Dr. S. Adithya
Psychiatry
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I want recommendations for depression medication. I have been diagnosed with depression and ADHD. I have used Escitalopram and Bupropion successfully, but I developed a ringing in my ears that became too difficult. So the doctor gave me Lamotrigine and Bupropion, which made me grumpy and miserable and caused headaches.
Do you have any recommendations?
Thank you.
Hi,
Welcome to icliniq.com.
Please elaborate more on your symptoms.
Since how long have you been on these medications?
Did you perceive any improvement with the above medications?
Thank you.
Patient's Query
Hi doctor,
Thank you for your answer.
I have had depression for ten years but did not know it until three years ago. I took Lexapro and Wellbutrin together for three years, and it worked wonderfully. I felt happy, relaxed, and motivated.I was in a great mood. slow to anger, and patient. I stopped taking it because my tinnitus became extremely loud, and that is one of the side effects of Lexapro. I also wanted to get a spect scan at a clinic to understand my brain's state better. So I wanted a good baseline without any drugs influencing the scan.
The scan confirmed depression, ADHD, and mood swings. So the doctor wanted to try Lomotragine. I took it for three months, but it made me angry, giving me headaches and burning my stomach when I took it. So I tapered off it about a month ago and started taking Lexapro and Welbutrin again. Unfortunately, the ringing got louder, so I stopped taking it a week ago.
I am struggling with depression and demotivation now. I am a CEO and own several companies. I have never had a problem with motivation. Happiness and anger are my problems. Not being able to find joy in anything, not being able to laugh, and being angry for no reason. I need to make an appointment with the doctor, but I wanted to have a chance to research some options before I talk to him. I want to find something that works like the Lexapro without the ringing. Unfortunately, the ringing has not gone down yet. Hopefully, it will go down some over the next couple of weeks. Otherwise, I will go back to Lexapro.
Thank you.
Hi,
Welcome back to icliniq.com.
Great that you had significant improvement with Escitalopram (Lexapro).
I wanted to make you aware of a few things.
1) It usually does not cause any ringing sensation in the ears. However, you need an ENT (ear, nose, and throat) specialist to evaluate ringing in the ears, which might be tinnitus.
2) So far, no investigations have been approved to diagnose depression, mood swings, or ADHD by scans. SPECT (single-photon emission computerized tomography) scan is not confirmatory. These are diagnosed only through interviews, not by any investigations.
3) I would recommend you take Lexapro (Escitalopram) again since you have improved with it in the past.
Thank you.
Patient's Query
Hi doctor,
Thank you for your answer.
There was a complete evaluation. Unfortunately, the SPECT scan was only one part of the program. I will look into an ENT specialist.
Thank you.
Hi,
Welcome back to icliniq.com.
Try doing physical exercises every day. Deep breathing exercises, talking to close ones who listen to you, and listening to music would also benefit you.
Thank you.
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Psychiatry
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