Is Fluoxetine an appropriate drug for severe depression with psychosis?

Question

2 years on , I am still concerned about my brother.He is much improved but not the same person.In the Initial stage of his "breakdown", he was unable to speak, terrified of certain things on TV such as fighting,amazed at regular things like a friend appearing at the door.I watched him once on his knees inspecting a motor bike in amazement as though it were a space ship.There is a strong family history of mental illness and i cannot help but wonder if he should have been treated with anti-psychotics.What do you think? Thank you

PS This SEEMS like psychosis to me but his GP never referred him to a psychiatrist

Answer 1

Any particular reason why he developed the depression and Psychosis? I ask because you mention he could not watch fighting on TV. Was he mugged or did anything happen to him resulting to this illness? Could it be Post traumatic stress disorder?

After 2 years of depression I think he should have been referred to a psychiatrist!

You do have the option of asking your brother if you can accompany him on his next GP visit OR

if you are still concerned about his welfare then go and see his doctor yourself and speak to him. The doctor wont be able to divulge confidential info to you about your Brother BUt there is nothing stopping you from informing him of any concerns you still have.

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Cognative therapy should be helpful. I have seen good results from that treatment.

Also it is worth noting that when on any ante-depressants alcohol will have a greater effect. It is best not to drink when on these medications.

Answer 2

Well whatever it is, it's not (solely) depression, and treating it with an anti-depressant alone does therefore seem inadequate. What dioagnosis has he been given? I totally agree he needs to get to a psychiatrist.Only a psychiatrist is properly able to diagnose what is and what isn't psychosis,. But clearly what he has is not solely depression,

Good luck,

ps And the psychiatrist will ask if he took illegal drugs ever, and especially at the stag do. Did someone spike his drink maybe? Try and find out

Answer 3

  take him back to the  dr, and ask him to refer him ,to counselling,

that should help sort a few of his problems  out, and  give him

more  confidence in himself, and you.

good luck,  

Answer 4

I think you need to take him back to the doctor, who should really refer him to a psychiatrist. Because these symptoms can be common to so many illnesses, it's easy for a doctor to misinterpret and give a wrong diagnosis. He may need treatment for psychosis, you should mention this and your doctor can investigate further.

Fluoxetine is an anti-depressant alone and cannot treat psychosis, so this may be why you're seeing less improvement in your brother than you'd like. When I was diagnosed with severe depression and schizophrenia, I was put on a combination of fluxoteine and risperidone. Risperidone is an anti-psychotic which deals with the way we think, feel and act. It can also help with sleep trouble and is sometimes used to treat people with bipolar disorder. It would help with psychosis. You should tell his doctor that you feel his medication isn't working fully and he would benefit from an anti-psychotic also. Make sure he is aware of everything you have said here.

Best of luck

Answer 5

If he has psychotic symptoms at present then he would need antipsychotics. He may not need these meds if the psychotic stage has passed. Most recently FDA approved Abilify for depression augmentation with an antidepressant medication. This may be an option if his depression does not get better and if he has any psychotic symptoms, since this medication is an antipsychotic.