Depression, weight loss, have knee replaced. On metformin and lesinopril. Suggest?
Patient: My husband suffers from depression . He was injured at work and we had to deal with Worker s Comp. for 22 months. He had to have total knee replacement and the surgeon has told him he won t be able to return to work. He has applied for dissability but because he s only 47, he was turned down. We have a lawyer and feel he s doing a good job. My husband feels like he should be taking care of his family and of course, staying inside all day certainly doesn t help. Our doctor has tried him on Celexa (29 mg) and Effexor (150 mg). He had 1 refill left on the Effexor so he started taking it again. With all the medicines out there, we don t know which might be best for him. He has an appointment next week with anothe doctor to get a second opinion. He has been on Metformin and Lesinopril but has stopped those since his weight loss from close to 270 down to 217. He s such a wonderful person and am not giving up on getting him help. He just gets very frustrated trying different meds. Any advice you can give will be greatly appreciated! Thanks in advance. I m sorry I can t pay this since I am the only one working. But thank you anyway. Doctor: Hi there ~  I understand that not being able to work can be handicapping in a lot of ways for a lot of people.  In your husband's case, I am sorry that his disability petition was turned down.  If effexor had helped him before, it would be prudent to go back on that medication until he sees a doctor.  However please watch for any side effects, most commonly gastrointestinal (nausea and vomiting) and increase in blood pressure.  Celexa is also an effective adjuvant medication for depression.  I am glad that he is working on making his day better.  I hope he is eating at regular times and sleeping well, not too much not too little.  Activity makes depression better, so the more he does with his hands the better he would be with his depression.  I would not bother too much about the weight loss.  Please wait for the doctor's appointment to see what the doctor says.  I hope this helps.  Take care and have a nice day !