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Dr. Bob is Robert Hsiung, MD,
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Posted by Denise528 on March 17, 2002, at 10:31:22
In reply to Re: Anyone had success with ECT?ISO M Shelli R » Denise528, posted by IsoM on March 13, 2002, at 21:27:19
Thanks again, don't want to drag this thread on for too long but I went to my Doctors on Friday and mentioned the possibility of ECT to him. He looked at me increduously and said that he would only recommend ECT to somone who was profoundly depressed and then went on to say that you would have to be suffering from delusions, that some people imagine that they are already dead and rotting and that it would only be cases such as this which would warrant ECT. I'm really at the end of my tether, I suppose I should be grateful because I can still get myself to work but I still feel deeply depressed, don't look forward to anything and there istn't a day that goes by when the life ahead of me doestn't seem just too long.
Denise
Posted by IsoM on March 17, 2002, at 14:32:43
In reply to Re: Anyone had success with ECT?ISO M Shelli R, posted by Denise528 on March 17, 2002, at 10:31:22
Your doctor thinks that ECT is only for "somone who was profoundly depressed and then went on to say that you would have to be suffering from delusions, that some people imagine that they are already dead and rotting and that it would only be cases such as this which would warrant ECT."
Not true. This is his professional opinion, mind you & I'm not a professional, but I've SEEN others cases where ECT was used for others. Dr. James G. Harris, both a research professor & a practicing psychiatrist, working out of the university hospital of UBC (University of British Columbia [Canada]) will use ECT in severely depressed people to get them out of their deep, suicidal depression, before finding treatment that they can be continued on for long-term benefit.
Like I said, I'm not a professional, but Dr. Harris is & has used these examples in his teaching classes - he told me this.
Posted by Hal on March 17, 2002, at 15:01:16
In reply to Re: Anyone had success with ECT?ISO M Shelli R, posted by Denise528 on March 17, 2002, at 10:27:20
> Thanks again, don't want to drag this thread on for too long but I went to my Doctors on Friday and mentioned the possibility of ECT to him. He looked at me increduously and said that he would only recommend ECT to somone who was profoundly depressed and then went on to say that you would have to be suffering from delusions, that some people imagine that they are already dead and rotting and that it would only be cases such as this which would warrant ECT. I'm really at the end of my tether, I suppose I should be grateful because I can still get myself to work but I still feel deeply depressed, don't look forward to anything and there istn't a day that goes by when the life ahead of me doestn't seem just too long.
>
> DeniseIt seems like your doctor is with holding a valuable treatment from you and the rest of his/her patients. ECT is very safe and the most effective treatment for many mood disorders. Many pdoc are uncomfortable with it because their lack of knowledge and training with ECT. Do not let this sway you from an excellent treatment modality ... find a pdoc who is more comfortable with the procedure if need be. This is your health, be proactive and protect it.
I just met a man refractory to all medical therapies who underwent 10 sessions of ECT one year ago. After ECT, not only was he free of depression/suicidal obsessions, but responded to celexa. ECT reset his brain receptors so he is now responsive to medications.
I hope your better soon.
Hal
Posted by Mags on March 17, 2002, at 15:35:28
In reply to Re: Candidates for ECT » Denise528, posted by IsoM on March 17, 2002, at 14:32:43
Hi there,
I am very interested in this post as my Psy doc has just recommended ECT to me.I live in Canada and he told me he considers ECT if the patient is suicidal and can't wait for meds to kick in or is non responsive to meds. As I meet both requirements I have seriously considered it.
I am home on a weekend pass after spending four weeks in hospital. He wanted me to think it over, talk to my husband and research ECT ( he knows I spend a lot of time here at PB looking for a magic cure ;o)
I go back tomorrow and am 99% sure I am going to give it a try.
Denise I hope you can keep working on your doc however if you are having a response to your med I would perhaps wait and see...ECT is for most the last resort.
Shelli,did you have any response at all?Please wish me luck!
Again thanks to all for the info.
Mags
Posted by IsoM on March 17, 2002, at 16:04:01
In reply to Re: Candidates for ECT, posted by Mags on March 17, 2002, at 15:35:28
Mags, when you decide to take ECT, please don't be discouraged if you find your memory affected a little. There's still problems with memories BUT the difficulties only occur with your most recent short-term memories.
It seems that the memories around the time of treatment don't always get 'imprinted' into long-term memory before the ECT blanks them out. You may feel foggy about what happened in the few days prior to treatment, so if there's anything you do want to stay in long-term, why not take this as an opportunity to write a sort of diary of things you'd like to remember (or even your daily routine) so when you reread it after treatment, you can say "oh right, I forgot that."
