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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 14 to 38 of 69. Go back in thread:
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.
Posted by Mags on March 23, 2002, at 13:31:37
In reply to Re: Anyone had success with ECT?, posted by Elizabeth on March 23, 2002, at 13:00:10
Thanks for great info Elizabeth. I am scheduled for ECT but have to first figure out how to get Lamictal out of my system and how long it should be out. I am presently on 100 mg which took forever to get there plus Remeron and Wellbutrin.
My doc is supposed to get back to me but it has been a week with no response. I don't feel like taking these drugs for no reason. I am BP11 and still in a DEEP atypical type depression. just got out of hospital after four weeks. Am very sensitive to drugs.
Any info is greatly apprecited!
Mags
Posted by OldSchool on March 23, 2002, at 15:04:53
In reply to Re: Anyone had success with ECT?, posted by Elizabeth on March 23, 2002, at 13:00:10
> 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.
It might be true that atypical depression doesnt respond as well to ECT. I agree the kind of depression ECT works best for is mood disorders with psychotic features. Or classic severe melancholia depression (endogenous depression). But in the real world, if you dont respond well to meds and get a referral for ECT, I dont think most shock docs differentiate that much between atypical depression and the other more conventional depression types. They just wanna shock you...period.I doubt most shock consultations the docs go thru a big long list of things like you just posted. You might know more about this than the docs do in some cases because of your readings. You know how it is in the real world, if you dont respond to meds you just get shocked, period.
As far as bilateral, its definitely better to start off with if you have psychotic features with your mood disorder. Also remember bilateral doesnt require an initial titration the first time like unilateral requires. Thus with unilateral, your first treatment is wasted. Bilateral is more effective, but has more memory side effects. Bifrontal ECT is supposed to be the best of both worlds, having effectiveness comparable to bilateral, but without the severe memory loss side effects of bilateral.
Old School
Posted by BarbaraCat on March 24, 2002, at 15:43:06
In reply to Re: Anyone had success with ECT?ISO M Shelli R » Denise528, posted by shelliR on March 13, 2002, at 23:03:30
Hi Shelli,
I just read your prior post:
> And I hurt all the time horribly. So ect was a last resort <well, actually a partial opiate is my last last resort.>I don't know if we've discussed this before or not, but have you considered that you have fibromyalgia? I do along with severe episodes of depression. I've been through all the newer ADs (with some old TCA's thrown in) and am very treatment resistant. When either the fibro flares up, or I'm having a bout with depression (honestly, I don't think they're separate anymore) I get horrible pain throughout my body. Flu-like aches that move around my body, extreme fatigue and a bleak dark despondent hopelessness. Feels like every cell in my body is sick and poisoned. If you do have fibro it's very important to attend to that metabolic dysfunction along with your antidepressant regimen. YET ANOTHER cause of body pain is hypothyroidism. I (lucky me) also have that. I believe for me all these diseases are interweaved so I know that if I don't take care of one aspect, the others fail as well. - Barbara
Posted by shelliR on March 24, 2002, at 20:51:33
In reply to Hurting all the time? » shelliR, posted by BarbaraCat on March 24, 2002, at 15:43:06
Hi Barbara,
I didn't know that hypothyroidism causes pain. Actually I do take a combination natural thyroid, but I should look at my records and make sure that my thyroid is the highest it can be in the normal range. At least that's where I was told, by a pdoc, it should be if I'm depressed.
Re pain. Mostly my pain is inseparable from my depression, also. But it is mainly in my chest. I have costochondritis (inflammation of the cartilage where ribs attach to the breast bone.) It hurts to the touch and my pain/depression was there 100% of the time before I started buprenorphine. I've also started taking advil or other anti-inflammatories round the clock and I've set up an appointment with a pain specialist to see if a cortisone shot will help.
As far as fibromyalgia, Lorraine recently suggested that. I'm sure my immune system is affected, but as I told her: I don't see much point in persuing it since my worst pain is in my chest, and also I can't see spending the time and money to see new doctors when there is really no cure for fms. Basically I'll just stay on bupe as long as I can get it. I feel pretty much like a normal person, although I do wish a doctor would prescribe it, instead of me getting it off the internet. But considering I was huddled up in bed a month ago, and not able to eat anything, I shouldn't complain.
Thanks for the suggestion, though.
