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Dr. Bob is Robert Hsiung, MD,
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Posted by linkadge on June 21, 2009, at 7:49:55
In reply to Re: ECT, posted by Rdragon on June 20, 2009, at 19:21:06
I am not saying you don't have depression, I am just saying it might be a goood idea to exhaust other options before going under the electrode.
This is a medication board where people have come shared their experiences with medication combinations. We are not experts but it is worth considering potentially effective medications combinations you havn't tried.
Linkadge
Posted by linkadge on June 21, 2009, at 7:54:05
In reply to Re: ECT » morganpmiller, posted by Zeba on June 20, 2009, at 22:01:36
Thanks for sharing your expereince. Your case raises a good point. Some people who try / consider ECT think that their depression is untreatable and won't consider some simpler, more obvious options.
I knew a guy who failed ECT, attempted suicide and then ultimately responded to (and is still doing well on) the herbal treatment St. John's Wort. You just never know.
Linkadge
Posted by Phillipa on June 21, 2009, at 19:12:53
In reply to Re: ECT » Zeba, posted by linkadge on June 21, 2009, at 7:54:05
St John's Wort and ECT? Phillipa
Posted by morganpmiller on June 22, 2009, at 0:02:09
In reply to Re: ECT » linkadge, posted by Phillipa on June 21, 2009, at 19:12:53
Wow yeah that's uh pretty amazing..ECT fails-St. John's Wort succeeds. Just goes to show how powerful SJW may be. I think SJW should be used as a first line of treatment by psychiatrists in many cases. God I hate Big Pharma!!!!
Posted by Meltingpot on June 22, 2009, at 7:30:56
In reply to Re: ECT » morganpmiller, posted by Zeba on June 20, 2009, at 22:01:36
Hi Zeba (xxxxx),
Well maybe you just had an "episode" of depression that went away on it's own or which responded to therapy (lucky you).
A lot of people on this board have suffered from unremitting depression for years and haven't responded to meds or therapy and don't have issues in life that they need to resolve. I guess to them (myself included) ECT might seem like a viable option and as it can be useful tool It shouldn't be removed from the list of things to try.
Denise
Posted by Deputy Dinah on June 22, 2009, at 7:55:21
In reply to Re: ECT - Zeba, posted by Meltingpot on June 22, 2009, at 7:30:56
> Hi Zeba (xxxxx),
I've x'd out the name above. Please don't post anything that identifies another poster.
If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
Follow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above posts, should of course themselves be civil.
Dr. Bob is always free to override deputy decisions. His email is on the bottom of each page. Please feel free to email him if you believe this decision was made in error.
Dinah, acting as deputy to Dr. Bob
Posted by Ant-Rock on June 28, 2009, at 21:37:52
In reply to Re: ECT - Zeba, posted by Meltingpot on June 22, 2009, at 7:30:56
> Hi Zeba (xxxxx),
>
> Well maybe you just had an "episode" of depression that went away on it's own or which responded to therapy (lucky you).
>
> A lot of people on this board have suffered from unremitting depression for years and haven't responded to meds or therapy and don't have issues in life that they need to resolve. I guess to them (myself included) ECT might seem like a viable option and as it can be useful tool It shouldn't be removed from the list of things to try.
>
> Denise
My new take on ECT...I'm on 90mg parnate, and my depression still isn't abolished. Somewhat better, but still suffer from morning exhaustion/brain fog and fatigue.
I exersize 3x week on top of working a pretty physical job 6days/week.
Word retrieval and not having the mental energy to focus properly are very prevalent.What I'm getting at, is these possible ECT side effects are no worse than the current state alot of us are in anyway.
I have an extremely experienced/compassionate psychiatrist I've been seeing on and off for most of my adult life. He's run out of medication/therapy choices for me years ago, and has always left the door open to ECT, which I have resisted so far.
He's told me several stories of young professionals in college and doing well after ECT.I'm seriously starting to think I've blown the best years of my life by resisting ECT out of fear.
Just my 2cents,
Anthony
Posted by Zeba on June 28, 2009, at 23:19:27
In reply to Re: ECT - Zeba (My Take)... » Meltingpot, posted by Ant-Rock on June 28, 2009, at 21:37:52
Why not try rTMS rather than go for the extreme??
Posted by Sigismund on June 29, 2009, at 2:02:45
In reply to Re: ECT - Zeba (My Take)... » Meltingpot, posted by Ant-Rock on June 28, 2009, at 21:37:52
>What I'm getting at, is these possible ECT side effects are no worse than the current state a lot of us are in anyway.