I've found that even depression has this effect of curtailing your memories. If you rmember any severe illness, you'll probably also find that your memories around that time are foggy. Stresses, illness, & other major events will sabortage our memories, not just ECT.
Posted by Hal on March 17, 2002, at 18:15:43
In reply to Re: Candidates for ECT » Mags, posted by IsoM on March 17, 2002, at 16:04:01
> Mags, when you decide to take ECT, please don't be discouraged if you find your memory affected a little. There's still problems with memories BUT the difficulties only occur with your most recent short-term memories.
>
> It seems that the memories around the time of treatment don't always get 'imprinted' into long-term memory before the ECT blanks them out. You may feel foggy about what happened in the few days prior to treatment, so if there's anything you do want to stay in long-term, why not take this as an opportunity to write a sort of diary of things you'd like to remember (or even your daily routine) so when you reread it after treatment, you can say "oh right, I forgot that."
>
> I've found that even depression has this effect of curtailing your memories. If you rmember any severe illness, you'll probably also find that your memories around that time are foggy. Stresses, illness, & other major events will sabortage our memories, not just ECT.Dear IsoM,
May I ask what medication you husband used for maintance after ECT?
Thanks.
Sincerely,
Hal
Posted by IsoM on March 17, 2002, at 21:48:27
In reply to Re: Candidates for ECT » IsoM, posted by Hal on March 17, 2002, at 18:15:43
Sure, Hal, though he's no longer my husband. He responded to some medications for a short while but within a month or two, every one would lost its effectiveness. I don't want to make a blanket statement because this may not be the reason for the lack of response, but still I have a gut-feeling, that his poor nutrition did play a part.
He was raised in a non-vegetable, non-healthy food family. He'd never tasted brocolli, green peppers, coleslaw & many other vegetable dishes until after our marriage, & he never did develop a taste for real food. He'd eat a small part of what I cooked - mostly the meat, & then eat junk food. He had a very high fat, high sugar, & high salt diet. He'd literally go through a gallon pail of ice-cream in a couple of days, bags of chips, pop, etc. I think without the needed vitamins & minerals, his body couldn't maintain itself.
So I wish I could say something worked long-term, but nothing did. The best med & the one that lasted the longest was Nardil, a MAO inhibitor.
Posted by IsoM on March 17, 2002, at 21:51:13
In reply to Re: Candidates for ECT » IsoM, posted by Hal on March 17, 2002, at 18:15:43
One more thing - because of his lack of response to meds, the doctor tried ECT two more times. The two additional treatments were separated by a number of months. The second time, there was an improvement but after the third time, there was no response. The doctor didn't think it was worth trying after that & my (ex)husband agreed.
Posted by Hal on March 17, 2002, at 23:25:29
In reply to One Additional Thing » Hal, posted by IsoM on March 17, 2002, at 21:51:13
> One more thing - because of his lack of response to meds, the doctor tried ECT two more times. The two additional treatments were separated by a number of months. The second time, there was an improvement but after the third time, there was no response. The doctor didn't think it was worth trying after that & my (ex)husband agreed.
Hey IsoM,
Thanks for answering my prior questions. Your ex-husband's situation sounds terrible, I haven't heard of too many individuals failing ECT. May I ask how he is now? Anything helping his depression? What do you do if you fail ECT?
I guess I am asking because your ex-husbands story is frightening, I hope I never reach a point where ECT does not work. My sympathies go out to him.
Sincerely,
Hal
Posted by IsoM on March 18, 2002, at 1:17:59
In reply to Failing ECT! » IsoM, posted by Hal on March 17, 2002, at 23:25:29
The doctor in charge had no idea of what happened. It was very frightening for him, & everyone else involved, at the time. The third time it was used, he came to very early (they use a short-acting anesthesia) & was highly belligerent, starting fighting them to leave. It took eight people to hold him down & give an injection of a short-acting sedative. He ended up in intensive care for a half day with his blood sugar plummeting. He had diabetes but wasn't too good with diet or monitoring it (actually he was terrible - his blood glucose readings were all over the place, up & down) & they wondered if that might have been part of the reason. It was nothing like anyone had ever seen in that field before & they were awfully nervous about ever using ECT on him again. He can't remember anything of that episode, though he remembered waking up & being transferred back to bed from the other two times he was treated. It was a very unusual reaction, to say the least, & his behaviour at the time was certainly not his normal behaviour.
He seems to be doing the same as he ever was (simply plugging along) but he won't take anything now. Basically said it wasn't worth bothering. Mentally/emotionally, he seems the same. Physically, he's gone downhill & is in poor health. Sorry to sound so discouraging. Do remember that the doctor & the ECT technicians had never, ever experienced any other patient like that.
