I am a psychiatrist. I would like to switch a patient from 300 mg Effexor to Celexa. I know how to taper the Effexor. But, when can I add in Celexa? I have tried Cipralex, Prozac, Effexor and Abilify, but the depression is not responding. All the routine laboratory tests are normal.
You seem to be dealing with a patient with treatment-resistant depression. What is the thyroid status of the patient? Since you have tried SSRIs (selective serotonin reuptake inhibitor) and the patient seems to be a non-responder to these, I feel that Celexa (Citalopram) will not benefit this patient. I suggest a mood stabiliser Lamotrigine 25 mg to the existing Venlafaxine. I would also consider a low dose of Olanzapine 5 mg at night as augmentation. You can also prescribe Bupropion 150 mg once daily to the existing combination. Let us wait for one month and look for at least 25 percent reduction in Hamilton depression rating scale scores. If still non-responsive, then you can add 25 mcg of Thyroxine to the current regimen and admit the patient for a course of electroconvulsive therapy (ECT). Thank you.
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.. is detrimental to healthy living. One should never mix Citalopram with alcohol and that too in sleep apnea patient.
The center of breathing in the brain in these patients is stressed as the patient is not getting oxygen properly and hence constantly ne Read full
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