Resistant Depression


Q: Hallo

I had treatment resistant depression with no results...SSRI induced too much apathy and lethargy and did nothing for me, the same way effexor/symbalta/wellbutrin...lamictal was also used but there was too many side effects.

Now we want to try strattera...i'm the 3 day on it, and have tiredness but a little more focus...My main problem is depression with anxiety and low motivation...Maybe Strattera and Zoloft or Lexapro will be good combo. I just want to know your opinion.

I'm from Moscow (Russia), so sorry if my English is not too good :)

Symptoms:  Apathy, depression, depersonalization, anxiety, lack motivation

A:   Hello,
Thanks for choosing "Ask The Doctor" for posting your query.
Strattera (atomoxetine ) is a good medicine for depression and being a stimulant, it will improve the attention symptoms as well. Now that you have just started on strattera, it would be wise to try a mono therapy for 3 weeks at least and if there is no response, only then the combination of medicines can be used. May be you can then add up venlafaxine or sertraline along with the strettera.
Also among the options for resistant depression are :
1) Adding a mood stabilizer like valoproate or lithium.
2) Adding thyroid supplementation.
3) Ketamine injection therapy
4) Electro Convulsive Therapy.
Even Strattera and Zoloft or Lexapro will be good combination.
Hope I am able to answer your concerns.

Wish you good health!

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