Depression medication

Patient: I suffer from depression, I’m on Rimron, ativan2mg 4x daily, I still have know relief the only time I have a smile is when I use opiates, I’v been on every anti depression med. you can think of but like I said the opiate works the best. my question is do Dr. use opiates in the treatment of depression

Doctor: HelloThanks for using “Ask The Doctor” for posting your query.Opiates are not used for depression. The problem wit h opiates is that initially it may cause short-term feeling of well-being but, in the long run, it may lead to depression. Moreover, in the long run, there is a risk of dependence. If Remeron is not helping you then you may try other options like venlafaxine or desvenlafaxine or escitalopram etc. These all help in the depression. I would suggest that you should switch your current Remeron with 50mg of desvenlafaxine and if there is no improvement then you may increase it to 100mg.Do meet your Doctor and discuss these options.Hope this helps.Wish you a good health.