Well, you won't know until you try it, but I'm very doubtful.
Posted by alchemy on June 29, 2009, at 11:15:52
In reply to Re: ECT - Zeba (My Take)..., posted by Sigismund on June 29, 2009, at 2:02:45
a side note: ECT has a much higher success rate than rTMS or antidepressants. The main issues of course are the memory, and will the results last? But there is the option of maintenance ECT.
Posted by Ant-Rock on June 29, 2009, at 12:58:12
In reply to Re: ECT - Zeba (My Take)... » Ant-Rock, posted by Zeba on June 28, 2009, at 23:19:27
> Why not try rTMS rather than go for the extreme??
Thank you for the suggestion Zeba.I was actually one of the first to try rTMS in a depression study at Beth Isreal back in 2000.
I recieved the real treatment, not the sham. There were no major side effects, but it also did nothing for my depression, not even a little.That was a while ago, and it is possible the parameters of the treatment have changed, but my shrink doesn't seem to think it's very effective.
Anthony
Posted by Rdragon on June 30, 2009, at 8:29:35
In reply to Re: ECT - Zeba (My Take)... » Meltingpot, posted by Ant-Rock on June 28, 2009, at 21:37:52
> > Hi Zeba (xxxxx),
> >
> > Well maybe you just had an "episode" of depression that went away on it's own or which responded to therapy (lucky you).
> >
> > A lot of people on this board have suffered from unremitting depression for years and haven't responded to meds or therapy and don't have issues in life that they need to resolve. I guess to them (myself included) ECT might seem like a viable option and as it can be useful tool It shouldn't be removed from the list of things to try.
> >
> > Denise
>
>
> My new take on ECT...
>
> I'm on 90mg parnate, and my depression still isn't abolished. Somewhat better, but still suffer from morning exhaustion/brain fog and fatigue.
> I exersize 3x week on top of working a pretty physical job 6days/week.
> Word retrieval and not having the mental energy to focus properly are very prevalent.
>
> What I'm getting at, is these possible ECT side effects are no worse than the current state alot of us are in anyway.
>
> I have an extremely experienced/compassionate psychiatrist I've been seeing on and off for most of my adult life. He's run out of medication/therapy choices for me years ago, and has always left the door open to ECT, which I have resisted so far.
> He's told me several stories of young professionals in college and doing well after ECT.
>
> I'm seriously starting to think I've blown the best years of my life by resisting ECT out of fear.
>
> Just my 2cents,
> Anthony
>
>
>
>I agree with this post, and I don't want to end up like you. I've decided to wait about another 10 or so months before I go ahead and get the ECT done. I'll have to afford it on my own however, since my parents don't want me getting it. I'm praying that this goes away with time and medication however, and I plan on being on Lexapro, Geodon (or Zprexa), and Lithium. Life is too short to spend it being miserable and I will DO WHATEVER it takes to be normal again (namely ECT).
Posted by SLS on June 30, 2009, at 21:37:11
In reply to Re: ECT - Zeba (My Take)... » Meltingpot, posted by Ant-Rock on June 28, 2009, at 21:37:52
> I'm seriously starting to think I've blown the best years of my life by resisting ECT out of fear.
You have done the best you could on a moment by moment basis with what little you have had to work with. That includes the decision making processes that have thusfar had you avoid trying ECT. My best guess is that if you were to respond to ECT, you wouldn't spend too much time lamenting lost years. I think the wondrous feelings and ease of function that life can bring in the absense of depression will fill you with such gratitude, the grieving process won't be so protracted. You might come to terms with the loss fairly quickly.
Good luck with whatever you choose to do.
- Scott
Posted by Zeba on June 30, 2009, at 23:41:30
In reply to Re: ECT - Zeba (My Take)...))Ant-Rock, posted by Rdragon on June 30, 2009, at 8:29:35
Be careful thinking ECT will allow you to feel normal. I lost 26 IQ points, can't find my way places anymore, have word fluency and word retrieval problems, slowed processing of information, poor concentration and attention, and short term memory deficits to name a few.
I feel like Hemingway did before he committed suicide after undergoing ECT at Mayo. He said some famous quote about how the cure made it impossible for him to write again and so no career. He wasn't so depressed, but he could no longer write. He felt his life had been destroyed, and so he just could not go on.
