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ECT & VNS is the LAST resort for me !


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The Crisis center people said if this effexor doesnt work then ECT. And I'm like how am I gonna pay for that shit with NO job. Dumbass. Plus everyone who has had that mess, has constant headaches and misery.

Anyone have any suggestions? I live alone, I'm not working, I'm depressed, all I wanna do is sleep, I am not motivated to do anything with myself. I spend most of my day by myself. I watch TV when I am up. Anyone who has been in this situation have any ideas??? Oh I have applied for ssi and was denied. I dont know what to do with myself anymore.

[Cross posts merged, a.m.]

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The Crisis center people said if this effexor doesnt work then ECT because I've tried all the ssris. And I'm like how am I gonna pay for that shit with NO job. Dumbass. Plus everyone who has had that mess, has constant headaches and misery.

Anyone have any suggestions? I live alone, I'm not working, I'm depressed, all I wanna do is sleep, I am not motivated to do anything with myself. I spend most of my day by myself. I watch TV when I am up. Anyone who has been in this situation have any ideas??? Oh I have applied for ssi and was denied. I dont know what to do with myself anymore.

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I don't know much about ECT, but I know that sometimes depression can be treated with meds other than SSRIs. I see you're on seroquel so I'm guessing you've tried that, but... just keep in mind that just because it's not designated specifically for depression doesn't mean it won't work. ativan (lorazepam, I think) has helped my depression more than any SSRI. I think the prozac's just for kicks, anyway. ;)

don't give up on meds just because the SSRIs didn't work. there are others. although I'm not in your situation (I'm under eighteen and still with my parents) I can understand it's hard. good luck. take care of yourself.

(edited to add: I didn't pay enough attention to your meds. you're on lorazepam. so, I dunno. maybe another benzo would help or... something. I don't know. I'm just making a fool of myself so I'll stop. sorry. good luck.)

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Have you tried an MAOI? Parnate or Nardil? Emsam patch? Marplan (depending on where you live)?

You probably shouldn't go to ECT if you haven't tried an MAOI yet, or if you can't take an MAOI. There are diet restrictions that you do need to take seriously -- but they can work a miracle. Parnate certainly has been amazing for me, and my next step was ECT.

Fiona

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I am afraid of taking the nardil cause they have the diet restrictions and alcohol restrictions. What if I eat something wrong

It really is NOT that hard. (Speaking as someone who's done it. The list is much less restrictive than before. If you're not sure, try a very small amount, and wait, There's a lot of indivudual variability and even with the same individual over time)

My theory (no offense meant) is that if you're not ready to do without pastrami. (etc.) how depressed can you be? Surely, you can spend a little time studying a simple list of forbidden, moderate, and OK foods. What if you had diabetes or kidney disease and HAD to follow a restricted diet for medical reasons? Wouldn't you cope.

These drugs are the best antidepressants out there, IMO (and I'm not alone) - certainly, for many who don't respond to others. You just may need more dopamine instead of more serotonin, ya know? What then?

And FYI ECT is no piece of cake either, nor is it guaranteed. . Often (if not usually) you require repeated series, "touch ups" and even then...

To speak bluntly, doctors are afraid of MAO inhibitors now for two reasons, primarily:

1) Fear of lawsuits. (depresed patients tend to be suicidal. A medication requiring a dietary restriction however manageable, may seem risky as it can appear to invite serious depressives to take advantage of abusing the diet (if having a stroke is your cup of tea!) .

Even for accidentally non-compliant pts., this may not be a reaslitic appraisal of the docs' liability risk and (frankly) may also may not be a recommendation made with your best interests at stake.

2) Ignorance. Most younger shrinks have zilch experience working with them having been trained in the era of SSRIs and variations. (Hence they steer you away from them).

However, MAO inhibitors are potent and indispensible members of the modern AD arsenal. For those who need that particular compound, there is no substitute. No, they are not the treatment of first recourse, but like Fiona I'd definitely put them ahead of ECT in terms of utility, cost and safety.

rt

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Or a TCA?

I know somebody who had tried every SSRI and every multiple re-uptake inhibitor there is, including Wellbutrin. And all this in combo with an atypical AP.

One day she tried clomipramine, and it made her so happy that her doc thought that she was getting a bit hypo-manic. She wasn't, she was just very very happy.

So you just never know.

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I agree that it doesn't appear that you have nearly exhausted all the medications that are known to be helpful for depression. While I feel strongly that ECT is a valid treatment for intractable depression, I would encourage you to strongly reconsider trying the MAOI's. While the food restrictions can be a pain in the rear, nonetheless the MAOI's have an excellent reputation for helping depression. Surely something worth trying before fiddling with temporary memory loss. Do you really mean to imply that you cannot give up drinking for your health?

