Looking for advice on anti-depressants please

Have a very good 25-yr-old friend who has quite severe depression. Afraid to go to sleep, has lost all confidence and interest in life.
I'm wondering what the latest news/research is on current anti-depressants.

Thanks

I consider the anti-anxiety med that I was given 10 years ago a lifesaver. Zoloft. Now I take the generic version. Some doctors joke that Prozac should be in our drinking water. (No flames please.) I wish your friend a way toward calm, peace, and joy.

I'd think referring him/her to a psychiatrist would be more productive than trying to research medications on your own. If I had a young friend in this situation, I'd do what I could to reach out to his/her family, particularly if s/he doesn't have (and needs) funds for treatment. A psychiatrist likely would put him/her on low dosage of one or more medications, review progress (likely with some level of "talk" therapy) and adjust the medication(s) over time.

But if you're looking for people to advise "this is a great drug" I think that's going down the wrong road. Also, how would you or your friend access those medication(s)?

What apple44 said. Your friend should get a referral to a psychiatrist and talk to him or her about this. I don't think you can crowd source antidepressants very effectively. But I appreciate your concern for your friend.

Problem is she has Medicaid. Close to impossible to get an appt. I hate to generalize, but I've been to a number of Medicaid doctors with my friends, and they can be less than stellar. Thus, I'm doing a bit of research.
Free or reduced psych care can take a long time to get an appt, and she needs one immediately.

She's a refugee from Iraq. No family or money. I'm it.

krugle1, an internist is able to prescribe anti-depressants and anti-anxiety meds. My post was not to recommend a particular medication, but to say that being prescribed a medication (initially by an internist with follow-up psychiatrist) can be very valuable. Sometimes people are able to take the medication for a period of transition and then taper off.

You could google types of doctors and others (social workers? nurse practitioners? etc.) who can prescribe medication, and perhaps set up an appointment. The generic versions of some of these medications are not expensive, although returning to a doctor every two weeks for follow-up visits might be.

I hope there is a clinic of some kind. I would perhaps change the thread title or start a new thread asking for information about services for refugees. I know that Catholic Charities is very active up here in Maine. I hope your friend is connected to one or more support groups. I can only imagine the stress she is feeling.

This is for the general public as well as those who are having substance abuse problems.

Click the box that says "For Adults'

Have faith.........."A journey of 1000 miles begins with the first step"

https://www.highfocuscenters.com/adult-programs

Thanks lisat,
The federal Free Clinic system serves them, but it's pretty rough going there. Easy 6-hour wait, gruff employees.

Very tough to have no insurance and mental health issues.

author,
Have you ever been or know someone who's gone to High Focus? Thanks

The SSRI's are a godsend for many people. (Zoloft and Prozac being 2 common examples). Those are the antidepressants that are most commonly prescribed for depression and or anxiety. Where does this person live? Around here? In the city?

When I worked in a clinic we got psychiatrist names from those finishing training. GP's can prescribe.

krugle 1 My experience has been with several friends who have used the services of Low Cost Psychotherapy of Essex County.........All benefited from the program

The only problem is that involves a series of interviews and probably a few weeks before receiving their services.

The High Focus seems to offer a broader range of services and a faster track into their programs.

Always worth a phone call.

I'm not sure if this was what others were suggesting but contacting the mental health association of Essex County could be a good place to start. 973-509-9777http://www.mhaessex.org/

As for an IOP, High Focus is supposed to be good. I did Genpsych which I would recommend.

The 1st thing to do is get the blood test that will tell if she is likely to respond to SNRI (i think it is only for that type...don't know if it covers others like tricyclic or wellbutrin). Don't trust the doctors. A study showed that 50% of people diagnosed with bipolar did not have it and another study showed that 69% of people medicated for depression did not have it. I know a couple people that are under mental health care and the stories are horrendous. The alleged professionals are disinterested, give wrong info about medications, etc. None have ever spent enough time with the people to get an accurate diagnosis. One got services from the mental health association and it was pure nonsense. The worker was clearly passive aggressive and wildly inappropriate. The supervisors were indifferent. Technically, Zoloft is an anti depressant, not anti anxiety...but is used for anxiety. I've known of psychiatrists to quickly put people on high doses of strong meds quickly which is blatant malpractice. These doctors that couldn't care less took private insurance..including a golden state employee plan...its not just medicaid doctors it is all doctors.PCPs and other specialists are bad in my experience too. Mental health seems like the least caring specialty.

I do think NJ has a low cost clinic that serves medicaid patients in each county...try calling the state or county mental health office to see where the essex mental health clinic is (assuming she lives in Essex). These people usually have a significant wait list to get in for the 1st appointment, but at least you can make an appointment and not sit there for 6 hours.