As they say, be careful what you wish for.
Zeba
Posted by SLS on July 1, 2009, at 4:26:43
In reply to Re: ECT - Zeba (My Take)...))Ant-Rock » Rdragon, posted by Zeba on June 30, 2009, at 23:41:30
> Be careful thinking ECT will allow you to feel normal.
I underwent a series of 15 ECT treatments. I would neither endorse them nor condemn them at this point. Just as the application parameters of rTMS have been refined over the last decaded, so, too have those of ECT. However, I just don't trust that ECT will be a benign treatment for everyone. What seems to slip by peoples's attention, is that being very treatment resistent to antidepressant medication makes for a reduced prognosis that ECT will work. Still, if you have reached the end of the line pharmacologically, the choices are few:
1. ECT
2. VNS
3. rTMS
4. DBS
5. PsychotherapyI can't think of any more at the moment. Please add to this list, as I feel that I have reached the end of the line myself.
- Scott
Posted by linkadge on July 1, 2009, at 15:52:25
In reply to Re: ECT - Zeba (My Take)...))Ant-Rock, posted by Rdragon on June 30, 2009, at 8:29:35
>will DO WHATEVER it takes to be normal again (namely ECT).
Well, that is if you think ECT will make you "noraml" again. Even if it does induce some sort of improvement, it will be (from a statistics standpoint) only temporary.
Linkadge
Posted by linkadge on July 1, 2009, at 15:56:35
In reply to Re: ECT - Zeba (My Take)... » Ant-Rock, posted by SLS on June 30, 2009, at 21:37:11
>if you were to respond to ECT, you wouldn't >spend too much time lamenting lost years.
And if you don't respond? What happens when you relapse? Many people regret having ECT and do infact spend much time lamenting the decision and lamenting the fact that they don't have the memory or cognative capacity to do many of the things they used to. Plus, there is the depression on top of that to deal with.
>You might come to terms with the loss fairly >quickly.
Some might, some don't. Thats ECT for you. A crap shoot.
Linkadge
Posted by linkadge on July 1, 2009, at 16:00:14
In reply to Re: ECT - Zeba (My Take)...))Ant-Rock » Rdragon, posted by Zeba on June 30, 2009, at 23:41:30
Thats the problem with the whole ECT thing. People justify their fears about having it with some sort of grandiose belif that ECT is the "big gun". "This is my answer". They've generated this little place in their brain in which ECT sits upon this big pedistal. This association is flawed. The efficacy of ECT is overblown, and new statistics suggest that between nonresponse and relasepe 80% will be back to where they started within about 6 to 8 months.
Linakdge
Posted by linkadge on July 1, 2009, at 16:03:54
In reply to Re: ECT - Zeba (My Take)...))Ant-Rock, posted by SLS on July 1, 2009, at 4:26:43
>What seems to slip by peoples's attention, is >that being very treatment resistent to >antidepressant medication makes for a reduced >prognosis that ECT will work.
Bingo.
Thanks for bringing this point up. Nonresponse to pharmalogical antidepressants is a strongish predictor of failure for ECT. So if you have failed many chemical AD's and think that ECT is your ticket, you may want to think again. This is, of course, contrary to what many people consider the prime application of ECT.
Linkadge
Posted by Phillipa on July 1, 2009, at 19:47:18
In reply to Re: ECT - Zeba (My Take)...))Ant-Rock » SLS, posted by linkadge on July 1, 2009, at 16:03:54
So after reading Scott's list is there a real answer? Phillipa
Posted by Ant-Rock on July 1, 2009, at 20:28:49
In reply to Re: ECT - Zeba (My Take)...))Ant-Rock, posted by linkadge on July 1, 2009, at 16:00:14
Linakdge
"80% will be back to where they started within about 6 to 8 months."
In 6 to 8 months, 100% Who get no help from meds/therapy will get progressively worse and wish they were dead, or worse, act on their wish.
Look, I always respect your posts on this board, and I'm not trying to start a war here.
All I'm saying is that my shrink is an experienced and compassionate person, who actually is jaded with the big pharma mentality.He has offered me ECT for years, and I resisted. Actually I have no immediate plans to try it yet,\
but if he tells me he has several succesful professionals who have benefitted greatly from it, why woudn't I believe him. He's also had zero ect patients with permanent memory problems.Anthony
Posted by SLS on July 1, 2009, at 23:08:54
In reply to Re: ECT - Linakdge, posted by Ant-Rock on July 1, 2009, at 20:28:49
I know you have been working and working and working to get well. It sounds like your doctor has your best interests in mind.
