Psycho-Babble Medication | about biological treatments | Framed
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Re: ECT or switch up medication or stay put

Posted by linkadge on August 8, 2018, at 7:38:29

In reply to ECT or switch up medication or stay put, posted by CheckTest on August 7, 2018, at 22:05:04

Ok. You posted a lot.

The first thing that strikes me is that your doctor is recommending ECT when you say you are doing "ok overall". If you're not feeling sure about it, then just tell your doctor you'd rather not (at this time).

Personally, I would lean more towards ECT only if your symptoms move into the severe range and aren't responding at all (or very little) to medications.

Have you tried mirtazapine and venlafaxine together? This combo can work well for some.

I currently take effexor + mirtazapine + lithium (in varying ratios). I use mirtazapine mainly for sleep (it has some antidepressant effect, but not that much, for me). I find lower doses work better (< 7.5mg). Higher doses actually made me more depressed. If you are taking Remeron more for sleep, you might try reducing the dose. The noradrenergic action can induce sadness (mirtazapine blocks a shutoff switch for NE release). Mirtazapine is more sedating in lower doses (mostly an antihistamine) and starts to engage other systems at higher doses (norepinephrine release via alpha-2 blockade). For some people, alpha-2 blockers can induce sadness.

Couple recomendatiosn from reading:

- Zinc is very important for depression (more evidence than many other supplements - cheap - enhances the effect of dopamine reuptake inhibitors)

- methylating substances can be used in conjunction with regular antidepressants - folic acid is probably the most important

- scopolamine (have used myself) can be used on an as needed basis (can work quickly and effects can last, for some)

You mentioned that ritalin and vortioxetine worked in the past. When they stopped working, what were the key symptoms that returned?

You mentioned that cholinergics make you worse (although not consistently). I notice the same thing. However, choline, somtimes can help me dramatically. Many of the psych meds enhance the monoamine / acetylcholine ratio. This can sometimes cause apathy.





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