DEAR DR. ROACH: My wife was diagnosed with depression, and she has tried many medications such as risperidone, lamotrigine, amitriptyline, Depakote and others. The longest time a combination worked before her relapsing was less than three months. Some of the medicines that were given were even making the matter worse, and all efforts to convince the doctor weren’t successful. Presently, we are at home, just changing her diet and having her take plenty of water. — J.O.K.

ANSWER: Depression is a medical illness that can lead to serious consequences if it is not successfully treated. Medication is one of the two mainstays of treatment (along with therapy), and there are many classes of antidepression medicines. For my patients with moderate to severe depression, I recommend psychotherapy in addition to medication, but this also depends on a person’s preference.

However, you didn’t specifically mention two of the most common classes of antidepressants: the SSRI class (such as citalopram or sertraline) and bupropion. She may already have tried these, but two of the medicines you mentioned are anti-seizure drugs (lamotrigine and Depakote). One is an antipsychotic medicine. These are often tried when the first-line medicines haven’t worked, so if she hasn’t tried one of the SSRIs or bupropion, these would be reasonable choices.

When a person doesn’t respond to the first-line treatment, then it is appropriate to begin seeing an expert in depression, such as a psychiatrist. Augmentation with a different class of medicines is a reasonable consideration at this point. Respiridone is a common choice, but there are many others.

Alternatives include transcranial magnetic stimulation and electroconvulsive therapy (ECT). Prior to medical school, I remember being horrified by ECT (based on some of the books I had read), but having seen the effect that ECT can have on severe depression, I have come to accept it as a very reasonable treatment for resistant, severe depression.

I don’t know how serious your wife’s depression is. Not everybody needs to consider all of these options. But it sounds like she is still having significant symptoms that aren’t being treated, so if at all possible, I would find a doctor who specializes in depression treatment.

DEAR DR. ROACH: I am a 76-year-old man. I’ve always had a knack for remembering numbers. Back around 1993 or so, I was given a phone number to call. I’ve called this number once, but I remember the number to this day. When this number was given to me, I knew I would always remember it. Would medical science be interested in this trait? I mentioned this knack to my regular doctor, who seemed to dismiss this talent as a simple quirk. — L.J.

ANSWER: Although there are people who have developed an exceptional memory through a variety of mental strategies, there are a few people who, without effort, are able to recall mamy life experiences with extremely high accuracy. This condition, called hyperthymesia, is quite rare, and I hesitate to suggest that as a diagnosis without getting much more information from you.

This condition is distinct from savant abilities, although autistic people may have hyperthymesia. A study from Johns Hopkins provided a detailed look at the brain of a person with exceptional memory and did find subtle structural differences compared to a typical brain.

Regular doctors (like me) tend to focus on helping people, and it doesn’t sound like you need help. A research doctor, such as those who wrote up the article I read, might be more interested in your story.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803. (c) 2025 North America Syndicate Inc. All Rights Reserved