Psychiatry & Psychology--General/changing my antidepressant

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Hi. I have been taking Wellbutrin, 300mg daily, for about four years. My depression has progressively gotten worse over the past two years and has gotten very bad within the past year. I sometimes have thoughts of harming myself, but probably could not go through with anything. I am going to begin seeing a therapist this week. But I do think I need a different medication as well. What are some meds that a psychiatrist may prescribe?  I just don't think this medication works for me anymore, as I am very moody and irritable nearly ALL of the time, EVERY day, I cry way too much, want to quit my job every day, want to sleep all day and do sleep all day on my days off. I previously have taken Lexapro for a brief time, but it made me feel extremely drugged. I took Effexor at a higher dosage for a couple years and it did seem to help, but my psychiatrist took me off of it because she thought it was raising my blood pressure.  So I am going to a new psychiatrist soon, since my primary dr will not change my Wellbutrin.  (I also take Klonopin, 2 mg daily, and it does help.)  Just wondering what your thoughts are on meds that may be effective when Wellbutrin is not.

Answer
I would ADD a medication to the Wellbutrin, from a different chemical class, like Paxil or Prozac or Lithium or Depakote (others might work as well).  Rather than just change away, additional medication might be the answer, together with psychotherapy.  

Psychiatry & Psychology--General

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Daniel S. Harrop, M.D.

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Dr. Daniel S. Harrop received his B.A. and his M.D., both from Brown, and his M.B.A. from the Edinburgh Business School, Scotland. Board-certified in adult and geriatric psychiatry, he is a past president of the R.I. Psychiatric Society and a member of the Committee on Medical Quality of the American Psychiatric Association and the Committee on Continuing Medical Education of the R.I Medical Society. He serves as a consultant to four of the top five major medical management companies, including OptumHealth/United Healthcare, Magellan Behavioral Health Services, ValueOptions and APS Healthcare, and maintains a private practice in Providence, R.I. He also serves as chief psychiatric consultant on the Medical Advisory Board at the R.I. Workers Compensation Court. He was formerly on the faculty at the medical schools at both Brown University and Harvard University.

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