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.