Anyway, here is a list from my files that you can use as a checklist (btw, the dates are FDA approval dates):

Tricyclic Anti-Depressants - TCA

Elavil/Amytriptaline

Tofanil/Imipramine

Sinequan/Doxepine

Pamelor

Mono-Amine Oxydase Inhibitors - MAOI

Marplan MAOI

Nardil 1961 MAOI

Parnate 1961 MAOI

Selective Serotonin Reuptake Inhibitors - SSRI

Prozac 1987 SSRI

Zoloft 1991 SSRI

Paxil 1992 SSRI

Luvox 1994 SSRI

Celexa 1998 SSRI

Lexapro 2002 SSRI

Selective Norepinephrine Reuptake Inhibitor - SNRI

Strattera 2002 SNRI

Edronax / Reboxitine ???? SNRI

Multiple Reuptake Inhibitors - MRI

Wellbutrin 1985 MRI

Effexor 1993 MRI

Serzone 1994 MRI

Cymbalta 2004 MRI

Miscellaneous Anti-Depressants

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I am afraid of taking the nardil cause they have the diet restrictions and alcohol restrictions. What if I eat something wrong

Actually, you can drink some kinds of alcohol if you're really determined to do so. I have an occaisional glass of white wine, and had quite a bit of champagne the day I submitted my dissertation. Alcohol is, however, a depressant. While it might give you a momentary 'happy joy drunk' feeling, in the longer term (counted in hours and days) you will feel worse than if you had not over-indulged/indulged.

The diet restrictions are strict for some things and moderate for others. Yeast extract is a clear NO, but other things depend on person and brand and amount. I eat some soy sauce, and all I've wanted of yogurt, brie, havarti, feta, all things that appear as potentially 'moderation' foods.

If you screw it up the consequences range from driving headache through stroke to potentially death. The death thing is very hard to achieve accidentally, so even if your subconscience is out to get you it's going to have to do some planning.

I've taken Parnate, for 18 months now and I took it for a year some time ago. I've had one or two headaches possibly from it, and one ER trip that may or may not have been diet related. I would have survived without the ER trip, but it was before I had much experience, and before I had my own blood pressure cuff, and my partner freaked.

I do strongly suggest keeping a blood pressure monitor at home and getting an idea of what your "normal" pressure is, so you'll know when it's high. As a side bonus, MAOIs were developed as blood pressure meds, so they lower your blood pressure and make you feel better!

Within six or eight weeks I went from deeply suicidally depressed -- the kind where my partner got nervous if I spent too long in the bathroom -- to feeling decent and then more gradually to where I am now, which is quite 'normal.' This is one of the big positives for MAOIs: they work fast. I was past the suicidal stuff within ten days, less really, and it's never come back.

Sure, there are things I can't eat. And I have to pay attention, especially at restaurants, but my good friends have a good idea what to not give me and save packages for me to read the ingredients. It's not that different from being diabetic and watching your diet or vegetarian or vegan (vegan is probably more restrictive!). It's much less restrictive than my friend who is lactose intolerant, can't have gluten, and has IBS. Given a choice between this and ECT or this and suicidal depression? This wins completely.

After 18 months it's just become a habit, like being vegetarian (which I also am), and my partner and friends see it much the same. And it's more than worth feeling good -- Parnate enabled me to finish my dissertation, take up my full work schedule, and have the motivation and confidence to pursue a full-time position I want.

No one is getting that bottle of Parnate out of my living hands! (Or my partner's!)

Fiona

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definately definately try other meds first. are you young? i dont believe in ECT for people younger than 45... we all have growing to do yet!

try the tricyclics like anafranil, trazadone, and desipramine, try the mood stabilizers like lithium, topamax, and lamictal. try the zyprexa, the risperdal, an increase of seroquel like up to 800mgs... ask your doctor to come up with a concoction of meds for you. like one antidepressant, one benzo, one antipsychotic, one mood stabilizer... well maybe not all of that at once, but it could work!

here's what happened to me... i was dianosed with major depression and anxiety disorder. i tried antidepressants after antidepressants, they all made me more anxious and i felt worse.

THEN a miracle happened... the doctor said i was bipolar II. so we started out with Lamictal, then we added Klonopin, then we added Effexor, then I stopped the Klonopin because I wasn't so anxious anymore.

I've had a job for 4 mos being on the klonopin, lamictal and effexor. seriously all the meds failed me until i added a mood stabilizer. it is possible your anxiety is part of some twisted hypomania like mine... (you know, all the anxiety and fears with no happiness...)

dont give up. you haven't tried many meds... at all! i hit that many meds in the first two years of taking meds... and i was like 17-18.

of course im not doing so hot now, but i'm damn better than i used to be, and i'm working on adding something new to the ones i take.

dont give up

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