Hello,

Thank your for your consult at DoctorSpring.com. I have gone through your question in detail and I can understand what you are going through.

I understand that you have both depression and anxiety and they can be managed by both the combinations that you have stated of mirtazapine with tianeptin or mirtazapine with buspar. Both options are good.

However your ear ache cannot be managed by these meds. That will need thorough evaluation of your ear. Many times the culprit is the tympanic membrane. You may need antibiotics such as amoxycilline and cetrizine. It may not be a sign of depression or anxiety.

If you are averse to medications for depression and anxiety then the other option is cognitive behavioral therapy which involves weekly sessions by a therapist who focuses on change in the pattern of thinking and there by cure depression and anxiety.

Hope that was helpful. I would be glad to help you if you need any further details.

Regards
Dr.Srikanth Reddy MD

Hello
Thanls for the follow up information.
Your suspicion seems to be right where in the earache does appear to be a type of migraine. If it is so then it should respond to divalproex sodium or propranolol daily. Even carbamazepine is a good drug for nerve pain when ecute.
Also get an MRI brain done to have a look at the head inside.
Yes buspirone can be taken with stablon however stablon has never become popular as an anti depressant and is mostly a second choice drug. There are better drug available like venlafaxine paroxetine bupropion etc...
Hope that helps
Regards.
Dr. Srikanth Reddy

Hello,
Thanks for the follow up.
Yes, cymbalta is a good option as it has trials on nerve pain and somatoform disorder. You can certainly give it a try.
Regards
Dr. Srikanth Reddy