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ECT or switch up medication or stay put

Posted by CheckTest on August 7, 2018, at 22:05:04

Hello there- I believe this is my first time posting here but I've read some from over the years. Saw my Psych today and he is leaning toward ECT for my current depression, have a consult scheduled later in August, but they might move it up. Uncertain about ECT.

Right now I am really doing ok, overall. Little flat, some periods of sadness, suicidal ideation, consistent feelings of worthlessness/inability, but nothing quite at a hospital level. Getting through what needs to be done. Eating, sleeping, hours at work (part). Little bit of psychomotor slowing but not consistently, though a couple bad times.

Dx: MDD, some anxiety,
h/o insomnia (maintenance, early) doing fine on mirt

Current medications:
Mirtazapine - 60 mg
Vortioxetine - 15(20) mg
Bupropion - 75x2 mg
~Methylphenidate ER - 10 mg

[2000 IU vitamin D3, magnesium threonate from a sibling, tried various supplements]
Some exercise, good diet. In therapy, consistent.

~I haven't been taking the ritalin lately, so I plan to start taking it consistently because it does seem to make me less anxious and get me out of my head some. Just have been not wanting to take medication, I guess.

Cut down on vortioxetine a few weeks ago. Mezza-mezza, don't have any problems with it. It was one of the most effective medications I was on for some time, combined with ritalin.

Bupropion I can't really say. Might stop it some time.

Mirtazapine. Getting sleep. Little sedating. Not sure how well it really is working.

Previously on:
Tranylcypromine - 70 mg
with methylphenidate - 5-15 mg
short period buspirone as well.

Was out of depression on ritalin and vortioxetine in past.

Others in past, various combos I can't recall:
Fluoxetine, sertraline, escitalopram
Venlafaxine, duloxetine
Desipramine, amitriptyline, ?nort

Bupropion in other combinations

Lithium, lamotrigine

Aripiprazole (hospitalized 2nd day on it - SI)

Benzos make me more depressed, absolutely. Don't do much for my anxiety either.
Trazodone is mediocre. There are others too.

Did low dose naltrexone for a bit. Might check if my doctor wants to try that again.

rTMS - L DLPFC protocol seemed to be good?
R DLPFC trial didn't seem to do anything?

Usually have minimal side effects, most tolerable [wore compression socks for hypotension from parnate, careful with diet]. Switched due to lack of efficacy.

Various: Have a sibling who has done a bunch of 'natural' routes and I have gotten some of her leftovers. The methylation route didn't seem to be as effective as effexor. But some do fantastic- people can have different experiences.

Not taking medications and doing only diet and exercise - went poorly, multiple times.

Ashwagandha - insomnia, ?worse minor.
Rhodiola - nothing notable
Probiotics? - no diff
Magnesium - might make me flatter, glycinate insomnia, may try not taking for a bit
Melatonin - ineffective for sleep over a range of doses (500mcg - actually 50 mg). mood worse?

SAMe - can't recall. May try again
Methylfolate - nothing notable

5-htp - nothing notable? I think?
l-tyrosine - nothing much. Might have been good for when I worked out too much.
phenylalanine - ""

I did some 'nootropics' in the past but at that time I was fairly depressed and mood variable, so nothing reliable and consistently likely can be said. Aniracetam did make me feel worse a few times. Cholinergics(Choline, alpha-GPC) are generally bad news, though not as consistently bad as might be expected.

Possible rash from prescribed modafinil- not sjs but allergic [diffuse]

Tianeptine 12.5 mg x3 - possibly worse. accurate dose.
Opioids after surgeries made me sick and slow. I'm happy to not be an addict. A tough disease.

Actually I did have a scopolamine patch that was beneficial during a previous episode. I might try that again. It is used for cognitive impairment and memory studies for a reason, however.

Minocycline for infection- helped the infection, can't say I noticed much for mood. Maybe fuzzier

Thank you for any input! Little scared about ECT, and I might wait it out after the consult, but thought I would check in.

Best of luck to all of you out there! Keep on going! The world is a maddening, perplexing, but interesting place! Hopefully all of you can be part of it and find some comfort!




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