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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by craig getty on September 22, 2004, at 14:21:34
Has anyone heard any good/bad reports about ECT? Specifically, not just in cases of knife-to-the-wrist suicidal thoughts - because then anything is better than the Final Cut. But I'm talking about for cases of milder depression, like dysthymia, that are extremely annoying and just won't go away despite how much money we dish out to these pharmaceutical companies, whose CEO's are curing their own depression with every single deposit they make into their bank accounts.
P.S. I don't mean to sound (too) negative. I'm happy for you if you've found the right drugs that have managed to help you for more than a few months before losing their effectiveness and causing you to use more and/or combine with others. (Isn't that the way they used to say that drug pushers got you hooked back in the nancy reagan 'just say no' days?)
Posted by catmint on September 22, 2004, at 15:17:23
In reply to Dysthymia. What to do? ECT anyone?, posted by craig getty on September 22, 2004, at 14:21:34
Hi,
I suffer from that nagging low-grade depression known as dysthymia as well. I also have Bipolar Disorder, so SSRIs are out of the question.I get suicidal about once a month, but not enough to actually take my life, or even hurt myself, I just fantasize about it; I'll occasionally smash something.
I take Lamictal presently. I had to increase it after 2 years, now I'm at 300 mg. It helps with certain symptoms of depresssion, mainly energy levels, but I constantly feel sad, and guilty about something or other. I guess the best for dysthymia for me is exersize. That is the only thing. It actually makes me feel joyful and hopefull if only for an hour or so, but hey that's something. Try that before ECT. Try something really hard like trail running or rock climbing. My friend took numerous ADs and Lithium to calm him down and keep him from killing himself. Now he is med free but works out constantly, he is extremely cut from rock climbing. Learn to climb at a gym. If you could join a yoga class, you'd be surprised.
Let us know.
Posted by Cybele on September 22, 2004, at 16:34:51
In reply to Dysthymia. What to do? ECT anyone?, posted by craig getty on September 22, 2004, at 14:21:34
I am also dysthymic (30 years now, since age 13) and haven't had much success with ADs. I am currently weaning off Effexor (75mg for 3-1/2 months) as the small improvement, if any, wasn't worth the 15 pound weight gain.
I gotta tell you, the only thing that helps me is exercise at least 5x a week for at least 30 minutes (preferably 45 minutes) at 70-90% of my maximum heartrate. Three times a week seems to work OK if the workouts are really hard (studio cycling classes from tough instructors). I've been doing that whilst on the Effexor, and I think that's what has caused my improvement. I no longer have "bad" (unmotivated, tired, forgetful) days.
Check out this article:
http://bjsm.bmjjournals.com/cgi/content/full/35/5/342
Posted by King Vultan on September 22, 2004, at 17:00:33
In reply to Dysthymia. What to do? ECT anyone?, posted by craig getty on September 22, 2004, at 14:21:34
> Has anyone heard any good/bad reports about ECT? Specifically, not just in cases of knife-to-the-wrist suicidal thoughts - because then anything is better than the Final Cut. But I'm talking about for cases of milder depression, like dysthymia, that are extremely annoying and just won't go away despite how much money we dish out to these pharmaceutical companies, whose CEO's are curing their own depression with every single deposit they make into their bank accounts.
>
> P.S. I don't mean to sound (too) negative. I'm happy for you if you've found the right drugs that have managed to help you for more than a few months before losing their effectiveness and causing you to use more and/or combine with others. (Isn't that the way they used to say that drug pushers got you hooked back in the nancy reagan 'just say no' days?)
I don't know exactly what you've tried, but I would certainly recommend trying either or both of the MAOIs before ECT, as well as talk therapy. ECT is probably not as bad as it used to be, but my understanding is that amnesia can still be a definite problem.Todd
Posted by Bob on September 22, 2004, at 18:51:39
In reply to Dysthymia. What to do? ECT anyone?, posted by craig getty on September 22, 2004, at 14:21:34
I've been through a hellish litany of meds over the past 12 to 13 years. I am no better mentally, and am far, far, far worse physically. I've been through life threatening withdrawls with Anafranil, Effexor, and Topomax, to name a few. I respond quite poorly to drugs with high SSSRI action, and don't know if I can take any of them any longer. Currently, my meds are only Eskalith and Welbutrin - they keep me "functioning" at a very low level. I lost my job a few years ago, so when I say functioning, I mean not lying in bed thinking about suicide the entire day. So, I'm saying all this because I think I'm going to try ECT in November, even though I'm not actively suicidal 24/7. There just aren't a lot of options left. Drug trials are too brutal now, as the process of going on and off is too life threatening.