She can go to an ER...and even voluntary admit herself. They might even try involuntary even if there is no evidence that she is suicidal. Trinitas and Overlook have very bad reputations. I'd have to look up others. I know someone that had a bad experience at Barnabas years ago, but I think they closed their psych unit.

I also know someone who was abused as a client of Catholic Charities. I would not recommend there.

Social Workers cannot prescribe meds.

As far as specific meds:

trazodone and silenor (doxepin) are good in low doses for sleep. Trazodone supposedly helps you fall asleep and Silenor helps you stay asleep. Unfortunately, Silenor is only a brand drug and the generic doxepin doesn't come in the right doses for sleep and the pills can't be split. Silenor is 3-6 mg. doxepin is 10mg for the lowest dose. Trazodone is cheap (i don't remember if that is the generic name or not). It used to be $4 for the generic at Walmart.

for anxiety..lexparo (SSRI i think) is used and probably has the least side effects...others are zoloft and celexa (which is an early version of lexapro).

actual anxiety meds are the benzodiazopines which can be very dangerous and quit working quickly....buspar and vistiril are better options to try first.

other sleep meds that are safer than benzos are ambien, lunesta, and a new one called Belsomra...Ambien and lunesta say you can take them longer, but they can stop working...

as far as anti depressants..there are a lot of types: SSRI, SNRI, tricyclic and another one similar to that, wellbutrin i think helps the 'n' neuro transmitter like and SNRI, but also one that starts with a 'D" i think, but not serotonin..

and then there are ones for psychosis or bipolar and the adjuncts....

some can be combined some can't

http://www.state.nj.us/humanservices/dmhas/home/hotlines/MH_DIRECTORY_by_County.pdf

I am guessing you would want a hospital that is a 'short term care facility'. They might just give an outpatient RX, but they might force in patient for a few days.

If her issues are all trauma induced, medication might not help.

I DON"T KNOW HOW ANYONE WITH ANY COMMON SENSE GOT THE IMPRESSION THAT I WAS TELLING YOU WHICH SPECIFIC DRUGS SHE SHOULD OR SHOULD NOT TAKE> THIS I CLEARLY NO MORE PRESCRIBING MEDS THAT THE WIKI PAGE ON PSYCH MEDS. HOW ANYONE CAME TO THE CONCLUSION THAT I WAS SUGGESTING YOU GET THESE MEDS ON YOUR OWN IS BEYOND ME.

PROACTIVE/INFORMED PATIENTS (AND THEIR FRIENDS) REGULARLY RESEARCH THEIR OPTIONS SO THAT HAVE KNOWLEDGE OF WHAT THEY CAN DISCUSS WITH THERE PERSONAL DOCTOR-INCLUDING ASKING FOR INFORMATION FROM NON MEDICAL LAY PEOPLE WHO HAVE BEEN THERE DONE THAT.....NOT TO MENTION I USED TO WORK IN THE MEDICAL FIELD MYSELF.

THIS POST WAS ONLY MEANT TO POINT OUT OPTIONS AND GENERAL INFO ABOUT THOSE OPTIONS.

I NEVER THOUGHT YOU WERE TRYING TO TREAT YOUR FRIEND ON YOUR OWN>>>THAT IS AN ABSURD ASSUMPTION-I ASSUMED YOU WERE JUST TRYING TO GET A HEADS UP ON WHAT THE POSSIBILITIES WERE ONCE YOU COULD GET TO A DOCTOR.

THE ATTACKS ON ME IS NONSENSICAL BULLYING!

What a complete load of *****.

bikefixed said:
What a complete load of *****.

hahaha

That's what I was thinking.

Glad you guys said it first. Although some of that post was of value, most was not helpful at all.

Again, there is no way (safely or legally) to get hold of any kind of mental health medication without seeing a physician of some kind. A primary care physician can give her something on an emergency basis while trying to work out how to get help in the long run, but I don't see any point whatsoever in a lot of lay people trying to advise a person we have never met on what kinds of mental health drugs they should be taking.

SMH.

Just lost an hour of my life trying to get mental health services for Medicaid or non-insured. Nothing is out there at all!! Three to four month waits, blah, blah, blah. What a country we live in.

What about an ordinary doctor? Even a straightforward internist can prescribe something for anxiety or depression if the need is urgent. Has she seen a doctor at all???

peggy,
That's what we will do, but her GP is not the greatest. But desperate times call for desperate measures.

