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Depression Taking A Toll
Dec 4, 2003

I have a question about depression and meds. I went off my anti-depressants (Celexa 10mg/day and Wellbutrin SR 300 mg/day) in July. Aug rolled around, a lot happened at work, at home, in my personal life and I became really depressed. Went back on the meds, started going to therapy. In mid October I found out I was HIV +. Wow, that news really showed me a new level of low.

So now we are at Dec 1. I am still at an all time low. I'm not as emotional as I was following the HIV+ news, but there are days when I feel so incredibly empty and alone. There have been a few external developments: I started HIV meds, My best friend is no longer really available to me, but nothing life-threatening. Should I ask my doctor to increase my Celexa dosage? Maybe switch to different meds? The one thing that I don't like about increasing the meds are the sexual side affects. I know I need to work through some issues and I am trying to do that with my therapist. However, the depression is starting to take a toll on my social and professional life. Thanks in advance for advice that you may have.

Response from Dr. Horwath

If you're still taking Celexa 10 mg, that's a very low dose. Usual adult doses are in the range of 20-40 mg/day. Increasing the dose is very likely to help you with your depression. I realize that the sexual side effects are difficult to tolerate, but it may be that you'll respond to a higher dose, and be able to taper back to a lower dose at a later time, when things are more stable for, and you've managed to work through some of the issues you mentioned.

If a higher dose of Celexa doesn't work for you, you might consider switching to another type of antidepressant, such as Effexor or Remeron. What you should not do is continue to suffer with your depression, because good treatment is available and can bring you relief from your symptoms and restore your social and professional life.



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