[Vilko]

15April 1998

Dear Dr.Rogers,

RE: MR. VILIM KOVACIC D.O.S. 11/11/41

Thank you for your letter about Mr. Kovacic. I understand from Mr. Kovacic that he has recently changed his general practitioner and is now seeing you.

I have been seeing Mr. Kovacic since March 1992. At that stage, he was living in Whyalla and had been on a Workcover claim with BHP for some time. He had been seen by Dr. Norman James who had initiated treatment for his Major Depressive Disorder. However Dr. James moved to Victoria and for this reason
Mr. Kovacic was referred to me.

When I saw Mr. Kovacic, I diagnosed him as having a Major Depressive Disorder,a Panic Disorder, with Agoraphobia and Obsessional personality traits. He had been tried on a number of different antidepressants without much effect. Over the years, I have found that the best antidepressant has been Paroxetine 40mgs a day and Clonazepam 2mgs bd for his anxiety. On this medication his depression is reasonably under control but his anxiety is still quite intense at times. It is particularly intense during periods of stress.

Over the years that I have known him, there have been a lot of changes in his life. He terminated with BHP and moved from Whyalla to Adelaide. More recently they have moved from their house in Adelaide to a unit in a retirement village. As well as these major changes in their own life, there have also
been changes in the lives of their two sons. This has also impacted on them.

Although Mr. and Mrs. Kovacic are convinced that they have done the right thing, it has taken them quite a long time to adapt to living in a small unit in a retirement setting. More recently, they have been more concerned about going on holidays to Europe. This too has been quite a stressful event to organise.

The other significant stress this year was the diagnosis of “ASBESTOSIS”.

He is very concerned about this and this was a major reason for the holiday back to Europe to see his family.

Both Mr. and Mrs. Kovacic have quite a number of medical compliants as well.
These can pre-occupy them. At the moment, Mrs. Kovacic has quite severe diarrhoea which appears to be due to irritable bowel. A trial of immipramine did not work for her and she is back en moclobemide 300mgs a day. At the same time that this was happening, Mr. Kovacic also decided that he wanted to see
whether a different antidepressant might have a better anxiolytic effect. This has led to two months of chaos. In ..the end, he decided that Paroxetine was the best antidepressant for him. He is just beginning to restabilise on this.

/ P1.