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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by fellowmike on August 23, 2009, at 1:14:29
okay... i have tried many ssri's/snri's...and lexapro was the only one that ever worked..but one day it just quit on me!@:[[[...so i tried out antipychotics and i just felt even worse..then i tried anticonvulsants and they didnt work either..then my doctor let me try out MAOIS and ensam didnt work, i got to much anxiety, parnate gave me to much anxiety also, and nardil just drugged me up to the point where my eyeslids were always sagging....so now my shrink is taking a step back and im trying a TCA, "Amitriptyline 75mg"...and i just started taking "Lyrica 150mg" too....my diagnosis is "Agitated Depression"....
Is Amitriptyline effective?? i mean Nardil was suppose to be like the god of all drugs, but didnt even help me...so i dont see how amitriptline could work if all those others didnt
i just want to get the S@#* shocked out of me and put my brain back in to order...ps. my insurance reached its max...so everything is free until december 31 2009...
so what else do i have to take to be a canidate for ECT???
and could a TCA possibly work better then the so called "superior" MAOIS???
thanks and GOD bless you if you can give me some feedback:]
Posted by Meltingpot on August 23, 2009, at 5:35:47
In reply to Electric Convulsive Therapy!/TCAs???, posted by fellowmike on August 23, 2009, at 1:14:29
Hi,
I think you have to be virtually cotamose in order to be referred for ECT, not sleeping, not eating and just not functioning at all. Well that seems to be the case in the UK because they won't let me try it.
I think in the States it's different though. The guidelines seem to be that if you have tried everything to no avail then ECT is the next step.
Have you asked your psychiatrist about ECT?
Denise
Posted by SLS on August 23, 2009, at 6:40:43
In reply to Re: Electric Convulsive Therapy!/TCAs???, posted by Meltingpot on August 23, 2009, at 5:35:47
Some people report that drugs that failed to work pre-ECT seem to prevent relapse post-ECT. There might be some older studies involving tricyclics regarding this. However, I would not recommend ECT unless you fit the criteria described by Meltingpot. The probability of responding to it are not good if you have already demonstrated treatment resistance.
I would look into rTMS if you are looking to produce neuronal currents in the frontal cortex. Its narrow focus on this area spares the memory centers. As of now, the only consistent side effect seems to be headache.
I had a course of 15 treatments of ECT. I felt better for half a day after treatment number 5. Thereafter, it provided no benefit. Once we switched over to bilateral, my memory and cognition became impaired, albeit temporarily.
- Scott
Posted by linkadge on August 23, 2009, at 11:51:45
In reply to Re: Electric Convulsive Therapy!/TCAs???, posted by SLS on August 23, 2009, at 6:40:43
Give amitriptyline a fair trial before thinking of ECT. Amitriptyline may also help lexapro work again (i.e. SSRI + TCA combos are very effective for some people)
Linkadge
Posted by Phillipa on August 23, 2009, at 12:11:25
In reply to Re: Electric Convulsive Therapy!/TCAs???, posted by linkadge on August 23, 2009, at 11:51:45
I was told that ECT didn't help anxiety. One girl I asked my pdoc why she did ECT and he said it was the only thing to keep her from suicide but she remained unable to return to school memory problems he thought would be better in six months. So I agree with Meltingpot. Phillipa
Posted by bleauberry on August 23, 2009, at 15:47:26
In reply to Electric Convulsive Therapy!/TCAs???, posted by fellowmike on August 23, 2009, at 1:14:29
I think you need to keep looking at the combination strategy...TCA + SSRI; TCA alone; whatever + abilify, whatever + zyprexa. Stuff like that.
I think it helps a lot to also start researching other things...candida, infections, adrenal fatigue, heavy metals, importance of food choices, and such. These things are usually downplayed or totally ignored, but are huge players in mental disease.
