What other psychiatric treatment options are there in Singapore if prescriptions like SNRIs and SSRIs are ineffective?

Doctor's Answers 1

SSRIs (serotonin specific reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors) are medications that are commonly used by psychiatrists all over the world to treat anxiety and depression. These are considered first-line treatments for anxiety and depressive disorders.

For someone with a depressive disorder, there are many other antidepressants that can be considered. For example, bupropion, mirtazapine, vortioxetine, agomelatine, etc can all be considered. We can also add on a mood stabiliser to augment the response to an antidepressant.

Electroconvulsive therapy (ECT) is used in the management of treatment-resistant cases or when we need patients to have a quick response to the treatment; for instance, if the patient is eating poorly or has lost some weight or is highly suicidal. Psychotherapy is also readily used in clinical practice in the treatment of depression.

For someone with an anxiety disorder, psychotherapy can be considered in the early stage of treatment. We commonly used cognitive behavioural therapy to help patients deal with their anxiety and the triggers to their anxiety.

There are different types of anxiety disorders and treatment approaches and emphasis may be slightly different. The medicine pregabalin can also be used to treat anxiety and to help individuals with their sleep as it has been shown to increase deep sleep.

To conclude, the good news is that there are many possible ways to treat anxiety and depression. So if you fail to respond to SSRIs and SNRIs, do not despair as there are still many options available. Your treating psychiatrist will strive to find for you the optimal treatment.

Meanwhile, do take good care of yourself.

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Are there any alternatives like psychotherapy that are able to completely replace medication for anxiety and depression?

Thank you for asking this question for the benefit of everyone. It sounds that you are having a tough time, and its double whammy when the treatment gives you unbearable side effects. Unfortunately in medicine, it is often times a zero sum game. Everything seems to have its "costs" and "benefits". Fortunately for you, there are alternatives, like psychotherapy or more commonly known as talk therapy. The good side is that if it works for you, the effect is equivalent to medications, and the effects lasts way longer than medications.

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