ECT

[dixie60]

Hi everyone,

Have been on the darkest of darkest pits of lower hell/depression-land lately.

it has been so scarey. not suicidal...well pretty sure that I would never do that as have 13 year old, But the alternative to suicide on the other hand has seemed un-doable. That is-living.

Anyway this is all a clinical or non-situational depression. details of my life are actually pretty good-except for the not wanting to live part. lots of guilt also about inflicting this kind of depressed mom on my kid...

I have been very very commited to getting help. Going to pdoc weekly, changing meds wwhen he says,,,trying to gert better.

so...saw pdpc in emergency sesssion (or, would have gone to er as was on line looking at inpatient clinics and suicide hotlines and such).I know it is confusing even to me...

Told him of severity and constant thoughts of death and dispair. I had just switched from effexor(a month or so ago..) to cymbatla, and just two weeks ago uped the cymbalta to 90 mgs. He felt that it was not enough time for the cymbalta to take full effect, (I do not feel any).He said I had two choices today in this emergency.

1) ECT ,OR, 2) DEXEDRINE.

[CrazySoprano]

i will write more tomorrow.  right now i have to go to bed.  brain has already gone, so i should keep him company.  just wanted to let you know we're listening.  sending you all my positive vibes and chocolate chip cookies.

the drunks outside would like to offer you a beer.

sleep well!

~cs

[Fiona]

If the dexedrine made you feel calmer, then it was doing what it was supposed to be doing.  Hopefully, that will help you along.

ECT is a frightening, but it is a solution. It has a very high success rate, the highest  of any treatment aside from MAOIs. Have you considered an MAOI? Parnate? Nardil? (You have to watch your diet closely, but they are miracle drugs).

ECT also acts very quickly; you feel better in a very short time and you continue to feel better although it's usually a good idea to continue an antidepressant at the same time.

If you search through this board you'll get a bunch of posts about ECT and if you go over to the old board (read-only now), the URL is around here somewhere, you'll see several long threads about it.

If/when you do research on the internet for this, remember that there are a lot of groups out there who are opposed to ECT in particular and psychiatry in general and who are often less than rational about this matter. So make sure to check your sources before you decide how much to believe.

Fiona

[Catnapper]

I don't know much about ECT, although Andrew Solomon has an informative piece on it in his book about depression, "The Noonday Demon".  He interviewed some patients as well as studying the medical information to put together the info in his book. 

If dexedrine is helping, you might want to talk to your pdoc about either more of that or one of the other attention deficit drugs.  I have major depression and recently added Adderall to my cocktail (see below), and it seems to be helping.  Adderall is a mix of four different types of amphetimine that all have different times of action; i.e., one works after an hour, one after four hours, etc.  The idea is to soften the highs and lows you get from straight speed. 

Hope you find something good for you!  I hate depression, as I'm sure you do, too.  It sucks.

[stipple]

A m.a.o. like nardil  might be what works for you but #1  they take along time to effect you #2  you have to have normal blood pressure #3  the list of stuf you shouldn't eat is the size of a phone book.    i think if you are down real low with situations & some long term depression stuff the m.a.o.s are great if you can handle the food list which is mostly about fermented,aged and preserved foods.  hang in there it always gets better .

[Fiona]

A m.a.o. like nardil  might be what works for you but #1  they take along time to effect you

Actually, Parnate and Nardil are among the fastest acting meds available. You start to feel the results in only a week or 10 days, about the same as with ECT.

#2  you have to have normal blood pressure

True. They can really mess with blood pressure.

#3  the list of stuf you shouldn't eat is the size of a phone book.

Current research is that the list of "forbidden" foods is far far shorter than what's been given in the past. Even things like the patient information from the pharmacy is wrong. I did an actual literature review and found the actual research supported only a narrow range of forbidden foods and, while everyone is different, it's been very effective. I eat an assortment of things previously thought to be on the "don't eat" list.

i think if you are down real low with situations & some long term depression stuff the m.a.o.s are great if you can handle the food list which is mostly about fermented,aged and preserved foods.  hang in there it always gets better .

