instruction: hello doctor I am 56 years old male and have been treated for depression for 32 years I have tried numerous antidepressants I have responded to eat extremely well in the past but it did not hold me I could no longer afford monthly maintenance treatments I have currently started a treatment called theta burst stimulation after nine minute sessions I have had a few normal days but more days where I feel depressed I am more depressed after I have started this treatment is this normal I am scheduled to have a total of 36 minute sessions
output: hello I read your query and understand your concerns although it is too early to measure the effect of tabs theta burst stimulation after the nine sessions there is a good possibility that there will be an enduring effect over the coming weeks my statement is based on the fact that early response may be transient one is an indicator of long term response for most antidepressant therapies including medications tis transcranial magnetic stimulation eat electroconvulsive therapy and now rims repetitive transcranial magnetic stimulation and tabs considering the above fact I like to state that reversal of symptoms after a few days of normalcy at this stage is considered normal and we need to hold on till the completion of therapy although this is not the part of the question I like to draw your attention to the suboptimal dose of effexor for someone who has depression over the 30 years I rarely see any patient who responds to below 150 my of effexor after a prolonged history of depression say 30 years I hope this helps