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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 79. This is the beginning of the thread.
Posted by Bob on May 8, 2005, at 13:33:35
Has anyone here either known someone, or they themselves undergone a full course of ECT (at least 6 or more treatments), and then, in the end, gotten little or no response? Or maybe even a negative response?
What options would be open to someone who has taken a number of psych drugs/drug combos, and then figured a last ditch effort would be a course of ECT, just to find that it's now worse then ever? Is this a one-way street to suicide, or what?
Posted by SLS on May 8, 2005, at 15:08:26
In reply to ECT failure?, posted by Bob on May 8, 2005, at 13:33:35
I believe that you can move on to respond to medication after a failed course of ECT. Unfortunately, the more resistant one is to their initial courses of antidepressants, the more they are likely to fail at ECT. It makes you wonder just who ECT is best indicated for. Consider ECT as nothing more than another medication failure. Move on aggressively to other things.
MAOIs?
Mood stabilizers?
- Scott
> Has anyone here either known someone, or they themselves undergone a full course of ECT (at least 6 or more treatments), and then, in the end, gotten little or no response? Or maybe even a negative response?
>
> What options would be open to someone who has taken a number of psych drugs/drug combos, and then figured a last ditch effort would be a course of ECT, just to find that it's now worse then ever? Is this a one-way street to suicide, or what?
Posted by linkadge on May 8, 2005, at 15:24:26
In reply to Re: ECT failure?, posted by SLS on May 8, 2005, at 15:08:26
ECT has the ability to increase the senesitivity and density of serotonin receptors. So it often makes medication more effective.
I supose its always unwise to throw in the towel. I read a few case of indivuduals who failed to respond to ECT, and then responded to SJW ??!!
Crazy isn't it ??
I'll see if I can find those reports.
Linkadge
Posted by Bob on May 8, 2005, at 16:16:48
In reply to Re: ECT failure?, posted by linkadge on May 8, 2005, at 15:24:26
Thanks for the responses, people. I'll tell you that the failure of the ECT has me scared as I thought that it was usually a last resort after meds don't work. The medecines were becoming too much to bear, and I figured that at least ECT wouldn't have anti-cholinergic type effects. That ended up being true, but now I feel like I have PTSD.
Yeah, I suppose MAOIs might be a possibility. Doesn't have me too excited, though.
Posted by linkadge on May 8, 2005, at 16:56:43
In reply to Re: ECT failure? » linkadge, posted by Bob on May 8, 2005, at 16:16:48
Lets just say that MAOI's were discovered because they noticed that a bunch of crochety, 75 year old war vetrens, who were being treated for TB (I think) started to show signs of spontainious but robust euphoria.
ECT is definately not the end of the road.
You could even probably avoid the MAOI diet by trying a combination of selegeline (MAOB) and moclobemide (MAOA).
Linkadge
Posted by bipolarspectrum on May 8, 2005, at 17:04:28
In reply to ECT failure?, posted by Bob on May 8, 2005, at 13:33:35
Hey,
I failed a full course (10) of ECT.. it sucked but I dont think its the end.. it helped direct me more towards bipolar-type medications as opposed to unipolar ones... but ect itself was awful... anywayz, no, i dont think its a one way road to suicide.. its just another treatment
bps
Posted by MidnightBlue on May 8, 2005, at 17:21:21
In reply to ECT failure?, posted by Bob on May 8, 2005, at 13:33:35
This is more of a question than an answer. I know with rTMS they talk about the importantance of the LOCATION of the magnet as well as the strength. Is it possible the location of the ECT was just a bit "off?"
I haven't had either, but I was scheduled to try rTMS in a trial before I flunked the EKG.
MidnightBlue
Posted by linkadge on May 8, 2005, at 18:05:58
In reply to Re: ECT failure?, posted by MidnightBlue on May 8, 2005, at 17:21:21
What sorts of things led you to flunk the EKG ??
Did you have epileptiform activity or something ???
