Effectiveness of Effexor, Strattera, Abilify and worsening of depression

[aerozeppelin]

A family member of mine has been seriously depressed for more than 2 years now. She was put on medication about 2 years ago - Effexor, Strattera, and Abilify - and since then, her psychiatrist, with whom she had only about 3 personal sessions, has only lowered or increased dosages of these drugs. Her depression is of the less emotional kind - she exhibits few emotional reactions and talks very little. Recently - about for a month now - she has been in a worse condition - less talking, inability to do things she could do before, almost complete inactivity, much worse concentration and memory. She has also apparently stopped taking Abilify and Strattera but continues to take Effexor, although probably skips doses. She doesn't speak much so it's hard for me to know and certainly the fact that she stopped using the drugs probably influenced the worsening of the condition.
My questions are these: given this very vague sketch of her symptoms,
1) Are the drugs listed above right for her? Do they lose their effectiveness at some point?
2) What can I do to help her get back on track? Recently, after finding out about her not taking the drugs, I convinced her to continue taking them. She took them a few times and then stopped again, apparently - I can't quite supervise her.
3) Is there a possibility that light therapy may help?

Thank you very much for your response.

[Roger Gould, M.D.]

I am going to strike out on all three questions, not enough information to speculate. But I can make a suggestion. You are entitled to a consultation with another psychiatrist.  YOur relative may not trust his or her recommendations.  Your relative may be better off with a combination of talk therapy with drug therapy.  In fact, that is the recommended treatment. Explore these options.

[downstairs mary]

Off the top of my head, I would say that you could encourage her to take walks outside. She doesn't have to talk, and it would
make her feel physically better, which improves attitude.
She may get a feeling of accomplishment from that one simple change. I know there is more complicated work to be done for her, also, but this is something small and unquestionably healthy. Could she take care of a little dog, who would keep her company?

[BonnieH]

I currently am on Effexor, and I had to gradually quit taking it for about 5 weeks, and it was hell. I'm back on it again, almost 4 weeks now, and just starting to feel better again. My doctor also had me increase the dosage up to 150 mg, and it has helped greatly. She cannot skip dosages, as this leaves you even more depressed. I know this from experience. It works wonderfully for alot of people, but I know you have to be consistent. Maybe she should seek a physiatric physician that could help her with her medications. Good Luck

[BelCanada]

I just went through the whole trying to find the magic drug for me and agree that the only solution is a combination of talk therapy and drugs.  While she may want to keep her psychiatrist for now to deal with the drug side, I would strongly suggest she finds a psychologist or therapist who specializes in this area to talk to.  While psychiatrists have a place in the medical field (sorry all of you psychiatrists out there), I have not found that talk therapy is really one of their strong suits.  I would love to be proven wrong in this area but nonetheless, she needs to find someone (no matter their professional title!) that she feels she can talk to and is on her side.

Keep supporting her and encouraging her until she finds someone to talk to that she WANTS to talk to and actually feels good about seeing (as in feels they are helping).

Good luck!