Posted by Denise528 on March 18, 2002, at 6:54:31
In reply to Re: Candidates for ECT, posted by Mags on March 17, 2002, at 15:35:28
Mags,
Good luck with the ECT, I really hope it works. Keep us updated.
Denise
Posted by Mags on March 18, 2002, at 17:59:01
In reply to Re: Candidates for ECT - Mags, posted by Denise528 on March 18, 2002, at 6:54:31
Thank you all so much for your responses and good wishes. I got home from hospital today and will know Wednesday what the schedule is for my ECT's. I will let you know results.....
Mags
Posted by Mags on March 18, 2002, at 18:04:02
In reply to Re: Candidates for ECT » Mags, posted by IsoM on March 17, 2002, at 16:04:01
Thanks for the scoop Iso...My doc did tell me about the memory thing..will do as you suggested about writing things down ...great idea...I know what you mean about about poor memory and depression...I figure the ECT can't be any worse than the way my memory is right now..it is very frustrating.....
> Mags, when you decide to take ECT, please don't be discouraged if you find your memory affected a little. There's still problems with memories BUT the difficulties only occur with your most recent short-term memories.
>
> It seems that the memories around the time of treatment don't always get 'imprinted' into long-term memory before the ECT blanks them out. You may feel foggy about what happened in the few days prior to treatment, so if there's anything you do want to stay in long-term, why not take this as an opportunity to write a sort of diary of things you'd like to remember (or even your daily routine) so when you reread it after treatment, you can say "oh right, I forgot that."
>
> I've found that even depression has this effect of curtailing your memories. If you rmember any severe illness, you'll probably also find that your memories around that time are foggy. Stresses, illness, & other major events will sabortage our memories, not just ECT.
Posted by shelliR on March 18, 2002, at 20:15:50
In reply to Re: Candidates for ECT » IsoM, posted by Mags on March 18, 2002, at 18:04:02
Mags,
Good luck. My memory and orientation came back within about a week or so after my last ect. It's true, it all blended together with my depression and the confusion of being away for almost two months. So I have lost a bit of the past, but now my thinking and capasity to work are fine.
Shelli
Posted by OldSchool on March 18, 2002, at 20:26:15
In reply to Re: Anyone had success with ECT?ISO M Shelli R, posted by Denise528 on March 17, 2002, at 10:27:20
> Thanks again, don't want to drag this thread on for too long but I went to my Doctors on Friday and mentioned the possibility of ECT to him. He looked at me increduously and said that he would only recommend ECT to somone who was profoundly depressed and then went on to say that you would have to be suffering from delusions, that some people imagine that they are already dead and rotting and that it would only be cases such as this which would warrant ECT. I'm really at the end of my tether, I suppose I should be grateful because I can still get myself to work but I still feel deeply depressed, don't look forward to anything and there istn't a day that goes by when the life ahead of me doestn't seem just too long.
>
> DeniseMy understanding of the main uses for ECT is that it is used as a last ditch treatment for severe and refractory mood disorders. Its not used for mild depression at all. You dont use ECT to treat dysthymia or any form of depression which responds well to drug treatment. ECT is used in SEVERE clinical depression that hasnt responded adequately to drugs. Or for psychotic depression, as in when delusions or hallucinations are present. ECT is also very effective for bipolar mania. And for catatonia. Any mood disorder with psychotic features is supposed to respond well to bilateral ECT. That would be either unipolar or bipolar mood disorders.
Posted by Dave1 on March 21, 2002, at 12:18:48
In reply to Re: Anyone had success with ECT?ISO M Shelli R, posted by OldSchool on March 18, 2002, at 20:26:15
> > Thanks again, don't want to drag this thread on for too long but I went to my Doctors on Friday and mentioned the possibility of ECT to him. He looked at me increduously and said that he would only recommend ECT to somone who was profoundly depressed and then went on to say that you would have to be suffering from delusions, that some people imagine that they are already dead and rotting and that it would only be cases such as this which would warrant ECT. I'm really at the end of my tether, I suppose I should be grateful because I can still get myself to work but I still feel deeply depressed, don't look forward to anything and there istn't a day that goes by when the life ahead of me doestn't seem just too long.
Hi Denise,
I had treatments a few years ago. They were effective, but I relapsed quickly. I had no follow treatment or medications to prevent a relapse - DUMB.
New research has indicated that a combination of Pamelar and Lithium will prevent relapse in like 70% of patients. You might also need a follow up treatment here or there.