Linkadge
Posted by Phillipa on May 8, 2005, at 18:21:52
In reply to Re: ECT failure? » MidnightBlue, posted by linkadge on May 8, 2005, at 18:05:58
I still wonder what happened to the lady who had ECT when i was in the hospital. She was organized and acting normal. She was intent on suicide so that's why she received it. A few days after she went home she returned to the hospital and couldn't remember a thing. And she was in la la land. Not trying to scare you. I also remember as a new RN in orientation a young girl had ECT. Before the tx they said she wouldn't bathe, get out of bed, etc. After one tx she was great. Grooming herself, talking to everyone, etc. The experienced staff all wondered if she had been faking her depression. my only exposure to it. Fondly, Phillipa
Posted by linkadge on May 8, 2005, at 19:37:10
In reply to Re: ECT failure?, posted by Phillipa on May 8, 2005, at 18:21:52
ECT will also cure "fake" depression, since after treatment, you are likely to forget exactly what it was you were faking :)
Just kidding
Linkadge
Posted by Phillipa on May 8, 2005, at 19:57:13
In reply to Re: ECT failure?, posted by linkadge on May 8, 2005, at 19:37:10
Link, I'm laughing. That was good! Fondly, Phillipa
Posted by aleslie on May 8, 2005, at 23:45:55
In reply to Re: ECT failure? » linkadge, posted by Bob on May 8, 2005, at 16:16:48
I myself have had 23 ECTs and each time I've gone in for a round I've come out on the positive side.I have a psychiatrist that I trust and she is the one who administers them. Not everyone has had negative results from this course of treatment.What it comes down to is wether or not you are willing to try anything in your power to get better.This whole psych.drug thing is in itself just a big guessing game anyway. Follow your gut. Good luck,
Amy
Posted by MidnightBlue on May 9, 2005, at 0:43:41
In reply to Re: ECT failure? » MidnightBlue, posted by linkadge on May 8, 2005, at 18:05:58
I had frequent extra ventricular beats. I had never even had an EKG before. I tried to tell the pdoc it was just nerves or stress. He didn't buy it!
Posted by Bob on May 9, 2005, at 9:14:09
In reply to Re: ECT failure?, posted by aleslie on May 8, 2005, at 23:45:55
> I myself have had 23 ECTs and each time I've gone in for a round I've come out on the positive side.I have a psychiatrist that I trust and she is the one who administers them. Not everyone has had negative results from this course of treatment.What it comes down to is wether or not you are willing to try anything in your power to get better.This whole psych.drug thing is in itself just a big guessing game anyway. Follow your gut. Good luck,
> Amy
It was never my intention to impy that everyone has negative results from ECT. I am told on a daily basis about how much all the meds and treatments I have miserably failed are actually helping other people. The "one way road to suicide" comment was in reference to someone who has already failed numerous med trials, as well as ECT treatments. I didn't mean it as a suggestion for anyone who trys ECT at all.
Posted by Bob on May 9, 2005, at 9:17:08
In reply to Re: ECT failure?, posted by MidnightBlue on May 8, 2005, at 17:21:21
> This is more of a question than an answer. I know with rTMS they talk about the importantance of the LOCATION of the magnet as well as the strength. Is it possible the location of the ECT was just a bit "off?"
I have no idea. I have thought about the possiblity that something went wrong in one of the treatments, but I don't know what incentive the hospital would ever have to tell me about something like that. Seems like it would open them up to liability issues.
Bob
Posted by Bob on May 9, 2005, at 9:42:44
In reply to Re: ECT failure?, posted by bipolarspectrum on May 8, 2005, at 17:04:28
> Hey,
> I failed a full course (10) of ECT.. it sucked but I dont think its the end.. it helped direct me more towards bipolar-type medications as opposed to unipolar ones... but ect itself was awful... anywayz, no, i dont think its a one way road to suicide.. its just another treatment
> bps
What about your course of ECT sucked, exactly? Did it leave you more depressed, or agitated, or anxious, or was it mainly the memory problems that bothered you?Bob
Posted by linkadge on May 9, 2005, at 19:24:31
In reply to Re: ECT failure? » bipolarspectrum, posted by Bob on May 9, 2005, at 9:42:44
If you havn't tried an MAOI, then you've still got a barganing chip.
The one MAOI that I tried, Parnate, was a completely different medication than any other I have tried.
I have been on maybe 20 different antidepressants which were roughtly the same old story for me. All I can say was that Parnate was an "entirely different ballgame" .