<{POST_SNAPBACK}>

Parnate absolutely saved my life about a year ago. If it hadn't worked, I would have had ECT as the only option left. I was desperate enough to consider it seriously, and talk to my partner and pdoc and a second opinion about it partly because I wasn't sure I was in any condition to make such a big decision.

I'm more than willing to handle the food and few side effects of Parnate. And I'm going to keep taking it, nothing can pry those little rose pills out of my hands!

Fiona

[dixie60]

Thank you all soso so much for your time, for your replies.

I will talk to pdoc about the MAOs. I don't  drink and I know I could handle the food thing/not sure about blood p. totally worth looking into Fiona.  Not sure why he wouldn't mention it before the ECT option. jeeze. the dex IS WORKING> it is a fucking miracle that after the first pill, after about an hour the depression is gone. Suicidal, and I mean death-wish depression- months, crying ALL THE TIME-all the time in front of your kid depression ( I know you all know what I mean).. It is gone. poof.fuck it is that easy.

Is this stufff bad for me?

IS THIS DEX A DRUG LIKE A DRUG-DRUG? ( like coke or heroine -which i have never taken-( I sound soo stupid))

This is amazing to me. I do hate the way the dex  makes me feel a little too jagged, whatever that means-maybe can request lower dose-now am on 10 mg suspended bid- so am taking all your suggestions and researching them and will present them to pdoc.

(am going in to another session next week).

ECT seems too scry but have done hours of research snd it shows effective and that seems promising.  I would see it as a last resort though.

I really want to talk (write) to someone who has experieced it!!!!!!

Because the dex works, why not use a CNS stim as the depression is life thretaning and so horrible?

I am already committed to this chemical romance.( okay-I have a 13 year old and DO listen to his music).

Thank you thank you thank you.

Crazyboards is the best

-dina

[Catnapper]

Is this stufff bad for me?

IS THIS DEX A DRUG LIKE A DRUG-DRUG? ( like coke or heroine -which i have never taken-( I sound soo stupid))

There are lots of abusers in my family, mostly of alcohol, so I was also worried about the possibility of getting hooked on the Adderall prescribed for me.  Adderall and dexedrine are speed and therefore addictive like painkillers, but I don't think they're as bad as coke or heroin; however, that's just my opinion.  I did a little coke a long time ago, never tried heroin, but have seen the effects of addiction to both and it's not pretty.

My pdoc's response to my concern was that he was much more worried about getting me out of my worsening depression, and he didn't think it likely that I would get hooked, but if I did, he would get me clean again.  The main reason he didn't think I would get hooked is because I was depressed so that the effect of the drug would bring me back to normal and not get me high.  If I started taking it when I felt normal, I might get high from it, and if I had a past history of abusing prescription drugs he would be more concerned.

I've been taking it since July and haven't noticed any desire to increase my dose, one sign of getting hooked.  Also, I've missed taking it a few days in a row here and there because my sleep schedule has been messed up, and I didn't crave it on the days I missed it.  The pdoc said it was o.k. to skip, it doesn't have to reach a steady level in you like anti-depressants.  He tells his AHAD patients that he gives it to not to take it on the days their AHAD isn't a concern like the weekends.  Of course, his preference would be for me to get on a regular sleep schedule and take it every day, but he also understands I'm not going to miraculously get better overnight. 

[roo44]

I had ECT.  The only real negative I found was memory isssues.  It was not major but just triva things; like that word that sticks on the tip of your tongue or that person who stars in that move.  Triva things.  Though I had always prided myself on that.  Oh well.  I find myself backsliding so it is difficult to say if it worked.  On the other hand at the time I was really going down.  I am still here so I have to give it some credit. 

The actural ECT was not bad at all.  It is no longer the "One Flew Over the kookoo Nest"  Few times I had mild headache.  I can say during those weeks I was close to giddy and felt pretty darn good. 