So there's an example of someone considering ECT even though the "final cut" is not currently nigh.
Posted by craig getty on September 22, 2004, at 19:03:41
In reply to Re: Dysthymia. What to do? ECT anyone?, posted by King Vultan on September 22, 2004, at 17:00:33
Thank you all for your posts. If nothing else,they made me smile - I don't know why. I guess it's refreshing that people who don't know me for jack care enough to give a few kind words. Maybe I should join a group therapy thing - god, it just brings visions of the whimps in Fight Club or that bad Steven Segall movie.
Not to worry - I'm not bad off, just frustrated. I've tried ALL MEDS in one combination or another - nothing really does the trick. Today I'm getting by on my usually 400 XL mg Wellbutrin, 40 mg of adderall ER (10 mg more than my prescription), 0.5 mg of Klonopin and a delicious Sam Adams Octoberfest (okay, I just popped open my 2nd...err 3rd). I hope to get some pot later today. I haven't smoked in a few months, but I find it initially makes me very happy and silly (at least until I smoke too much and get bummed).Your statements on the exercise thing is ONE HUNDRED PERCENT CORRECT. I've witnessed my family members who suffer from depression make remarkable strides from exercise. So, to anyone considering it.......EXERCISE - it's worth it.
As for me I used to be a pseudo-weekend warrior in my 20s, but, unfortunately, I'm now a lame-o with a bad back. Even swimming messes it up. I've thought about rock climbing - looks fun - but my lame back probably won't handle it. Right now, I deal with that pain with Vioxx everyday, and I definitely do not want to have to go back to my Vicodin regiment if the pain increases (see, I now I am not easily addicted to drugs b/c I quit Vicodin in 5 days despite some nasty flu-like symptoms). I've thought about Tai Chi, but it seems kind of boring for someone who use to wrestle in college. I did start a regiment of speed walking 4 days ago, and felt great, but a fight with my girlfriend the other night made me bummed out and then I realized the walking benefit was all just an illusion that I caused myself to believe. The Exercise Placebo effect.
Sorry about the rambling post - the 3rd Sam Adams kicked in....
P.S. Seriously, ECT does seem f.....ed, I mean messed up to me, but if anyone knows of it's positive effects on non-suicidial fed up depressives, please post away.
Posted by craig getty on September 22, 2004, at 19:14:46
In reply to Re: Dysthymia. What to do? ECT anyone? » craig getty, posted by Bob on September 22, 2004, at 18:51:39
Bob,
My heart goes out to you, and I wish you the best of luck. When I posted this morning it was out of frustration and anger. Today I have "caught a buzz" which has made me "happy" in a not necessarily healthy way. However, I was seriously considering ECT. I once asked my pdoc right before going on MAOIs: "So, I've tried all the new antidepressants, and I've tried many of the tricyclics - I'm ready to try these MAOIs. If these don't work, what next?" He answered, "ECT". I thought he was kidding (visions of Cuckoos Nest floating in my head). Since then, the MAOS weer not better than anything else (my apologies to that guy Ace who swears by them). Anyway, my research on ECT has shown that it is not the horror that the media might portray it to be. Though I am still suspect, but would still consider it. I'm only suicidal like 5% of them time, and then it is more out of hypothetical planning or mentioning it to a friend to try and get sympathy rather than a real plan to do it. Good luck with your challenges and please keep me posted whether or not you try ECT.
> I've been through a hellish litany of meds over the past 12 to 13 years. I am no better mentally, and am far, far, far worse physically. I've been through life threatening withdrawls with Anafranil, Effexor, and Topomax, to name a few. I respond quite poorly to drugs with high SSSRI action, and don't know if I can take any of them any longer. Currently, my meds are only Eskalith and Welbutrin - they keep me "functioning" at a very low level. I lost my job a few years ago, so when I say functioning, I mean not lying in bed thinking about suicide the entire day. So, I'm saying all this because I think I'm going to try ECT in November, even though I'm not actively suicidal 24/7. There just aren't a lot of options left. Drug trials are too brutal now, as the process of going on and off is too life threatening.
>
> So there's an example of someone considering ECT even though the "final cut" is not currently nigh.
>
>
Posted by AuntieMel on September 23, 2004, at 14:28:45
In reply to Re: Dysthymia. What to do? ECT anyone? » craig getty, posted by Bob on September 22, 2004, at 18:51:39
aka finelinebob, bob, bobnotdoctor.....the bob that saved my life bob?
