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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Psychquackery on August 24, 2003, at 22:59:38
This article, by noted ECT doctor Max Fink claims that many cases of "treatment resistant depression" may in fact be psychotic depression. Fink explains that TRDepression cannot adequately be treated by antidepressants alone and that the only treatment which results in remission is ECT.
Fink explains that the neuroendocrine system of individuals with TRD and psychotic depression are profoundly disturbed to the point that drugs just dont work. And only ECT will work. Fink calls for earlier use of ECT in TRD cases, to prevent chronic disability from setting in.
Read the article here:
Posted by Psychquackery on August 24, 2003, at 23:19:41
In reply to TRDepression maybe psychotic depression , posted by Psychquackery on August 24, 2003, at 22:59:38
Fink says:
"Also treat those with melancholia, inanition, severe weight loss and insomnia, concentration and memory difficulty, stupor, or suicidal ideation as if they had psychotic depression. These symptoms and signs are evidence that the patient’s neuroendocrine system is disturbed, an indication of severe depression that responds poorly to antidepressant drugs alone."
So, even if you arent hallucinating and having delusions but you are losing large amounts of weight, having severe insomnia, cognition decline, etc. you should be treated basically as if you have psychotic depression. ECT is best for this form of depression according to this article.
Igor
Posted by Larry Hoover on August 25, 2003, at 4:28:43
In reply to TRDepression maybe psychotic depression , posted by Psychquackery on August 24, 2003, at 22:59:38
> This article, by noted ECT doctor Max Fink claims that many cases of "treatment resistant depression" may in fact be psychotic depression. Fink explains that TRDepression cannot adequately be treated by antidepressants alone and that the only treatment which results in remission is ECT.
Fink owns the largest manufacturer of ECT equipment. Given his direct profit from the use of these machines, I cannot see anything he writes as unbiased.
Lar
Posted by tealady on August 25, 2003, at 5:04:40
In reply to Re: Severe melancholia should be treated with ECT, posted by Psychquackery on August 24, 2003, at 23:19:41
1. Dumb question..what is ECT?
2. <severe depression that responds poorly to antidepressant drugs alone>...OK, so why doesn't the doc try something else if antidepressants alone don't work....like thyroid or estrogen? "Hormones and the Mind" By Edward L. Klaiber M.D a psychoneuroendocrinolgist, explains how some women don't respond to antidepressants until their estrogen levels are fixed. I assume similar stories would occur with other hormones.
Posted by Psychquackery on August 25, 2003, at 8:26:28
In reply to Re: TRDepression maybe psychotic depression , posted by Larry Hoover on August 25, 2003, at 4:28:43
> > This article, by noted ECT doctor Max Fink claims that many cases of "treatment resistant depression" may in fact be psychotic depression. Fink explains that TRDepression cannot adequately be treated by antidepressants alone and that the only treatment which results in remission is ECT.
>
> Fink owns the largest manufacturer of ECT equipment. Given his direct profit from the use of these machines, I cannot see anything he writes as unbiased.
>
> LarThe view that ECT is the most potent treatment for severe depression is held widely across psychiatry. Not just among the Max Fink's of the psychiatry world. In fact, my own psychiatrist who does not perform ECT, says the same thing about ECT as Max Fink does in this article. That its the single most effective treatment for severe forms of depression. My own psychiatrist, who has nothing to gain financially from ECT, says he has seen "miracles" from ECT. As in full remissions from the most severe depressions.
Fink has studied the reasons ECT most probably works. Oddly enough, his conclusion centers around the "neuroendocrine" effects of ECT. ECT unlike rTMS and other meek treatments for depression, gets right to the heart of the problem and does it quickly.
Fink's claiming that ECT's effects on the neuroendocrine system is in sync with the current emphasis on the cortisol theory of depression. Which is attracting so much pharmacological emphasis these days.
Wouldnt it be ironic if we had a neuroendocrine "drug" that combats the most severe forms of depression all along? That being old fashioned ECT!!
Igor
Posted by Psychquackery on August 25, 2003, at 12:45:32
In reply to Re: Severe melancholia should be treated with ECT, posted by tealady on August 25, 2003, at 5:04:40
> 1. Dumb question..what is ECT?
ECT is a robust treatment for severe mood disorders known as ElectroConvulsive Therapy. Or shock treatment.
>
> 2. <severe depression that responds poorly to antidepressant drugs alone>...OK, so why doesn't the doc try something else if antidepressants alone don't work....like thyroid or estrogen? "Hormones and the Mind" By Edward L. Klaiber M.D a psychoneuroendocrinolgist, explains how some women don't respond to antidepressants until their estrogen levels are fixed. I assume similar stories would occur with other hormones.Augmentation strategies for refractory depression are poorly studied and usually dont work as well as psychopharmacologists would like us to believe. ECT on the other hand, is extremely well studied and its effectiveness is well documented. Study after study after study concludes bilateral ECT is the single most effective treatment for severe depression, mania and catatonia and works even when drugs dont work.
Submitting refractorily depressed individuals to endless drug/hormone augmentation strategies is cruel and usually yields shoddy results. Going straight to ECT is more of a sure thing and is backed up by tons of credible studies.
Igor
>
>
Posted by stjames on August 25, 2003, at 21:26:06
In reply to Re: Severe melancholia should be treated with ECT, posted by Psychquackery on August 25, 2003, at 12:45:32
> Submitting refractorily depressed individuals to endless drug/hormone augmentation strategies is cruel and usually yields shoddy results. Going straight to ECT is more of a sure thing and is backed up by tons of credible studies.
>
> IgorHowever, in some of us "endless" is just 2 trials. 20+ years and the meds still work for me.
Posted by KimberlyDi on August 26, 2003, at 12:12:51
In reply to TRDepression maybe psychotic depression , posted by Psychquackery on August 24, 2003, at 22:59:38
Posted by Questionmark on August 26, 2003, at 16:28:01
In reply to Re: Severe melancholia should be treated with ECT, posted by Psychquackery on August 25, 2003, at 12:45:32
> Augmentation strategies for refractory depression are poorly studied and usually dont work as well as psychopharmacologists would like us to believe. ECT on the other hand, is extremely well studied and its effectiveness is well documented. Study after study after study concludes bilateral ECT is the single most effective treatment for severe depression, mania and catatonia and works even when drugs dont work.
> Submitting refractorily depressed individuals to endless drug/hormone augmentation strategies is cruel and usually yields shoddy results. Going straight to ECT is more of a sure thing and is backed up by tons of credible studies.
>
> IgorOkay, it's unfortunate that Igor was just blocked, cuz i wanted to see what you/he had to say to this, but.... i have also heard about the sometimes incredible effectiveness of ECT for psychotic and severe depressions, but everything i have observed concerning ECT also suggests that, in addition to significant memory problems (maybe transient though), the positive effects of ECT only seem to last about a month to a few months or so. So it seems like it would require extra ECT treatments every few months or so for ... the rest of one's life (?). This doesn't seem worth the amnesia and other adverse effects. Maybe it would be worth it to some people, but i'm just saying it doesn't seem to be the grand treatment you make it out to be. Please correct me if i am mistaken though and ECT does often work after only one or a small # of treatments.
This is the end of the thread.
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