[SunshineOutside]

As a last resort, I had ECT a couple of years ago.

[hollow log]

Hi there,

I've had ECT 11 times, whilst I was in hospital about 3 years ago.  I got all the common side effects from it, and I do know it pulled me out of depression, but not for very long.  And when I think about it now I think there were other things that could have been tried.

To have it again I would have to be really really really bad. It's very invasive.  The feeling that I've been invaded in that particular way has haunted me ever since.  And when you receive ECT there is approximately enough electricity to power a 100w light bulb delivered up to a second.  I'm just not comfortable with that being applied to my brain.  All the anti-psychiatry hysteria, and the psychiatrists' "no brain damage" claims aside, common sense would tell you that that amount of electricity would cause some kind of damage to the extremely delicate cells of the brain, and it would obviously be irreversable.  I'm not making a factual claim; I don't exactly know, but I question it.

Also, ECT is obviously a big money-spinner for psychiatrists, and also the ECT machine manufacturers.  I remember the bill!  You're a paying "customer" really.  So, there is very good economic reasons why the treatment still exists.  Sometimes I think we forget how much of a business mental health care is; it's quite profitable.  So I think this is a factor in the overall picture of this treatment.

So, at the end of the day ECT doesn't look good for me.  As I said, I would have to be extremely bad, with no other options whatsoever, and life hanging by a thread, to have it again.

Cheers,

Tim

[PBF]

Is this stufff bad for me?

IS THIS DEX A DRUG LIKE A DRUG-DRUG? ( like coke or heroine -which i have never taken-( I sound soo stupid))

<{POST_SNAPBACK}>

Yes, dexedrine is a drug as in pharm lab street drug.  Its amphetamine, dex, dixie pills, speed, crank pop, rave dope.  I tried it when I was a hippie kid.  Its a stimulant that gives you a high a bit like cocaine excepts it lasts much longer, its smoother and isn't as addictive (but its still addictive).  For depression I think it is a very bad idea.  What goes up must come down.  If you're on speed, you'll crash, someday.  You might want to explore antidepressants, antipsychotics and mood stabilizers.  These are more appropriate for depression.  What kind of doctor would prescribe speed to a depressed person anyway???  Stimulants are usually reserved for ADHD and are potent drugs. 

PBF

[WholeNewHomeBody]

Is this stufff bad for me?

IS THIS DEX A DRUG LIKE A DRUG-DRUG? ( like coke or heroine -which i have never taken-( I sound soo stupid))

<{POST_SNAPBACK}>

Yes, dexedrine is a drug as in pharm lab street drug.  Its amphetamine, dex, dixie pills, speed, crank pop, rave dope.  I tried it when I was a hippie kid.  Its a stimulant that gives you a high a bit like cocaine excepts it lasts much longer, its smoother and isn't as addictive (but its still addictive).  For depression I think it is a very bad idea.  What goes up must come down.  If you're on speed, you'll crash, someday.  You might want to explore antidepressants, antipsychotics and mood stabilizers.  These are more appropriate for depression.  What kind of doctor would prescribe speed to a depressed person anyway???  Stimulants are usually reserved for ADHD and are potent drugs. 

PBF

<{POST_SNAPBACK}>

Actually, stimulant add-ons to regular regimes of AD's in which a person has become "stuck" is a totally legit and not uncommon practice. 

Well, it *was* until the pharmaceutical industry decided that the  ADs du jour are atypical anti-psychotics. 

[PBF]

huh, didn't know that it was common practice to prescribe amphetamines to the depressed.  Seems kind of risky to me, but I'm no doc.  Yeah, its true pharm companies push atypical APs for depression.  But atypical APs don't cause dependence and don't give you a high. 

PBF

[WholeNewHomeBody]

Small doses of stimulant drugs as an add-on, yeah. And generally these are drugs like ritalin or provigil. Not amphetamines. If you're going to quote me, get it right.   