I am an ECT survivor. This topic comes up now and then. All I can say is, don't do it. Here's why:
1. It did not work for any of the 6 of us that got it done (bilateral) in 12 sessions.
2. When it does work, the relapse rate is extremely high and occurs soon.
3. Damage to memory and thinking ability can be much worse than anyone tells you. A six month chunk of my life is still gone, as well as quite a few other random periods of my life. Wiped out. Even in my worst depression I was a high achiever and A+ student. Now it is a struggle just to be average, I can't remember anything, and everything takes slow thought before I do it.Benefits of ECT:
1. It is good for the hospitalized mental ones who would otherwise never leave an institution. It can get them well enough to at least move temporarily into a halfway house, though never well enough to hold a job or family. It won't keep them out of the hospital, but reduces their stays and length of stays.
2. While it erases a lot of potentially good memories, it can also erase a bunch of bad ones...like the last 3 months. That could be a good thing. It is kind of like getting a fresh start. Not in any better shape, but a new start. Some of the bad stuff forgotten.
Posted by fellowmike on August 23, 2009, at 16:44:25
In reply to Re: Electric Convulsive Therapy!/TCAs???, posted by bleauberry on August 23, 2009, at 15:47:26
wow i had no idea that ECT takes a toll on your memory that much..
..but im in great physical shape, eat well, exercise daily to maintain physical shape, and so on and so forth..the only biological disfunction i have is hypothyroidism, but i am on 150mg of synthroid and now my levels are normal...
u think so the next step i should take is asking the shrink about doing an SSRI+TCA combo??
Posted by fellowmike on August 23, 2009, at 16:46:35
In reply to Re: Electric Convulsive Therapy!/TCAs???, posted by SLS on August 23, 2009, at 6:40:43
thanks for the info scott,
do you know if some good insurances could partially cover rTMS?, or is it going to be straight out of my wallet?
Posted by fellowmike on August 23, 2009, at 16:51:40
In reply to Re: Electric Convulsive Therapy!/TCAs???, posted by linkadge on August 23, 2009, at 11:51:45
for a healthy male that is a fast metabolizer -6'1 180-185ish...what would the average TCA dose be with 10mg lexapro?..cause thats what i responded to before.
..and 75mg of amitriptyline seems to be too low of a dose for me right now..i started it 10 days ago.
thanks again for your post :0
Posted by fellowmike on August 23, 2009, at 16:55:01
In reply to Re: Electric Convulsive Therapy!/TCAs???, posted by Phillipa on August 23, 2009, at 12:11:25
okay now i am convinced to stay away from the memory killing ECT!!
do you know anything or have any advice about TMS, repetitive TMS (rTMS), or CES?
Posted by fellowmike on August 23, 2009, at 16:58:58
In reply to Re: Electric Convulsive Therapy!/TCAs???, posted by Meltingpot on August 23, 2009, at 5:35:47
many members have responed also, and have agreed with you and said to stay away from ECT, so therefore i will!!!
....and yeah i have asked him about ECT but he wants to try out the TCA class first....
..and do you have any advice about TMS, rTMS, or CES??
^^i havent asked my psyhiatrist about any of these by the way,,,
thanks for the response! :]
Posted by gibbons482 on August 23, 2009, at 17:32:50
In reply to Re: Electric Convulsive Therapy!/TCAs??? » Meltingpot, posted by fellowmike on August 23, 2009, at 16:58:58
I just wanted to chime in that I've had ECT and didn't have the problems others experienced. I was suicidally depressed and constantly planning to commit suicide. I didn't have time to wait for medication to work. I had 8 unilateral ECT's, and I had great results. I have lost my memories of the time period I have having ECT but nothing else. But I see a few missing memories are worth it compared with suicidal depression.
I just wanted to point out there are some ECT success stories.
Posted by jerrypharmstudent on August 23, 2009, at 17:54:39
In reply to Re: Electric Convulsive Therapy!/TCAs???, posted by bleauberry on August 23, 2009, at 15:47:26
> I think you need to keep looking at the combination strategy...TCA + SSRI; TCA alone; whatever + abilify, whatever + zyprexa. Stuff like that.
