A male asked:
anti-depression medications hello, my fiance suffers from depression and is on several antidepressents... zoloft 200mg, straterrn 60mg, celexa 50 mg, abilify 2mg. is there anything new on the market that might be better than this combination? side eff
3 doctor answers
Dr. Andrius Baskys answered
45 years experience Geriatric Psychiatry
The : The lethargy that your fiance is experiencing could be due to toxic side effects of multiple medications that this person is taking. It is important to keep in mind that a risk of side effects is directly proportional to the number of medications. In other words, the more medications a person is taking the more likely it is that he or she will experience significant side effects. One of the reasons physicians prescribe several antidepressants is a lack of benefit from one antidepressant. This could happen for a number of reasons, one of them being an incorrect diagnosis. Therefore, obtaining a second opinion to clarify the diagnosis could be a good strategy. There are other reasons why a drug may not be working, some of them genetic. For example, there are individuals whose genetic makeup is such that many antidepressants, even if taken in high doses, do not cross what is called the blood-brain barrier or bbb. This prevents the drug from acting on brain cells and synapses. As a result, drug treatment is ineffective while side effects could be significant. A gene responsible for antidepressant drugs passing through the bbb is called abcb1. Some people carry small variations called single nucleotide polymorphisms or snps in that gene. Certain snp combination could prevent antidepressant drugs from passing the bbb. There are also other genes that have snps preventing antidepressant drugs from working effectively. Nowadays a person can be tested for snps and antidepressant drugs selected for maximum effectiveness and least side effects.
Answered on Oct 3, 2016
Dr. Monika Heller answered
13 years experience Child Psychiatry
Options: There are several new medications on the market and new combinations that may be helpful. Additionally, there are other treatment of depression such as specific therapies and other options that can help medications work to their maximum potential.
Answered on Oct 4, 2016
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