Linkadge
Posted by aleslie on May 9, 2005, at 20:42:04
In reply to Re: ECT failure? » aleslie, posted by Bob on May 9, 2005, at 9:14:09
Bob,
I was not trying to imply that you were saying anything of the sort. I am truely sorry if you got that feeling. What I was trying to do is be of some support. Obviously I failed in that area. I am not here to pass judgement or "troll". I am the last person who would do that. Again let me apologize for coming off as a know it all.
Amy
Posted by Bob on May 10, 2005, at 9:41:11
In reply to Re: ECT failure?, posted by aleslie on May 9, 2005, at 20:42:04
> Bob,
> I was not trying to imply that you were saying anything of the sort. I am truely sorry if you got that feeling. What I was trying to do is be of some support. Obviously I failed in that area. I am not here to pass judgement or "troll". I am the last person who would do that. Again let me apologize for coming off as a know it all.
> Amy
Don't worry, Amy. I wasn't upset - just wanted to avoid a misunderstanding.Bob
Posted by jerrympls on May 10, 2005, at 19:29:44
In reply to ECT failure?, posted by Bob on May 8, 2005, at 13:33:35
> Has anyone here either known someone, or they themselves undergone a full course of ECT (at least 6 or more treatments), and then, in the end, gotten little or no response? Or maybe even a negative response?
I had 8 courses of bilateral ECT treatments back in 1994. Unforuntately, it did not work for me and actually made things worse. My memory was toast - forgot friends' names, movies I had seen jusst a couple weeks earlier - I even had trouble reading music (and I have studied music since I was 4 years old - I'm now 33). My conceptualization skills were fried. I had to rebuild my memory - my wit, sense of humor. Weird thing is is that I can remember everything about the treatments - I can still remmeber that the anesthesiologist was a tall african-american man, I can remember them inserting the bite guard, the sting of the needles, waking up and having a nurse with grey hair in her 40's put a warm blanket around me. I can remember being wheeled back up to my room on the psych ward. My mother was there for each treatment and she sat next to my bed reading a romance novel while I rested. When I got home, I did notice an unusual increase in mood - like a buzz - not manic or anything - but I remember telling a friend that I thought the ECT worked and that my depression was gone. That wore off quickly.
A couple weeks later I started back at college. I remember sitting in orchestra rehearsal staring at the music as if I were reading a foreign language. I felt uncoordinated - and as I said - I had been playing cello since I was 4 years old.
Soon after I noticed more profound memory effects. Friends came up to me and started talking about things we had done the summer before - and I couldn't remember what they were talking about - nor could I remember their names. I felt really embarrassed. From then on I had terrible times trying to commit things to memory - including music, information that I read for classes, etc. It took years to "rebuild" and "reroute" how I worked my memory.
That was 1994 and now in 2005 I still have problems with memory - but it's better. For example, I'll forget that I talked with a friend over the phone 5 days ago - but if my friend reminds me or tells me what we talked about - then I'm able to call it up in my head and I "remember." Short-term memory is ok - but damaged.
I hear now that unilateral placement of the electrode reduces memory problems.
I wish I had better news for you....but for what it's worth, I have known people who have been helped tremendously through ECT.
Jerry
Posted by Bob on May 11, 2005, at 11:53:01
In reply to Re: ECT failure? » Bob, posted by jerrympls on May 10, 2005, at 19:29:44
> I had 8 courses of bilateral ECT treatments back in 1994. Unforuntately, it did not work for me and actually made things worse. My memory was toast - forgot friends' names, movies I had seen jusst a couple weeks earlier - I even had trouble reading music (and I have studied music since I was 4 years old - I'm now 33). My conceptualization skills were fried. I had to rebuild my memory - my wit, sense of humor. Weird thing is is that I can remember everything about the treatments - I can still remmeber that the anesthesiologist was a tall african-american man, I can remember them inserting the bite guard, the sting of the needles, waking up and having a nurse with grey hair in her 40's put a warm blanket around me. I can remember being wheeled back up to my room on the psych ward. My mother was there for each treatment and she sat next to my bed reading a romance novel while I rested. When I got home, I did notice an unusual increase in mood - like a buzz - not manic or anything - but I remember telling a friend that I thought the ECT worked and that my depression was gone. That wore off quickly.
