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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Geezer on November 23, 2002, at 11:01:49
Has anyone had success with an SSRI following ECT treatments? I had great success with Prozac (for a year and one half - prior to poop-out), spent the next 14 months in depression where nothing would work. Have now completed 10 ECT treatments (2 more to go). Have been taking Parnate for 10 days but having trouble with SE's. Stopped taking Parnate this AM, will wait the required 2 weeks prior to starting an SSRI. Would appreciate any experience anyone would wish to share.
Thank you,
Geezer
Posted by phoebes on November 23, 2002, at 12:32:28
In reply to SSRI's After ECT, posted by Geezer on November 23, 2002, at 11:01:49
I can't speak from experience, but I know that some say that meds that didn't work before ECT may work afterwards. I'm starting ECT Dec.3 and am planning to stay on Paxil and Remeron (which aren't currently working), so I'll let you know...
How are you doing, generally? Still well?> Has anyone had success with an SSRI following ECT treatments? I had great success with Prozac (for a year and one half - prior to poop-out), spent the next 14 months in depression where nothing would work. Have now completed 10 ECT treatments (2 more to go). Have been taking Parnate for 10 days but having trouble with SE's. Stopped taking Parnate this AM, will wait the required 2 weeks prior to starting an SSRI. Would appreciate any experience anyone would wish to share.
>
> Thank you,
>
> Geezer
Posted by Geezer on November 23, 2002, at 12:59:52
In reply to Re: SSRI's After ECT, posted by phoebes on November 23, 2002, at 12:32:28
Hi phoebes,
Yes, doing OK in general (much better than I have been for the past year) but still feel the need for an AD of some sort. I can very definitley recommend the ECT treatments, at least based on my own experience. The only after effects I notice from the treatments is a drying out of the nasal passages (they give you a lot of oxygen) and some tiredness due to the anesthesia. Both symptoms clear up very quickly. I have found nothing to fear from the ECT. Wish you the very best.
Geezer
Posted by Peter S. on November 23, 2002, at 23:19:17
In reply to Re: SSRI's After ECT » phoebes, posted by Geezer on November 23, 2002, at 12:59:52
Hi Geezer,
Can you say what led up to your using ECT? What is your diagnosis? Also Do you have to go in to have more ECT sessions? Has the improvement been major?
Sorry to ask so many questions but I'm down to my last straw as far as meds go.
Thanks!
Peter
> Hi phoebes,
>
> Yes, doing OK in general (much better than I have been for the past year) but still feel the need for an AD of some sort. I can very definitley recommend the ECT treatments, at least based on my own experience. The only after effects I notice from the treatments is a drying out of the nasal passages (they give you a lot of oxygen) and some tiredness due to the anesthesia. Both symptoms clear up very quickly. I have found nothing to fear from the ECT. Wish you the very best.
>
> Geezer
Posted by SLS on November 24, 2002, at 0:25:51
In reply to SSRI's After ECT, posted by Geezer on November 23, 2002, at 11:01:49
> Has anyone had success with an SSRI following ECT treatments? I had great success with Prozac (for a year and one half - prior to poop-out), spent the next 14 months in depression where nothing would work. Have now completed 10 ECT treatments (2 more to go). Have been taking Parnate for 10 days but having trouble with SE's. Stopped taking Parnate this AM, will wait the required 2 weeks prior to starting an SSRI. Would appreciate any experience anyone would wish to share.
Thank you,
Geezer
-
Hi Geezer.
What side-effects of Parnate are you intolerant of. Many of them tend to abate or disappear over time. How long had you been on it?You might want to investigate the use of a tricyclic antidepressant.
What is your diagnosis? Melancholic? Atypical?
If you feel worst in the morning, and have little or no appetite, I would recommend trying a tricyclic. Desipramine and nortriptyline have the fewest side effects. Better yet, perhaps, is to try combining both a tricyclic and Prozac. Tricyclics affect ECT by lowering the seizure threshold (the amount of energy necessary to induce a seizure). This is compensated for by the doctor by adjusting the ECT device.
Had you tried taking 60mg of Prozac? It works for some people.
Do you experience moderate to severe social anxiety or social phobia? Do you feel worse in the evening? If so, I would recommend continuing with Parnate or trying Nardil or Marplan sometime in the future.
That's about it for now.
Hang in there. You have company.
- Scott
Posted by Geezer on November 24, 2002, at 10:41:15
In reply to Re: SSRI's After ECT, posted by Peter S. on November 23, 2002, at 23:19:17
Hi Peter,
Questions are no problem, I will answer as best I can.
