her medication. now shes only all these meds and I feel like its too much. she seems 'out of it' and I'm very concerned.
Submitted: 8 months ago.
Category: Mental Health
Expert:  Dr. Scott replied 8 months ago.

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Expert:  Dr. Scott replied 8 months ago.

When is your next appointment with the psychiatrist?

She's on a lot of medications that are sedating her.

She needs a follow up with a psychiatrist to get off a couple of medications.

Her depression could probably be managed with just one of those medications.

However, you cannot taper off these medications without supervision because some of them have very bad withdrawals.

I would recommend close follow-up with the psychiatrist until you find a medication and dosage that appropriately treats her depression and anxiety without causing her to much sedation. Ideally, should be able to go back to work on one medication.

Major depressive disorder is a common and well-researched which is characterized by a persistent low mood, a lack of positive affect, and a loss of interest in usually pleasurable activities (anhedonia) that is different from the patient's usual self and causes significant distress or impairment for ≥ 2 weeks.

The prevalence of major depressive disorder in the United States is approximately 7% per year with a lifetime prevalence of 16.6% so it is very common.

If she is a harm to herself or others she should be immediately hospitalized.

The treatment for moderate-to-severe depression is a combination of an antidepressant plus psychotherapy.

An alternative would be electroconvulsive therapy (ECT) for severe depression if she is unresponsive to psychotherapy plus antidepressants or if there is an urgent need for rapid response (suicidal, food refusal, catatonic).

For most patients, optimal medications include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), mirtazapine, or bupropion.

I hope this helps!
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Expert:  Dr. Scott replied 8 months ago.

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