Depression

[Jury]

Hello.
In 1998 my wife during sorts or labors has gone through a strong stressful situation on fault or wine of doctors (it except for sorts or labors, which in itself stress), as a result in 2 months at it or her has occured or happened an acute psychosis, after treatment in an insane hospital a status normolizovalos, but has begun strong enough depression (the dejectedness, unwillingness to live, full uncertainty in the actions, etc.) .lechenie was spent by amitriptyline of longly enough 5-6 months is out-patient.
In 2 years the situation has repeated, again depression, and before it or this predpsihoznoe a status (treatment by Azaleptinum) .lechenie depressions. Convalescence.

In it or this to year all has begun so. A stressful situation at job.
There was an aggravated feeling of validity, in conversations on the real facts and events, there were frankly invented events and the facts in which she believed. Recognized the participation in some events to which had no attitude or relation.
Accepted Truxalum. The status was normalized, but has again begun deressija .2 weeks we accept amitriptyline, have finished a daily dose up to 150 mg. Special improvements are not present, uncertainty in the actions, ideas on suicide (to accept a greater or big dose of tablets), etc.
It would be desirable to learn or find out your opinion and advice or council.
Can replace antideprisant?
How long these failures can repeat?
What it is possible to undertake still?
Thankful in advance for the answer.

[Doctor Vitaly]

Not seeing the patient and not having all completeness of data from a case history not probably to advise something concrete. If to argue on the given case, as a clinical example I can answer your questions the following:
1. An antidepressant to replace it is possible. Moreover, amitriptyline one of ancestors tritsiklicheskih antidepresantov, which efficiency always on the verge of a therapeutic dose and by-effects. The attending physician, having of all data about the patient, can pick up something from more modern preparations, narimer: Ludiomilum, lerivon, etc. Is neuroleptics with an antidepressive spectrum of activity (by that you tell about application of Azaleptinum at the beginning neuroleptics are necessary to her also). It is probable, that she would accept something from atypical neuroleptics. But assumptions and concrete the decision on the scheme or plan of treatment the doctor who will bear the responsibility for the purposes or appointments should accept all this.

2. Yes, these failures can repeat. As a rule, precise enough cyclicity of similar problems is observed. Actually you already have a cycle - two years. At correct and well-timed protivoretsidivnom treatment peaks of failures it is possible sgadit or to avoid them absolutely.

3. All that else is possible pedprinimat necessary to discuss with its or her doctor observing internally.

Therefore the most correct in this case is to find the spouse of the expert owning knowledge and using in job modern medicinal preparations who would observe its or her long time (if to not tell or say constantly) and to address to it or him;them on consultation for correction of purposes or appointments or it is simple for observation not less often than time in half a year.

[Jury]

Thanks for consultation.