Suggest treatment for suicidal thoughts despite taking Duloxetine
Patient: I take duloxetine Hc Dr 30 caps. 2 a day. But, I still feel like the world would be better off without me. Or maybe I would be better off with out the world. I lost my job about 4 months ago because the director of the nursing home I worked at told me he had to let me go because someone told I was crazy. This person wanted my job, even I knew that. But, I have not been able to get over it. I saw the director 2 weeks ago and he asked if I had lost my small ranch yet. When I said no he was very disturbed. I am having a hard time adjusting to being without a job. But, what he said about losing my ranch really bothers me. That is when started taking antidepressants. I just can t seem to get back to my old self. I am going to be 66 the 18 of this month and to tell you the truth it scares me. The last place I want to be is a nursing home at my age. Doctor: Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.  It's very disheartening to know about your condition at that age. As you rightly expressed about your suicidal thoughts inspite of taking Tab Duloxetine at adequate dosage, it's better to add on Tab Lithium low dose which effectively works to reduce suicidal thoughts and ideation. Consult your psychiatrist and discuss this with him and take a decision. Morning walk daily exercise for 2 to 3 days which makes you feel better, interact with your friends, watch movies, listen to songs, spend time with your family members. If possible, attend to cognitive behavior therapy sessions from clinical psychologist.  Hope I have answered your query. Let me know if I can assist you further.