Hello--I am writing you on behalf of my 70 year old dad. He is severely depressed and has been like this for about 4 months (following a cancer diagnosis of my mom). His PC increased his Prozac to 60mg and added wellbutrin XR 300mg. but he is not improved at all. It is a debilitating depression. It is hard to find psychiatrists in the area of florida where he lives. His PC suggested dropping Prozac to 30 and trying 10mg Lexapro. We aren t sure what to do about the wellbutrin. Does that require a tapering off? And he also added metropol 50mg recently and wonder if that can cause side effects and if we should taper that off.
Hello, Thanks for putting your query on Chat Doctor. I can understand what you are going through. If I had similar patient visiting my clinic, looking at his age, I would have given him Mirtazapine 7.5 mg and then gradually raised to 15 mg as required. It is considered antidepressant of choice for elderly because of better side effect profile than other antidepressants. Wellbutrin is mischievous to sometimes worsen depression and bring suicidal thoughts so if the patient doesn't improve, it should be stopped. Metoprolol might have been added to meet hypertensive issues, and it should be continued. Hope I have solved your query. If you have further queried please feel free to ask.