DX - Major Unipolar Depression, Melancholoic, Chronic. This is a condition that was inherited from my mother and I have been fighting it for more than 30 years. I decided to try ECT because none of the ADs had any effect on the depression any longer (no AD works forever). I have had 10 ECT treatments, will have 2 more at two week intervals, then MAYBE do one treatment per month for maintenance. There has been improvement but not what I would call major. I am hopeful the treatments will bring about better response from the ADs. If you are getting no benefit from the ADs I would encourage you to try ECT, I have experienced no adverse SEs from the treatments. In my experience the "horror stories" and "treatment of last resort" fables are complete nonsense.
Wish you the very best,
Geezer
Posted by Geezer on November 24, 2002, at 11:24:19
In reply to Re: SSRI's After ECT » Geezer, posted by SLS on November 24, 2002, at 0:25:51
Hi Scott,
Thanks very much for the reply - I follow your posts on a regular basis.
Your thinking is correct, I have not given the Parnate an adaquate trial (only about 10 days @ 30 mg.) but I hate the short half life, constipation, and afternoon "sleep attacks". After 3:00 PM I just don't function.....can't think, can't focus - feels like psychosis.
DX = Major Unipolar Depressed/Melancholic/Chronic. Don't seem to have any problem with social phobia or social anxiety it's just the terrable fatigue and lethargy, plus depression that is so miserable. I feel like I need high doses of Prozac and high doses of pstims. May get the Prozac but pstims are unlikely.
I did use Ludimil (tetracyclic) for several years while I was still working. I was able to function on it (until the inevitable poop-out) but never felt as well as I did on Prozac.
I am running out of strength.....if I can last through the next two weeks until all the Parnate is out of my system I will probably try high dose Prozac.
Thanks for your response,
Geezer
Posted by Pfinstegg on November 25, 2002, at 0:32:16
In reply to Re: SSRI's After ECT » SLS, posted by Geezer on November 24, 2002, at 11:24:19
Geezer- what about considering low dose T3-4 as an augmentation? I take both synthroid and cytomel, and think it helps mainly with putting a floor under the worst "crashes". (I have the same diagnosis as you) If you remember, Chloe found it helped to stabilize her moods when she was going on to maintenance ECT. It's safe and doesn't have side effects when given properly.
Pfinstegg
Posted by Geezer on November 25, 2002, at 9:46:14
In reply to thyroid supplementation in chronic depression » Geezer, posted by Pfinstegg on November 25, 2002, at 0:32:16
> Geezer- what about considering low dose T3-4 as an augmentation? I take both synthroid and cytomel, and think it helps mainly with putting a floor under the worst "crashes". (I have the same diagnosis as you) If you remember, Chloe found it helped to stabilize her moods when she was going on to maintenance ECT. It's safe and doesn't have side effects when given properly.
>
> PfinsteggThanks Pfinstegg - I will suggest that at the time of my next pdoc visit. Can you recommend dosage and how best to administer the T3-4? I am pretty much on my own in this mess.....the shrinks don't have a clue. Thank you for your help.
Geezer
Posted by Pfinstegg on November 25, 2002, at 17:41:42
In reply to Re: thyroid supplementation in chronic depression » Pfinstegg, posted by Geezer on November 25, 2002, at 9:46:14
If you are going to go on thyroid supplementation for its antidepressant effects, you first need to have a baseline TSH (thyroid-stimulating hormone), plus T3 and T4. If these are normal, you then start with .05 mg synthroid (T4) and 5 mcg Cytomel (T3). After a few weeks, you have the thyroid tests redone- the most important of these is is the TSH. Normal values range from 4.5 to 0.4. You want to aim for the low end of this range: 0.5 to 0.8 is ideal. You won't feel an AD effect from this, but should feel a greater stability to your moods. These low doses don't cause any jitteriness in most people. Also, many people with chronic depression have undetected slight hypothyroidism- that was the case with me, and correcting that is a big help.
Apparently, it is the T3 which has an antidepressant effect, but people are supposed to take T3 and T4, as that is what our bodies produce anyway when they are in balance.
If you decide to try it, let us know how it goes!
Pfinstegg
Posted by jumpy on November 25, 2002, at 19:13:01
In reply to Re: thyroid supplementation in chronic depression » Pfinstegg, posted by Geezer on November 25, 2002, at 9:46:14
Hey Geezer,
Here is a good link about thyroid supplimentation ...
http://www.psycheducation.org/thyroid/introduction.htm
Good luck ...
Jumpy/Paul
This is the end of the thread.
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