Take care,
Shelli
Posted by BarbaraCat on March 25, 2002, at 0:58:52
In reply to Re: Hurting all the time? » BarbaraCat, posted by shelliR on March 24, 2002, at 20:51:33
Shelli,
Regarding fms and no cure, I agree with you. I've spent alot of money on specialists who try one thing after the other and then finally admit that there's no cure at this time. I mainly control it by diet and stress reduction. I'm familiar with costocondritis, having had it myself about 5 years ago. It eventually went away. I remember it being very painful and not being able to raise my arms at all or take a deep breath.
Yes, low thyroid causes a deep muscular aching pain, muscle weakness and tingling. In fact there are some schools of thought that suggest improper functioning of the thyroid causes fms. I know that when I upped my dose (also taking natural brand) my fms pains diminished considerably. I'd urge you to get it checked since even a slightly low function can mean depression. AT the risk of repeating what you already know: Your TSH values should be around 1.0 - 1.5. Many doctors will let it go at 2 and above, but that is not good enough to get a good therapeutic antidepressant effect. Good luck to you. - Barbara
Posted by Elizabeth on March 25, 2002, at 14:43:45
In reply to Re: Anyone had success with ECT?, posted by OldSchool on March 23, 2002, at 15:04:53
> It might be true that atypical depression doesnt respond as well to ECT.
From what I've read, it's not totally clear to me whether there's solid evidence of this, or whether it's just a reputation. Interestingly, there doesn't seem to be any recent research on the subject at all. But anyway, these subtypes don't predict anything *absolutely*, so in some cases it's probably worthwhile to try ECT even if you seem to have "atypical" depression.
My pdoc and I did talk about ECT once (when I was in Boston), and he took the particular features of the illness (neurovegetative signs/symptoms, etc.) into consideration. This was when I'd tried a lot of things to augment Nardil (which had pooped out) and they didn't help. In the end we decided to keep trying with the medications. This ended up paying off, although it took a long time.
I think that doctors in a place like Boston, where there's a major medical center (three, in fact) and lots of research going on, would probably be more likely to take subtypes of depression into account than the average community doctor. Boston doctors also seem to be into trying experimental medication approaches, rather than just trying you on an SSRI, TCA, MAOI, and lithium and then referring you for ECT. :-)
> You might know more about this than the docs do in some cases because of your readings.
That's pretty scary, because I really don't know much about ECT. I definitely would not be willing to have ECT on the advice of a doctor who knew even less about it than I do.
> You know how it is in the real world, if you dont respond to meds you just get shocked, period.
Heh, my experience has that they just throw more meds at me!
> As far as bilateral, its definitely better to start off with if you have psychotic features with your mood disorder.
Hmm. It's been a long time since I seriously considered ECT, so I'm not sure that my information is up to date. My recollection is that it's a judgment call, though: you might want to start out using bilateral ECT for the most urgent cases, whereas if there isn't so much of a hurry you can afford to titrate so as to minimize the risk of cognitive side effects. Is there some other issue, or is that what you were thinking of?
> Bifrontal ECT is supposed to be the best of both worlds, having effectiveness comparable to bilateral, but without the severe memory loss side effects of bilateral.
I'm not very familiar with bifrontal ECT, but I'll keep this in mind (although I hope I never have to use the information myself!).
-elizabeth
Posted by Elizabeth on March 25, 2002, at 14:59:27
In reply to Re: Anyone had success with ECT? » Elizabeth, posted by Mags on March 23, 2002, at 13:31:37
> I am scheduled for ECT but have to first figure out how to get Lamictal out of my system and how long it should be out.
I'm not sure if there's any washout required beyond the time it takes to get the Lamictal out of your system, which is itself hard to predict because the elimination half-life is so variable. (Two weeks should probably cover it, I'd think. I'll be interested to hear what your doctor has to say.)
> I am BP11 and still in a DEEP atypical type depression. just got out of hospital after four weeks. Am very sensitive to drugs.
Is that one of the reasons you're trying ECT, because you have trouble with medication side effects? I hope that it works for you. Are you going to remain outpatient while having ECT?
It'd be great if you'd post here about the treatments; I think it's important for people here to get real stories from people about what ECT is like from people who've actually had it.
> Any info is greatly apprecited!
Sure. What would you like to know?
-e
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