 

Actually, stimulant add-ons to regular regimes of AD's in which a person has become "stuck" is a totally legit and not uncommon practice.

Well, it *was* until the pharmaceutical industry decided that the  ADs du jour are atypical anti-psychotics.

Nowhere do I say that it's common practice to prescribe AMPHETAMINES to "the depressed."  Stimulants drugs in certain circumstances. And they don't make us high anymore than they do an ADHD'er.

BTW, dexamphetamine (what was under discussion)  and methamphetamine (what you aree equating it to) are 2 completely different drugs. Although they can both be prescribed legally in the US, they aren't much.  But comparing a pharmaceutical to freebase is innappropriate.

Atypicals don't work for a lot of people (and, other than zyprexa, are a waste of money). 

APs in general can do some really bad things to someone with treatment resistant, refractory severe major depression disorder like myself. 

CAN WE PLEASE TALK ABOUT ECT NOW?!

[WholeNewHomeBody]

Dixie, I've had at least 3 shrinks push this on me. I am very near the edge, because, well, I am very near the edge.

However, I also don't believe that the 27 meds I've been on represent an exhaustion of all options. I think it would be totally excellent to have an independant shrink and insurance  that would cover my  meds.

I feel like I've  really dropped some IQ points along the way, and the truth of the matter is, ECT is going to cause some permanant damage. I am so tired of becoming a bigger and bigger moron each day, and being aware of it. I don't know that I will ever be able to admit myself for ECT.

This does not discount the extreme likelihood that I'll be certified/ court-ordered to it.

I just hope they remember that haldol makes my BP drop below 80/55 next time. 

Has anyone gotten ECT and honestly can say they lost nothing (mental-acuity wise)?

Defective or not, my brain is truly all I have at this point. Sometimes I hate it for getting me where it did (i.e. a doctoral program) but I don't want to electrocute it.

Aside from which, I stuck my finger into the empty power socket of a dryer (while I was living in Poland. . .I guess I thought it would make it start) and I just got  a badly messed up finger aand (once I managed to disentangle finger from hole) was thrown about 10 feet. I've also had at least one grand mal seizure. These options both sucked, and I know that ECT isn't a do-it-yourself thing, but  I don't know.. .  Ever read Flowers for Algernon?

[StrungOutOnLife]

I feel like I've

[Fiona]

There are several books available written by people who've had ECT.

Martha Manning's "Undercurrents" (I think that's the title) comes to mind immediately. I know there are others, but that should give you a place to start from.

Fiona

[WholeNewHomeBody]

There are several books available written by people who've had ECT.

Martha Manning's "Undercurrents" (I think that's the title) comes to mind immediately. I know there are others, but that should give you a place to start from.

Fiona

<{POST_SNAPBACK}>

Thanks, but I can't read blocks of text right now. It's one of my "no-duh" introductory signs to a new MD episode.

SOOL- thanks for the links. I've had 3 fuckiatrists reccomend this to me at this point.  They've all been upgraded from qdocs to fuckiatrists b/c pretty much every one of those links pointed to the contraindications to me having ECT.

It really strikes me as an excruciatingly dangerous procedure for a purging anorexic. I can cause my own cardiac arrythmias and-on special event days- MIs as well. Just wait till the fireworks fly. The osteoperosis issue is another big deal. 

Guess I'll wait for the court order.

[StrungOutOnLife]

There are several books available written by people who've had ECT.

Martha Manning's "Undercurrents" (I think that's the title) comes to mind immediately. I know there are others, but that should give you a place to start from.

Fiona

<{POST_SNAPBACK}>

Thanks, but I can't read blocks of text right now. It's one of my "no-duh" introductory signs to a new MD episode.

SOOL- thanks for the links. I've had 3 fuckiatrists reccomend this to me at this point.  They've all been upgraded from qdocs to fuckiatrists b/c pretty much every one of those links pointed to the contraindications to me having ECT.

