Patient 2
Patient 2 is a 52-year-old male with a childhood onset of anxiety, who
experienced his first MDD episode at age 20 (Table 1). Recurrent
episodes of depression followed in the subsequent years. At age 24, he
initiated contact with a specialized psychiatry clinic following a
suicide attempt. From age 33, he maintained continuous contact with the
psychiatric clinic due to recurrent depression and was diagnosed with
GAD. During the months preceding DBS surgery he had constant suicidal
thoughts and was unable to take care of his home properly. He had a
medical history of chronic pain in the shoulders and knee joints
secondary to physical traumas. Due to the chronic pain, he was treated
with dextropropoxyphene, tramadol, and finally methadone.
Before the DBS surgery, he had tried medications for MDD and GAD,
including antidepressants (sertraline, paroxetine, mirtazapine,
venlafaxine, amitriptyline, bupropion, mianserin), lamotrigine, and
augmentation therapy with quetiapine. ECT was administered but resulted
in increased anxiety, leading to premature termination. Over ten years,
he received at least three rounds of psychotherapy. He was treated with
buspirone, alimemazine, and benzodiazepines (e.g. triazolam, clonazepam,
oxazepam, and diazepam), and pregabalin for GAD without long-lasting
effects.