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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Bipolarsux on January 28, 2003, at 4:14:12
I have had treatment resistant bipolar disorder with comorbid panic disorder for about 10 years.
Antidepressants and "mood stabilizers" aggravate the manic symptoms and I did not respond to lithium. Benzos in large doses do something to ease the mania but leave me emotionally flat and zombie like. Despite the fact they aggravate my mania, I still need to take antidepressants to fight off the other "pole" of the bipolar, so I am caught in a very tight medication "vice". Still the underlying illness regularly breaks through.
My manic symptoms tend to be severe agitation and insomnia, *severe* panic attacks and racing thoughts punctuated with feelings of elation and delusions of grandeur. Always my mania has been more difficult to control than depression (although this is often severe, too).
My pdoc is telling me that literally every reasonable combination of medication has been tried without much success over a long period of time and that we should start to think seriously about ECT, with maintenance ECT to follow if it works.
I am not afraid of the procedure itself or even the memory loss (you should try large doses of benzos and mood stabilizers if you really want to experience amnesia) but I am afraid it will not work. This is because I have read in a few places that ECT does not work on anxiety or panic, but these are major components of my mania.
When I asked my pdoc about this he replied that in his experience ECT works for a broad spectrum of bipolar symptoms but it is impossible to predict beforehand how any given individual will respond.
If there are people out there who have received ECT and part of their illness involved anxiety or panic attacks I would very much like to hear how these symptoms responded.
Hopefully there will be at least some positive responses :/
Posted by Jumpy on January 28, 2003, at 22:15:56
In reply to Bipolar, PD and ECT, posted by Bipolarsux on January 28, 2003, at 4:14:12
Hey There,
I have severe depression and panic disorder and I received ECT about 2 months ago. It really helped the depression ... I felt normal for the first time in several years afterwards. I was motivated, calm, sleep well and felt refresh in the morning, reading again, socializing, etc. It didn't not help the panic/anxiety ... I still take 0.5 to 0.75 of klonopin to keep that at bay. I will say that I did have some mild cognitive deficits that are resolving ... difficulty calculating, concentrating, learning ... the so called "anterograde amnesia" stuff.
Remember ... for treatment resistant mood disorders, ECT is just temporary and most patients relapse. So if you do decide on ECT, you might have to consider maintenance ECT on a monthly basis after that. (Although some docs will say that ECT changes brain chemistry and will allow you to respond to meds your failed before .... but experts like Max Fink says that you should not expect medications to work after ECT if they did not work prior to ECT and that maintenance is required). BTW, I have relapsed back into the deep depression.
I would visit www.psycheducation.org to make sure you have exhausted you medication options .... like thyroid supplemention, lamictal, trileptal.
Good luck.
J
Posted by Bipolarsux on January 29, 2003, at 3:39:21
In reply to Re: Bipolar, PD and ECT » Bipolarsux, posted by Jumpy on January 28, 2003, at 22:15:56
Hi Jumpy.
Thanks for sharing your experience with me.
I am a little confused - are you saying that you were free of both depression and anxiety/panic or only depression, with the panic remaining after ECT?
I'm sorry that you have relapsed. Guarranteed I will as well if I don't receive maintenance ECT: my condition is severe and has not remitted in more than a decade. Both my pdoc and I are well aware of this.
There is not much use in counting pills but I am taking well over 10X your daily Klonopin dose. This is on top of Lamictal and some other medications so maybe you can see why I am drugged into a zombie? But the alternative is unbearable pain. We have tried literally scores of medications in the past decade, including the ones you suggested. For better or worse I am destined to undergo ECT.
If you don't mind me asking, did you receive bilateral or unilateral ECT? The literature seems to agree that memory problems are more prominent with bilateral. I hope that unilateral will work for me but I suspect I will need the higher efficacy of bilateral. I don't really care much about the memory loss anyway - I already have to carry a notepad around and write important things down because the Klonopin blows my memory away.
Plus I am sick of popping handfulls of pills and still feeling like crap. ECT can take my past memories so long as I feel good in the present.Thanks again Jumpy and best of luck to you.
Posted by Jumpy on January 29, 2003, at 8:00:16
In reply to Re: Bipolar, PD and ECT » Jumpy, posted by Bipolarsux on January 29, 2003, at 3:39:21
I have two types of anxiety ... the panic attacks and obsessive worrying (the worrying is secondary to the depression). ECT got rid of my obsessive worrying that was related to the depression. ECT did nothing for the panic attacks. But the panic attacks are easily controlled with the klonopin.
J
Posted by judy1 on January 29, 2003, at 10:45:09
In reply to Bipolar, PD and ECT, posted by Bipolarsux on January 28, 2003, at 4:14:12
when the search function is restored, check the archives for this type of thread. I looked into ECT (also bipolar/panic and med resistant) and (for me) was afraid of any brain damage since I already have a seizure disorder. Most of the posts were fairly negative, the consensus being that it worked for a while then a relapse. whatever your decision, I wish you the best- judy
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