It is sad that there are not better services available. I will say that these kinds of medications can be addictive (and, in fact, you need to be on them for a while and essentially become addicted in order for them to really work, at least in my experience.) They can be life-savers, but it can be a double-edged sword.

Very sad, sac. I'm sure our country would be in much shape if services were readily available.

While I'm on a roll: August 4 is first GYN appt I could get for her. She hasn't had a period for 3 years. A 2 month wait for Medicaid. Makes me scream.

It is sad, and more than a little frustrating. Is there a way to try another doctor for her?

My FIL, who died a few years ago, was also on Medicaid and had many health problems. At one point we realized he was extremely ill and that something had gone very wrong with the treatment he was getting.

His daughter, my SIL, made the rounds of all the various doctors he had been seeing and grilled them about the treatment he was getting. She ended up firing ALL of his doctors, including the general practitioner who had been making referrals to specialists willy-nilly (cardiac, kidney, hip replacement, gastro, endocrinologist). The only doctor who passed her exam was the nephrologist who had been working on his kidney issues.

Once she had gotten him to a new, smaller team of doctors she had handpicked, his medications were reviewed and dosages checked, and he became miraculously better. He lived for a couple more years after that with a much higher quality of life, despite advanced diabetes and kidney failure. He lived in Newark, BTW.

Bottom line is she should expect more and demand more from her doctors. People, even on Medicaid, have a right to good care and can do better than they might think if they hold the doctors accountable and don't just settle for what they think might be the best they can get.

I realize she is depressed and probably very discouraged, but perhaps a few phone calls could produce surprisingly good results? She doesn't have to settle for bad treatment just because she can't afford much.

You're a good friend to try to help with this.

krugle1 said:
While I'm on a roll: August 4 is first GYN appt I could get for her. She hasn't had a period for 3 years. A 2 month wait for Medicaid. Makes me scream.

This is not so strange, sad to say. Many if not most ob/gyn specialists are crazy busy. I had ordinary insurance and could have paid out of pocket for an appointment/exam, but couldn't get an appointment for a couple of months.

If she hasn't had a period in 3 years, though, you have to ask all kinds of questions. Could a regular doctor make an emergency referral and get quicker action?

I know, I'm being very pushy with you, and you are just her friend, not the patient. Again, it's good of you to take all this on for her.

1. You can call medicaid, explain the urgency, and then they will (possibly) find a patient advocate for her. The advocate will call some drs & try to find a more timely referral. I have seen this done.

2. Medicaid can pay for an out of network doctor if need be. They would have to decide if its needed and allow for it.

3. This is why many indigent people go to the ER - a way to get urgent attention. If she were in serious need for mental health help (needed urgently, in risk of causing harm to herself) then an ER would find help for her ASAP. They would possibly hospitalize her also which is a whole other ball of wax.

4. She really needs a therapist as well. If you can get an appointment with a therapist who felt she needed medication they would expedite a referral to a psychiatrist.

5. There must be a charitable group for refugees. I'd contact them. Sometimes drs do free or low cost work for referrals like this & an organization might know of who may help.

6. There are many "clinics" in the city that charge based on income. Washington Square Institute is one I am pretty familiar with. Psychiatrist on staff, very competent therapists. Fees can go pretty low! They are learning institutes for therapists who may be doing continuing ed. There must be something like this in NJ. Also, you can try any university who have psychology grad students supervised by experienced psychologists. If the client needs meds they will have a ready referral I'm sure. These student clinics my be free or charge a nominal fee.

peggy,

Having experienced Medicaid doctors through her, I am shocked at the sub-par level of treatment she has received. who are these doctors?? No wonder the poor die young. Smart move on your SIL. Sadly, I will be going to her PC appt with her, which is usually a 2 to 3 hour wait.

You are right, I'm going in with a new attitude. Thanks so much.

Jeff, that's why I'm asking about which antidepressants. Her doctor is a bit of a fool and I don't trust her. Normally, I would trust a doctor, but in this case....

krugle1 said:
peggy,
Having experienced Medicaid doctors through her, I am shocked at the sub-par level of treatment she has received. who are these doctors?? No wonder the poor die young. Smart move on your SIL. Sadly, I will be going to her PC appt with her, which is usually a 2 to 3 hour wait.
You are right, I'm going in with a new attitude. Thanks so much.
Jeff, that's why I'm asking about which antidepressants. Her doctor is a bit of a fool and I don't trust her. Normally, I would trust a doctor, but in this case....

Krugle, she needn't worry about which antidepressant. Her doc would have to be a complete fool not to know the proper dosage and I'm sure she does. She should have a trial of her doc's favorite antidepressant and evaluate it after 4 to 6 weeks. That would not be dangerous.

Thanks jeffl.