I have depression despite medication. What else to try?

Question

Hello doctor,

I have been having depression, anxiety, shoulder blade pain, and headache at the back of my head (migraine), and fatigue is destroying my life.

Now I have been ill for about two years, and doctors here in my place gave me Pregabalin, Amitriptyline, Olanzapine, Fluoxetine, and Duloxetine separately, but they did not work for me.

I am a student, and I am unable to study right now.

Please help me.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

The medications you have that were prescribed to you, Pregabalin, Amitriptyline, Olanzapine, Fluticasone, and Duloxetine, are all legitimate options, but the fact that they have not worked means a different approach is needed.

A few things you must discuss with a doctor are:

You need a complete re-evaluation by a psychiatrist.
It is important to rule out any other underlying conditions that might mimic these symptoms.
Tell the psychiatrist exactly which medications you took, at what doses, and for how long. They need this history to avoid repeating failed treatments.

There are still many other classes of antidepressants and combinations that can be tried. Medication alone is often not enough.

Cognitive behavioral therapy is highly effective for both depression, anxiety, and managing chronic pain. It can give you the tools to change thought patterns and cope with your symptoms.

A check-up with a good orthopedist is suggested for the shoulder blade pain, which could be useful to rule out a physical cause. Often, stress and anxiety cause severe muscle tension that leads to this kind of pain and headaches.

Physical therapy or massage might help you as well.

I hope you find this helpful.

Reach out to me anytime for more queries.

Thank you and take care.