>
> A couple weeks later I started back at college. I remember sitting in orchestra rehearsal staring at the music as if I were reading a foreign language. I felt uncoordinated - and as I said - I had been playing cello since I was 4 years old.
>
> Soon after I noticed more profound memory effects. Friends came up to me and started talking about things we had done the summer before - and I couldn't remember what they were talking about - nor could I remember their names. I felt really embarrassed. From then on I had terrible times trying to commit things to memory - including music, information that I read for classes, etc. It took years to "rebuild" and "reroute" how I worked my memory.
>
> That was 1994 and now in 2005 I still have problems with memory - but it's better. For example, I'll forget that I talked with a friend over the phone 5 days ago - but if my friend reminds me or tells me what we talked about - then I'm able to call it up in my head and I "remember." Short-term memory is ok - but damaged.
>
> I hear now that unilateral placement of the electrode reduces memory problems.
>
> I wish I had better news for you....but for what it's worth, I have known people who have been helped tremendously through ECT.
>
> Jerry
>
>Jerry:
Your story, and others like it, raises a question in my mind. Was the procedure considered an emergency at the time? How was your condition afterwards, apart from the memory? It often seems to me like many people who have ECT suffer great memory problems, but they don't really discuss having life threatening depression or similar problems afterward. I assume you had such problems afterward, but maybe not?
Bob
Posted by jerrympls on May 11, 2005, at 19:23:09
In reply to Re: ECT failure? » jerrympls, posted by Bob on May 11, 2005, at 11:53:01
> Jerry:
>
> Your story, and others like it, raises a question in my mind. Was the procedure considered an emergency at the time? How was your condition afterwards, apart from the memory? It often seems to me like many people who have ECT suffer great memory problems, but they don't really discuss having life threatening depression or similar problems afterward. I assume you had such problems afterward, but maybe not?
>
> Bob
>
>Hi Bob
Good questions you raise. I don't think my ECT treatment was considered an "emergency" treatment - it was more of a last resort becuase I wasn't responding to traditional meds. After ECT my depression got much worse and I started having panic attacks - which I had NOT had prior to treatment. I've had more "suicidal ideation" since my ECT - much much more so than prior to the treatments. I also have been in the hospital more (in psych wards) than before my ECT too. I've never attempted suicide - but have come very close. Currently I'm on a med cocktail that has kept me pretty stable and out of deep periods of severe depression. I currently take Lexapro, Klonopin, Dexedrine and hydrocodone. Yes, an opiate. My doc finally agreed to prescribe it for me and it's worked wonders - no miracle cure - but very close to "normal" and I'm able to work. I've been on opiate therapy for my depression for about 5-6 months now? and have had no problems with tolerance or abuse.Jerry
Posted by Mr.Scott on May 12, 2005, at 1:34:26
In reply to ECT failure?, posted by Bob on May 8, 2005, at 13:33:35
its late...I'm sleepy...just a few thoughts here.
Sounds like someone is on a bad mix of psychiatric or illicit drugs that is causing the problem...ECT is pretty darn effective at an 80% efficacy rate for straight depression. However if your depression is caused by drug addiction or the fact your whole world just fell apart then maybe it won't work.I guess there are chronic depressives that just can't and don't really get better.
Finally...although it may be hard to accept...Maybe its time for more therapy and less somatic intervention.
Posted by Mr.Scott on May 12, 2005, at 1:39:55
In reply to Re: ECT failure? » linkadge, posted by Bob on May 8, 2005, at 16:16:48
I'm feeling cocky here, but If you want...Give me a fairly detailed account of whats been going on with you... with ALL your meds listed out (length on them, dosage, etc) any drug/alcohol abuse, and life situation stuff.
Tell me when this all began and don't leave out the truth. I'll bet I can help you.
Scott
Posted by Mr.Scott on May 12, 2005, at 1:41:54
In reply to ECT failure?, posted by Bob on May 8, 2005, at 13:33:35
unilateral or bilateral? What anticonvulsants if any were you taking during ECT. 6 is just a start btw.
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