When I got my treatments, I went directly to the ECT doctors, I didn't bother trying to get a referral out of my non-ECT doctor. Just make an appointment with an ECT pdoc, and tell him your symptoms. I'm sure he would try ECT if you are suicidal and treatment resistant.
I got a list of doctors by calling the American Psychiatric Association and asking for a list of doctors in my area who do ECT. Then picked a couple and went for a visit. Make sure the one you pick knows about the Pamelar and Lithium.
The pdocs I associate with now know about, and have been using this drug combo., to prevent relapse, with good success.Bye,
Dave
Posted by Denise528 on March 21, 2002, at 12:53:36
In reply to Re: Anyone had success with ECT? Denise, posted by Dave1 on March 21, 2002, at 12:18:48
Hi Dave,
Thanks for the advice. Unfortunately I don't live in the States (Live in England) and I am not sure if we have any specific ECT Doctors over here. But it will be worth enquiring. Trouble is I feel so low lately I'm scared stiff that even if I had it it still wouldn't work just Like ISOMs husband. Lately my brain seems to be impervious to anything, impenetratable! Why does this bloody organ have to be so complex? Anyway I suppose it's worth a try if all else fails and thanks again for the advice.
Can I just ask, what sort of state you were in when you had it, were you suffering from delusions?
Denise
Posted by Dave1 on March 21, 2002, at 20:35:02
In reply to Re: Anyone had success with ECT? Dave, posted by Denise528 on March 21, 2002, at 12:53:36
Hi Denise,
I have had chronic, unremmitting unipolar depresssion for about 20 years. Some doctors say I have minor delusions (I think I'm going
insane, even though they tell me I'm not). But
no major delusions (I think the T.V. is telling me something).Regarding the doctors, you should call the psych wards of some major hospitals, and ask if ECT is done at them. If so ask for the names of the doctors that do them. I went to pdocs for 15 years, and even though I never responded to anything, none told me about ECT. I had to research it, and initiate it myself.
Regarding the efficacy, I was shocked, after 2 or 3 treatments, I started getting memories of my old emotions, and then I actually felt the emotions for the first time in 15 years.
Most ECT doctors tell me they get a 90% success rate. So I would be pretty surprised if you don't get atleast some relief.
Note: Not to scare you, but when I did it they used several different types of anesthesia. Waking up from Diprivan (Propofol) is easiest so I would insist they use it instead of one of the others such as Brevital or Pentothol. Waking up from these can be rougher, and Diprivan works just as well.
Go for it. I'm trying to get myself to do it again also.
Bye,
Dave
Posted by GB on March 21, 2002, at 21:12:42
In reply to Re: Anyone had success with ECT? Dave » Denise528, posted by Dave1 on March 21, 2002, at 20:35:02
Hey Dave,
Nothing works for me but Elavil, but that is causing me serious heart problems. Can ECT allow you to respond to a class of meds that didn't work for you in the past? I was hoping to try ECT and maybe that would allow me to respond to an SSRI.
Thanks
GB
Posted by OldSchool on March 21, 2002, at 21:19:28
In reply to Re: Anyone had success with ECT? Dave » Denise528, posted by Dave1 on March 21, 2002, at 20:35:02
> Hi Denise,
>
> I have had chronic, unremmitting unipolar depresssion for about 20 years. Some doctors say I have minor delusions (I think I'm going
> insane, even though they tell me I'm not). But
> no major delusions (I think the T.V. is telling me something).
>
> Regarding the doctors, you should call the psych wards of some major hospitals, and ask if ECT is done at them. If so ask for the names of the doctors that do them. I went to pdocs for 15 years, and even though I never responded to anything, none told me about ECT. I had to research it, and initiate it myself.
>
> Regarding the efficacy, I was shocked, after 2 or 3 treatments, I started getting memories of my old emotions, and then I actually felt the emotions for the first time in 15 years.
>
> Most ECT doctors tell me they get a 90% success rate. So I would be pretty surprised if you don't get atleast some relief.
>
> Note: Not to scare you, but when I did it they used several different types of anesthesia. Waking up from Diprivan (Propofol) is easiest so I would insist they use it instead of one of the others such as Brevital or Pentothol. Waking up from these can be rougher, and Diprivan works just as well.
>
> Go for it. I'm trying to get myself to do it again also.
>
> Bye,
>
> Dave
Dave, you are the man!!Old School
Posted by IsoM on March 22, 2002, at 1:02:56
In reply to Re: Anyone had success with ECT? Dave, posted by Denise528 on March 21, 2002, at 12:53:36
Denise, don't be scared of it not working. My ex-husband was the only case the doctors had ever heard of. I don't know if it made medical journals. They had thought that because his diabetes wasn't controlled, that it may have been a major factor for the stange reaction the last time. I don't think you should be scared or it - not enough to not give it a try.
