Q. I have been on a lot of antidepressants but I am no better. What can be done?
Hello doctor,
I am 65 years old, and I have seen a few psychiatrists from a young age. I have taken a lot of antidepressants. In the past, I have been on Anafranil, Zoloft, Aropax, Cymbalta, Pristiq, Lithium, Avanza, Amitryptiline, Allegron, Tofranil, and Luvox. I have not been on any antipsychotic or bipolar drugs. Now, I am on Parnate 10 mg times two per day and Xanax 1 mg. The doctor has asked me to take it for four to six weeks. I have been on it for four weeks now. I do not feel any better. I feel down. I like to stay at home. I do not want to socialize. I feel it is the end of my life. I am fine at the moment. I have had depression, OCD, and anxiety. I have also had low testosterone. I have blood pressure and diabetes problems. Is there any treatment for me? Any new drugs? I feel my psychiatrist wants to give up on me. He is not good to make any new treatment. Please suggest any new treatment.
Hello,
Welcome to icliniq.com.
If the testosterone levels are low, then it needs to be treated.
Also, you get a thyroid profile test, and vitamin D levels as a problem in them can also present similarly.
There are plenty of treatment options available.
You can discuss with your treating psychiatrist regarding adding Amisulpride or Aripiprazole. Some newer medications like Vilazodone can be given.
Seroquel (Quetiapine) is also known to help with depressive features, and rTMS (repetitive transcranial magnetic stimulation) is also quickly gaining popularity. Consult your specialist doctor, discuss with him or her and take the medicines with their consent.
Feel free to ask if you have any further queries.
Thank you doctor,
Yes, I agree with you. Currently, I am on Parnate. Will my doctor put me on the drugs you said? Can they be combined with Parnate? Can the rTMS be had now? Do I have to stop the Parnate? Please tell me. My testosterone is up now with treatment. My sex drive is not good for the last 10 years. I have had injections of 1000 mg of testosterone two times. There is not much difference. Can the doctor increase the dose? Please give me more advice.
Hello,
Welcome back to icliniq.com.
I have no experience with the Parnate (Tranylcypromine) though theoretically, Aripiprazole or Amisulpride can be added along with it in low doses. The only risk is that it can increase drowsiness.
It is better to taper off the Parnate (Tranylcypromine) and substitute it with other medicine.
The rTMS (repetitive transcranial magnetic stimulation) can be given along with the Parnate.
There is no use in increasing the dose of testosterone.
So, to sum up following options are available:
1. Add Amisulpride or Aripiprazole along with the Parnate (Tranylcypromine).
2. Taper off the Parnate and start Vilazodone or Seroquel (Quetiapine).
3. Opt for the rTMS along with the Parnate.
Feel free to ask if you have any further queries.
Thank you.
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