Have you discussed with your doctor:
1. Unilateral vs. bilateral vs. bitemporal?
2. High dosage vs. low dosage?
2. Unilateral left or unilateral right?
I don't know what to think about ECT anymore. I do think that *some* people come to blame ECT for memory difficulties that are, in fact, symptoms of the depressive illness itself. I know one person that I believe fits in this scenario. However, it is hard to ignore the horror stories that are present on the Internet. I would like to believe that ECT is safe. I do not know anyone personally who has had ECT and reported a horror story.There is one person who posts here who was excited to have ECT performed on him. He reporting having a bad experience with it. I don't know if there are any residual memory or cognitive issues with him, but he is quite vocal about his bad experience with ECT. Yet, I have met people who do well on ECT. Many of these folks do go for maintenance treatments. In this regard, it is really no different than treatment with medication. If you don't take them every day for maintenance, you relapse.
Without researching the latest and greatest protocols in ECT, I guess I would go for high-dosage unilateral right and try to avoid bilateral.
Like I said, I can neither endorse nor condemn ECT as a treatment. I am very ambivalent regarding this.
My only recommendation to you is that you research the recent advances in ECT protocols and discuss what you find with your doctor. At least you will feel more confident in whatever decisions you reach. If you have already reached a decision, then forgive my butting in.
Good luck to you.
- Scott
Posted by Zeba on July 2, 2009, at 0:26:16
In reply to Re: ECT » Ant-Rock, posted by SLS on July 1, 2009, at 23:08:54
I had a compasionate Pdoc and ECT doc too. They said they were actibg in my best interests. I had 7 right unilateral treatments at 5 imes the seizure threshold level. I had 2 treatments per week instead of the typical 3 per week, and still I ended up with documented damage per neuropsychological testing. I am just now starting rehab. I was diagnosed with ECT coghnitive decline. Parnate worked for me in the past but the pdoc wanted me to do ECT.
The behavioral neurologist said I was vulnerable to damage given my history of two concussions in my youth plus one later, Also, I have a family history of Parkinson's on both sides of the family. Any history of head trauma puts you at greater risk.
ECT is a crap shoot. Be very careful I have had depression on and off for 30 some years. It is hell to end up depressed and brain damaged. I have short period of no depression, but it always seems to come back. The answer is to perervere and keep on going.
Other things to try I guess would be herbal treatments, exercise, and acupuncture.
Posted by SLS on July 2, 2009, at 2:07:05
In reply to Re: ECT » SLS, posted by Zeba on July 2, 2009, at 0:26:16
Wow. It's stories like yours that have convinced me to no longer endorse ECT as a treatment.
Thanks for adding the additional predisposing factors that might have increased your risks for ECT cognitive damage.
I'm sorry that this had to happen to you.
- Scott> I had a compasionate Pdoc and ECT doc too. They said they were actibg in my best interests. I had 7 right unilateral treatments at 5 imes the seizure threshold level. I had 2 treatments per week instead of the typical 3 per week, and still I ended up with documented damage per neuropsychological testing. I am just now starting rehab. I was diagnosed with ECT coghnitive decline. Parnate worked for me in the past but the pdoc wanted me to do ECT.
>
> The behavioral neurologist said I was vulnerable to damage given my history of two concussions in my youth plus one later, Also, I have a family history of Parkinson's on both sides of the family. Any history of head trauma puts you at greater risk.
>
> ECT is a crap shoot. Be very careful I have had depression on and off for 30 some years. It is hell to end up depressed and brain damaged. I have short period of no depression, but it always seems to come back. The answer is to perervere and keep on going.
>
> Other things to try I guess would be herbal treatments, exercise, and acupuncture.
Posted by Meltingpot on July 2, 2009, at 14:51:35
In reply to Re: ECT - Zeba (My Take)... » Zeba, posted by Ant-Rock on June 29, 2009, at 12:58:12
Hi Anthony,
Just wanted to say that I have also tried rTMS to no avail. Actually when I was having it my mood was better than it is now but that was because the Seroxat was having more of an affect.
However, I do know somebody who has had ECT and is now having rTMS and he told me that they have both helped his depression. His depression is more Atypical though so not sure if that has anything to do with it. He is also on Parnate.
Denise
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