If so, thank you
Posted by Dave001 on September 25, 2004, at 16:41:43
In reply to Dysthymia. What to do? ECT anyone?, posted by craig getty on September 22, 2004, at 14:21:34
> Has anyone heard any good/bad reports about ECT? Specifically, not just in cases of knife-to-the-wrist suicidal thoughts - because then anything is better than the Final Cut. But I'm talking about for cases of milder depression, like dysthymia, that are extremely annoying and just won't go away despite how much money we dish out to these pharmaceutical companies, whose CEO's are curing their own depression with every single deposit they make into their bank accounts.
>I don't think ECT would be of much use for dysthymia. Even if it did provide some benefit, it would probably be short lived. Dysthymia is really just a "medicalized" term that describes a temperament on one end of the mood spectrum. Because of its chronic and genetic origin, its arguably even worse than episodic major depression.
> P.S. I don't mean to sound (too) negative. I'm happy for you if you've found the right drugs that have managed to help you for more than a few months before losing their effectiveness and
You have a good point about drug treatment that most people tend to overlook, which is that because the body is determined to maintain homeostasis via an endless structure of feedback loops, it is likely to lose responsiveness to any drug after some time. Whether this happens as a result of receptor downregulation, a decrease in sensitivity, enzyme induction (unlikely a problem), or some other feedback mechanism will of course vary depending on the drug, but it does seem inevitable. It also makes a strong case for the need to periodically switch drug treatment strategies, but even then you run into complications such as cross-tolerance.
The MAOI Parnate would probably improve your mood, but because of its many annoying side-effects, the least of which is diet, it's hardly an ideal long-term option. At least that has been my experience. Whatever you do, stay away from any shrink who tries to push you low-dose neuroleptics, which are now prescribed for everything but the common cold. Some people find that a low dose of selegiline increases energy and mood. It's cheap remarkably free of side-effects (no food restrictions) if the dose doesn't exceed ~ 10 mg/day or so. Not likely much help for major depression at that dose, but might help you, and unlike SSRIs or most other antidepressants, it doesn't lower libido or interfere with cognition; in fact it may improve it.
Dave
<snip>
Posted by sfy on September 25, 2004, at 20:47:26
In reply to Re: Dysthymia. What to do? ECT anyone?, posted by Dave001 on September 25, 2004, at 16:41:43
> The MAOI Parnate would probably improve your mood, but because of its many annoying side-effects, the least of which is diet, it's hardly an ideal long-term option. At least that has been my experience. Whatever you do, stay away from any shrink who tries to push you low-dose neuroleptics, which are now prescribed for everything but the common cold. Some people find that a low dose of selegiline increases energy and mood. It's cheap remarkably free of side-effects (no food restrictions) if the dose doesn't exceed ~ 10 mg/day or so. Not likely much help for major depression at that dose, but might help you, and unlike SSRIs or most other antidepressants, it doesn't lower libido or interfere with cognition; in fact it may improve it.
>
> DaveMany people have found that selegiline can be potentiated by 500-1000 mg of DL-phenylalanine (along with B6).
Posted by Bob on September 25, 2004, at 22:18:37
In reply to Re: Are you THAT Bob????? » Bob, posted by AuntieMel on September 23, 2004, at 14:28:45
> aka finelinebob, bob, bobnotdoctor.....the bob that saved my life bob?
>
> If so, thank you
I'd love to think I saved someone's life, but I don't think I'm the person you have in mind.
Posted by craig getty on September 26, 2004, at 0:26:19
In reply to Re: Dysthymia. What to do? ECT anyone?, posted by Dave001 on September 25, 2004, at 16:41:43
Thanks. I've tried Parnate and it didn't do anything. Nardil worked VERY WELL for a few months, but it was very UNenergizing - I had to take Provigil with it and drink about 4 cups of coffee a day (despite the fact that you're not supposed to have coffee). Eventually Nardil stopped working, so I upped the dose. All that did was make me gain weight and cause some "sexual frustrations."
Anyway, I've recently upped my Wellbutrin SR to 400 mg and started on Adderall ER (20-30mg). So far, things seem better...for now. I hadn't heard about selegiline so I guess it's good to know that there is still something out there that I haven't tried.
Posted by AuntieMel on September 27, 2004, at 8:59:44
In reply to Re: Are you THAT Bob????? » AuntieMel, posted by Bob on September 25, 2004, at 22:18:37
Interesting that Dr. Bob is allowing a name recycle.
I was referring to the Bob that posted a lot several years ago. He wouldn't know he saved my life, but it was largely his experiences that did (through the archives.)
Posted by Cybele on September 27, 2004, at 10:53:59
In reply to Re: Dysthymia. What to do? ECT anyone?, posted by craig getty on September 22, 2004, at 19:03:41
> Your statements on the exercise thing is ONE HUNDRED PERCENT CORRECT. I've witnessed my family members who suffer from depression make remarkable strides from exercise. So, to anyone considering it.......EXERCISE - it's worth it.