You're welcome. I didn't even think of it in terms of contraindications. I guess it helps that it's proponent literature, huh?

It really strikes me as an excruciatingly dangerous procedure for a purging anorexic. I can cause my own cardiac arrythmias and-on special event days- MIs as well. Just wait till the fireworks fly. The osteoperosis issue is another big deal. 

Guess I'll wait for the court order.

<{POST_SNAPBACK}>

By the way, it looks as ketamine will not only increase therapeutic response (they were having trouble in ducing seizures at 576 millicoulombs), but it will also prevent mossy-fiber sprouting without inhibiting neurogenesis. The second study has been quoted (and hard-returned) for your viewing pleasure (or not-as-much-frustration, such as the case may be):

J ECT. 2001 Mar;17(1):27-32.  Related Articles, Links

    ECS-Induced mossy fiber sprouting and BDNF expression are attenuated by ketamine pretreatment.

    Chen AC, Shin KH, Duman RS, Sanacora G.

    Abraham Ribicoff Research Facilities, Yale University School of Medicine, Connecticut Mental Health Center, New Haven 06508, USA.

    Recent evidence suggests hippocampal and possibly cortical atrophy is associated with major depression.

Chronic electroconvulsive seizures (ECS) induce brain-derived neurotrophic factor (BDNF) expression and sprouting of the mossy fiber pathway in the hippocampus, effects that may be related to electroconvulsive therapy's (ECT) mechanism of action.

The objective of this study was to investigate the role of NMDA (N-methyl-D-aspartate) receptor in mediating the ECS-induced mossy fiber sprouting and BDNF expression.

Timm histochemistry (staining agents are involved, I can tell you that) and in situ hybridization methodologies were used to determine the effect of pretreatment with ketamine, an NMDA antagonist (The PubChem ketamine page didn't exactly rule out any dopamine reuptake activity), and this study, "Pentobarbital inhibits ketamine-induced dopamine release in the rat nucleus accumbens: a microdialysis study." was certainly very suggestive) on ECS-induced sprouting and BDNF expression.

The results demonstrate the ability of ketamine pretreatment to attenuate ECS-induced sprouting in the dentate gyrus and BDNF expression in the medial prefrontal cortex and the dentate gyrus. In addition, we found a significant decrease in seizure duration with ketamine pretreatment.

These data suggest that NMDA receptor activation contributes to both the regulation of neurotrophic factor expression and the morphological changes associated with seizure activity.

However, other effects resulting from shortened seizure duration and seizure intensity cannot be excluded. These findings are of increasing interest, as they relate to the use of ECT in the treatment of depression, and the specific anesthetic agents that are used.

Basically, they were trying to figure out how seizure-seizures encourage mossy fiber (don't worry; this Wikipedia article is a stub; I apologize in advance for any gigantoid pictures of anyone's genitals when you get there.) sprouting, which some believe is involved in epileptigenesis (you're going to have to copy and paste and format this unless I can get the fulltext at my college, unless you live near one of the libraries it's at. I can't remember now.)

[Kat]

Have you considered doing rTMS first rather than ECT.  It is suppossed to have anywhere from a 40-80% success rate and does not have the side effects of ECT

[Fiona]

Have you considered doing rTMS first rather than ECT.  It is suppossed to have anywhere from a 40-80% success rate and does not have the side effects of ECT

<{POST_SNAPBACK}>

The results are looking quite optimistic -- it would certainly be a great treatment.

Depending on where you are, you may need to get into a clinical trial for it. I was evaluated for a trial last December, but didn't qualify because I was TOO depressed!

Fiona

[tonykure]

I think I have mossy fibers in the bathroom, oh nooooooooooo

[WholeNewHomeBody]

For me, I think it really is out of my hands, entirely under the government's control, because I live one of the US's shittiest Medicaid states.

More than half of my meds (head and other) are "non-preferred" here and thus not paid for.