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Pharmacy/change of meds and polypharmacy

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Question
dear Mary
may I ask some more? I'm 58 with treatment resistant depression and chronic anxiety
what difference does it make to replace lamotrigine with depakote? and venlafaxine with sertraline?
can you comment on the combo: sertraline, depakote, quetiapine and pregabalin; been on it for 2 years, is 4 psychiatric drugs too many, and 2 y too long in your view? are there adverse personality effects over time?

daily doses: SERT 100mg I think, QUETIAP 100 mg, PREGAB 400mg. DEPAKOTE 1000mg

Answer
HiPhilip,
Depakote and lamotrigine are both anitseizure meds but normally used as mood stabilizers. If 1 is not effective, the other med can be tried.
Lokewis, sertralone and venlafaxine are both antidepressanrs but exert their action in different ways, and are usually switched due to sideeffects. Mary

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Mary E Scott, RPh, CGP

Expertise

I am a certified geriatric pharmacist with over 23 years experience as a long-term care consultant to nursing homes. I also do community-based consulting on an individual basis. My facility-based monthly newsletter on pharmacy topics is read by nurses in over 200 long-term care facilities in 5 states.

Experience

I received a BS in Pharmacy in 1980 with post-graduate work in public health. I have had a Consultant Pharmacist license since 1984.

Organizations
American Society of Consultant Pharmacists
.I received certification in geriatric pharmacy in 1998.

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