>
> As for me I used to be a pseudo-weekend warrior in my 20s, but, unfortunately, I'm now a lame-o with a bad back. Even swimming messes it up. I've thought about rock climbing - looks fun - but my lame back probably won't handle it. Right now, I deal with that pain with Vioxx everyday, and I definitely do not want to have to go back to my Vicodin regiment if the pain increases (see, I now I am not easily addicted to drugs b/c I quit Vicodin in 5 days despite some nasty flu-like symptoms). I've thought about Tai Chi, but it seems kind of boring for someone who use to wrestle in college. I did start a regiment of speed walking 4 days ago, and felt great, but a fight with my girlfriend the other night made me bummed out and then I realized the walking benefit was all just an illusion that I caused myself to believe. The Exercise Placebo effect.
>
> Sorry about the rambling post - the 3rd Sam Adams kicked in....Hey Craig Getty, sorry to take so long replying. Been cramming too much in my head lately.
Have you tried recumbent stationary bikes, like this one?
http://www.megafitness.com/life-cycle-9500r-exercise-bike.html
After my younger son was born in 1999 I had terrible back problems. I'd bend down to pick up a toy off the floor and my back would go into an agonizing spasm. I finally starting exercising, using the recumbent bike at my gym, and swimming very slow, easy laps. I also lost 35 pounds on Weight Watchers. Again, for the AD effect you really need to break a sweat and keep it up for at least 30 minutes.
I'm 10 days into titrating off Effexor-XR (75 mg) with no serious side effects, just some nightmares (Benadryl at bedtime seems to stave those off pretty well) and a few headaches. Oh, I guess I'm kind of irritable. One thing I have found is that alcohol would make me so dehydrated on Effexor that I started avoiding it. Now that I'm weaning off, a martini seems like just the ticket most evenings with only mild ill-effects at night or the next day. I wish there were such a thing as Synthahol, like they have on Star Trek. It relaxes you, but leaves you in full-control of your faculties and with no after-effects.
Posted by Bob on September 27, 2004, at 12:13:06
In reply to Re: Are you THAT Bob????? » Bob, posted by AuntieMel on September 27, 2004, at 8:59:44
> Interesting that Dr. Bob is allowing a name recycle.
>
> I was referring to the Bob that posted a lot several years ago. He wouldn't know he saved my life, but it was largely his experiences that did (through the archives.)I've been here since at least, I dunno, year 2000? Maybe longer?
Posted by AuntieMel on September 27, 2004, at 16:25:42
In reply to Re: Are you THAT Bob?????, posted by Bob on September 27, 2004, at 12:13:06
The one that saved my life. Thank you again (I think)
How are you doing? I've been worried about you. Last I heard you left NYC and were having problems with PTSD. Any progress?
Posted by Bob on September 27, 2004, at 18:18:58
In reply to Re: Then you ARE that Bob!!! » Bob, posted by AuntieMel on September 27, 2004, at 16:25:42
> The one that saved my life. Thank you again (I think)
>
> How are you doing? I've been worried about you. Last I heard you left NYC and were having problems with PTSD. Any progress?
Like I said before, it's not me. His ID had to be something other than "Bob", as I've never seen another individual on this board with my ID. I've never lived in NYC, and never been diagnosed with PTSD. I am glad to hear that your life was saved, as it must mean you're doing better.
Posted by craig getty on September 27, 2004, at 20:10:40
In reply to Re: Dysthymia. What to do? ECT anyone? » craig getty, posted by Cybele on September 27, 2004, at 10:53:59
Cybele,
I've heard recumbent bikes are supposed to help, but I always get discomfort just from the sitting position that the bike forces you into. Maybe I'll try it again and use one of those chiropractic wedges to prop up my butt.
Good luck tapering off the Effexor. It's strange to me that it's such a problem for so many people. I was on 150 mg. and was able to taper down in 3 days and was fine.
You're right about the Synthahol, that would be great. Or maybe even the Soma from Brave New World...
Craig
Posted by Dr. Bob on September 28, 2004, at 23:01:59
In reply to Re: Are you THAT Bob????? » Bob, posted by AuntieMel on September 27, 2004, at 8:59:44
> Interesting that Dr. Bob is allowing a name recycle.
FYI, the Bob you're thinking of was here before there was a registration system...
Bob
Posted by AuntieMel on September 29, 2004, at 15:10:20
In reply to Re: name recycle, posted by Dr. Bob on September 28, 2004, at 23:01:59
Thanks for clearing up the confusion. I didn't think of that possibility.
This is the end of the thread.
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