Posted by Dave1 on March 22, 2002, at 12:24:47
In reply to ECT reset your brain chemistry » Dave1, posted by GB on March 21, 2002, at 21:12:42
Hi,
That is one theory. One doctor told me he can give the same after ECT and it works, even though it didn't before. Another doctor told me that this possible, but nobody is really sure if the theory is true.
Bye,
Dave
Posted by Dave1 on March 22, 2002, at 12:34:14
In reply to Re: Anyone had success with ECT? Dave, posted by OldSchool on March 21, 2002, at 21:19:28
>
>
> Dave, you are the man!!
>
> Old SchoolTHANKS, even though lately I've been avoiding getting ECT because I'm afraid of them.
Posted by OldSchool on March 22, 2002, at 22:54:05
In reply to Re: Anyone had success with ECT? Dave » OldSchool, posted by Dave1 on March 22, 2002, at 12:34:14
>
> >
> >
> > Dave, you are the man!!
> >
> > Old School
>
>
>
> THANKS, even though lately I've been avoiding getting ECT because I'm afraid of them.You demonstrate that you are a courageous person by having ECT. And by coming on here and describing your ECT experiences that means a lot. Usually all you read on the Internet is the usual anti-ECT spiel on the anti-psychiatry websites.
take care,
Old School
Posted by Elizabeth on March 23, 2002, at 13:00:10
In reply to Re: Anyone had success with ECT?ISO M Shelli R, posted by OldSchool on March 18, 2002, at 20:26:15
Hi everyone. I was just looking through this thread concerning indications for ECT.
It's true that ECT is mainly reserved for situations when medications don't work. ECT is very effective for major depression *in general*. However, it's more effective for some types of depression than others.
The main types of depression for which ECT is known to be especially effective are severe depressions with melancholic and/or psychotic features. These types of depression usually (not always) respond well to medications, though (in the case of psychotic depression, an antipsychotic drug is almost always necessary in addition to an antidepressant). ECT is sometimes used when the risk of suicide and/or starvation (or serious malnutrition) is immediate enough that it would be too dangerous to wait for an antidepressant to start working. (There are also some rapid-acting medications, such as antipsychotics, benzodiazepines, stimulants, and opioids, that may be used temporarily to keep the depression under control while waiting for an antidepressant to work.) In the past ECT has been used when medications were contraindicated for safety reasons; because of the discovery of safer ADs, I don't think that this situation comes up much anymore. (In the past, MAOIs were sometimes used as an alternative when TCAs were contraindicated, since MAOIs do not cause the potentially dangerous cardiovascular side effects that are seen with TCAs. If antidepressant medication in general was contraindicated -- for example, in pregnancy -- or if MAOIs didn't work, ECT was often used.)
Atypical depressions and depressions associated with personality disorders are frequently resistant to usual medication treatments; such depressions can be very severe, as well. But ECT is generally *not* an effective treatment for these types of depression. ECT is similarly ineffective for dysthymia (which, although not severe, can cause quite a bit of impairment and is sometimes refractory to medication treatments).
Many depressions don't meet the criteria for "melancholic" or for "atypical" features. It's not clear how well ECT works in these cases; because they are so heterogeneous, it's probably impossible to make any prediction. My guess is that it would be worth trying ECT in severe refractory cases of "undifferentiated" depression [not a technical term, just my word for it], particularly if the depression has features that somewhat resemble melancholia (e.g., melancholic-like neurovegetative signs with reactive mood).
In addition to depression, ECT is used to treat bipolar disorder (including mania) and schizophrenia. In bipolar disorders, ECT can be used to quiet down an acute manic or mixed episode (something that often can't wait; mixed states, in particular, are associated with a high degree of suicidality), as well as relieving depression (although, interestingly, ECT can trigger mania or hypomania when used to treat bipolar depression -- I think it's less likely to than antidepressants are, tho'). We don't have much information on the use of ECT for rapid-cycling bipolar disorder. Using ECT to treat episodes in bipolar disorder can be awkward since you can't take anticonvulsants while having ECTs!
ECT is effective for catatonic states, which occur in both mood disorders and schizophrenia and which aren't always treatable with medications.
In schizophrenia, ECT works best if the illness has been of brief duration, rather than chronic. ECT is used sometimes as an adjunct to antipsychotic medication in partial responders; by itself, it's less effective than antipsychotic drugs.
It's not clear when, if ever, bilateral ECT should be tried before unilateral.
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