Posted by Dave001 on September 25, 2004, at 16:41:43
In reply to Dysthymia. What to do? ECT anyone?, posted by craig getty on September 22, 2004, at 14:21:34
> Has anyone heard any good/bad reports about ECT? Specifically, not just in cases of knife-to-the-wrist suicidal thoughts - because then anything is better than the Final Cut. But I'm talking about for cases of milder depression, like dysthymia, that are extremely annoying and just won't go away despite how much money we dish out to these pharmaceutical companies, whose CEO's are curing their own depression with every single deposit they make into their bank accounts.
>I don't think ECT would be of much use for dysthymia. Even if it did provide some benefit, it would probably be short lived. Dysthymia is really just a "medicalized" term that describes a temperament on one end of the mood spectrum. Because of its chronic and genetic origin, its arguably even worse than episodic major depression.
> P.S. I don't mean to sound (too) negative. I'm happy for you if you've found the right drugs that have managed to help you for more than a few months before losing their effectiveness and
You have a good point about drug treatment that most people tend to overlook, which is that because the body is determined to maintain homeostasis via an endless structure of feedback loops, it is likely to lose responsiveness to any drug after some time. Whether this happens as a result of receptor downregulation, a decrease in sensitivity, enzyme induction (unlikely a problem), or some other feedback mechanism will of course vary depending on the drug, but it does seem inevitable. It also makes a strong case for the need to periodically switch drug treatment strategies, but even then you run into complications such as cross-tolerance.
The MAOI Parnate would probably improve your mood, but because of its many annoying side-effects, the least of which is diet, it's hardly an ideal long-term option. At least that has been my experience. Whatever you do, stay away from any shrink who tries to push you low-dose neuroleptics, which are now prescribed for everything but the common cold. Some people find that a low dose of selegiline increases energy and mood. It's cheap remarkably free of side-effects (no food restrictions) if the dose doesn't exceed ~ 10 mg/day or so. Not likely much help for major depression at that dose, but might help you, and unlike SSRIs or most other antidepressants, it doesn't lower libido or interfere with cognition; in fact it may improve it.
Dave
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poster:Dave001
thread:393737
URL: http://www.dr-bob.org/babble/20040921/msgs/394944.html