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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18653
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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My Name is***** (Female) from Egypt and am in desperate

Customer Question

Hi,
My Name is***** (Female) from Egypt and am in desperate need of consultation
after my father's death 8 months ago my sister had a sever depression and consequently she started feeling Numbness in her hand and right leg, headache,dizziness, and annoyed by the light.
we have done several MRI & Tests on the Immune System and others as her dr. suspected that it might be MS but thank god he said that it wasn't and nothing wrong with the immune system and he told her that she have white spots showing in the CT scan that might happened due to depression and he described her some medication but unfortunately it didn't do her any good and she is still suffering barring in mind that we have seen 4 doctors and none could help.
Thanking you in advance.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. D. Love replied 2 years ago.
Hello Hoda Yehia.
It will help if you could provide some further information.
What medicines have been tried for the depression?
Does she have any other medical problems or take any other medicines?
Customer: replied 2 years ago.

Hi Dr. D

she took calmepam and no she dosnt have any other problems expect for being overweight

Customer: replied 2 years ago.

Her Dr Prescribed the following and excuse the bad spelling

cerebrolysin (Injection)

miorotop 200

Customer: replied 2 years ago.

Hi Dr. Still waiting for my reply please

Expert:  Dr. D. Love replied 2 years ago.
Thank you for the additional information.

The calmepam is a benzodiazepine medicine. These medicines are very good for anxiety, including after the loss of a loved one. However, it is not as good for treatment of depression, particularly long-term treatment of depression. The Cerebrolysin is designed for support of brain function, but also does not have a strong antidepressant effect.

It would be a far better option to use one of the medicines that have been shown to be more effective for depression. The class of medicines that are most often used would be one of the SSRI antidepressants, such as fluoxetine, sertraline, or citalopram. There is no medicines that will work for 100% of patients, but the SSRIs will work for the majority of patients with depression. In the minority that do not respond sufficiently, then there are several other medicines that can be considered in different chemical classes, such as venlafaxine or bupropion.

I ask about other medical problems or medicines because another reason for persistent depression are certain systemic conditions, such as thyroid or adrenal disease. Since she has not yet been treated with one of the above antidepressants, it would be fine to do that first. But if the depression does not respond to the antidepressants, then there should be some consideration of evaluation for these conditions.

For someone that is depressed after the loss of a loved one, it also may help to seek psychosocial interventions, either by seeing a counsellor or considering a support group. Some people have a personality that is more receptive to these interventions, while others do not. Initially, she can be the best judge of whether to pursue these intervention. However, if the depression does not respond well to antidepressants, it could be a sign that seeking these interventions would be more important.

So, at this point, it would be appropriate for her to see her doctor to discuss starting an SSRI for the depression.

If I can provide any further information, please let me know.
Customer: replied 2 years ago.

Dr. the main problem is not the depression it's the white spots that shows and it's symptoms (Numbness in her hand and right leg, headache,dizziness, and annoyed by the light.)

what is the reason for those white spots showing in the CT and the reason for the symptoms??

Expert:  Dr. D. Love replied 2 years ago.
I thought you said she was told that the changes on the CT scan was due to the depression. Did I misunderstand what you said?
For me to analyze the CT scan findings, I will need more information.
Do you have a CT scan report in English?
If so, can you attach the report?
If not, could you give more details of the white spots, including number, size, location, etc.?
Customer: replied 2 years ago.

Expert:  Dr. D. Love replied 2 years ago.
This is an MRI report, not a CT scan report.

I will start typing an answer assuming that this is the abnrmal results that are in question, but could you also clarify whether there also is a CT scan? Or is this what you meant when you were referring to a CT scan?
Expert:  Dr. D. Love replied 2 years ago.
White sots on an MRI that are more prominent with T2/FLAIR images raise several issues.

The worrisome conditions that can cause these lesions would be an inflammatory condition, such as MS, so it is good that there has been further evaluation to exclude the diagnosis of MS or other immune disorders.

The most common cause of these changes, though, are due to small blood vessels disease, also called microangiopathic changes. These are more commonly seen in people with conditions that are risk factors for vascular disease, such as hypertension or diabetes. However, they are also seen in many people without any such risk factors, and they become increasingly more common with age.

In addition to any interventions to address risk factors for vascular disease, if there are associated neurologic symptoms, it would be appropriate to take a once daily aspirin. Anxiety and depression also may be exacerbating the symptoms, which is what her doctors may have meant when they said that this might have happened due to the depression. To the extent that there is a component related to depression, getting control of the depression with an antidepressant will help to ease that effect.
Customer: replied 2 years ago.

Expert:  Dr. D. Love replied 2 years ago.
This is a normal CT scan, so the only abnormalities are the findings on the MRI that I discussed above.
Customer: replied 2 years ago.

Thank You Dr. but could you please tell me if i should be worried as i get from your reply that she only needs to calm down and to take 1 aspirin every morning or do you advice of something further?

Expert:  Dr. D. Love replied 2 years ago.
There is no need to do any other interventions beyond that discussed above, including the aspirin and any treatment for depression that would be needed by the severity of her symptoms.
Dr. D. Love and 4 other Medical Specialists are ready to help you
Customer: replied 2 years ago.

Thank You Dr. D

Expert:  Dr. D. Love replied 2 years ago.
You are most welcome.