>
> I think it helps a lot to also start researching other things...candida, infections, adrenal fatigue, heavy metals, importance of food choices, and such. These things are usually downplayed or totally ignored, but are huge players in mental disease.
>
> I am an ECT survivor. This topic comes up now and then. All I can say is, don't do it. Here's why:
> 1. It did not work for any of the 6 of us that got it done (bilateral) in 12 sessions.
> 2. When it does work, the relapse rate is extremely high and occurs soon.
> 3. Damage to memory and thinking ability can be much worse than anyone tells you. A six month chunk of my life is still gone, as well as quite a few other random periods of my life. Wiped out. Even in my worst depression I was a high achiever and A+ student. Now it is a struggle just to be average, I can't remember anything, and everything takes slow thought before I do it.
>
> Benefits of ECT:
> 1. It is good for the hospitalized mental ones who would otherwise never leave an institution. It can get them well enough to at least move temporarily into a halfway house, though never well enough to hold a job or family. It won't keep them out of the hospital, but reduces their stays and length of stays.
> 2. While it erases a lot of potentially good memories, it can also erase a bunch of bad ones...like the last 3 months. That could be a good thing. It is kind of like getting a fresh start. Not in any better shape, but a new start. Some of the bad stuff forgotten.
>
>I agree completely. Don't give up on meds just yet. I had ECT done when I was 23 - I'm 37 now and still have short term memory loss and the ECT was unsuccessful.
I've found adding Geodon to Lexapro has helped me tremendously.
Jerry
Posted by morganator on August 23, 2009, at 22:38:02
In reply to Re: Electric Convulsive Therapy!/TCAs??? » bleauberry, posted by fellowmike on August 23, 2009, at 16:44:25
If you are exercising daily and staying in great shape you should not be looking into ECT. You should look into rTMS and some other medication combo that you have not tried.
Posted by SLS on August 24, 2009, at 6:07:11
In reply to Re: Electric Convulsive Therapy!/TCAs??? » SLS, posted by fellowmike on August 23, 2009, at 16:46:35
> thanks for the info scott,
>
> do you know if some good insurances could partially cover rTMS?, or is it going to be straight out of my wallet?From what I understand, Medicare will not pay for it, although I wouldn't rule out that a pursuasive appeal might work on a case-by-case basis. I think other insurance companies are using Medicare as their source of precedent.
In the US, each treatment costs around $400.
Treatments: 5 times per week; 4 weeks = $8000.
- Scott
Posted by atypical on August 24, 2009, at 14:55:17
In reply to ECT, posted by gibbons482 on August 23, 2009, at 17:32:50
Thank you for chiming in and providing some alternative positive outcomes! I had 11 ECTs myself. After the 10th I felt benefit, but then the side effects really were too much to handle and my veins were swollen from the IVs so I thankfully had to stop. I was neither suicidal nor comatose when I had ECT done. But three doctors recommended it for me for my TRD.
> I just wanted to chime in that I've had ECT and didn't have the problems others experienced. I was suicidally depressed and constantly planning to commit suicide. I didn't have time to wait for medication to work. I had 8 unilateral ECT's, and I had great results. I have lost my memories of the time period I have having ECT but nothing else. But I see a few missing memories are worth it compared with suicidal depression.
>
> I just wanted to point out there are some ECT success stories.
Posted by alchemy on August 25, 2009, at 21:53:02
In reply to ECT, posted by gibbons482 on August 23, 2009, at 17:32:50
> I just wanted to point out there are some ECT success stories.
I also have had positive results with ECT :)
But from reading your case, it is probably worth trying some other med mixes. For me, my agitated depressioin is better on Lamictal, 2mg Xanax XR, Celexa, and Wellbutrin - not completely better, but the agitation is a lot better. Antipsychotics make it much worse.
This is the end of the thread.
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