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charlotteshead

Treatment Resistant Depression

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I was recently dx'd with treatment resistant depression. Funny that it took them a decade and about 20 meds to figure it out...there's been some slight improvement with some meds, so I keep at it, even though no med works longer than about a year. There's been some discussion of ECT and rTMS but nothing too serious...

Anyone dx'd with this willing to share your experience...maybe even give me a little hope? I'm a tough girl but it gets hard, knowing I'll never be rid of this.

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I've got treatment resistant depression. First depression diagnosis 30 years ago. Things can be not good, and things can be good. Mostly I just keep on trying. Is that hopeful?

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I have treatment-resistant depression as well, though I hate that term, as it implies that the sufferer is somehow at fault. Have you tried tricyclic anti-depressants or MAOIs? I have found more success with tricyclics and a mood stabilizer. If you haven't tried those, I would suggest them before ECT.

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I have treatment resistant depression also. I'm now on a good cocktail now and much, much better than I have been in years. Hang in there. Basically, the skeleton of my magic cocktail is antidepressant + anticonvulsant + atypical antipsychotic. You will find your magic cocktail too. Also, ECT is not a bad choice and is a lifesaver for many people. 

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We sound pretty similar, even down to the name lol. We're both relatively young too. I hope sharing my experience helps somewhat. :)

I'm only 19 and I've must have tried 10 different meds since the age of 13. All they did is really prevent me from jumping in front of the subway or something similar. I was still suicidal, lethargic and could never genuinely laugh at anything; it was always forced. In the past two years, I've had upwards of 8 psych ward stays, some of them involuntary. Finally, I saw a different doctor and she recommended ECT.

I was so reluctant at first, partially because I had the mindset of ' I'm too young for ECT'. I am SOSOSO glad that I went through with bilateral ECT. Before I started, I had just attempted suicide so you could say that I was pretty depressed lol. I've been depressed since the age of 12, could never wholeheartedly commit to living(suicide wouldn't be taken off of the table) and constantly was reminded by my peers about how depressed I looked. Now, I can laugh without faking it; for me, that reveals it all. All of my friends notice how 'perky' I am. I never imagined the term perky ever being used to describe me.

I'm likely going to need maintenance ECT but I'm willing to do anything to feel this good. I'm on a high. Ha my mother even said that she was worried I could be manic.

Best of luck! As cheesy as it sounds, there really always is hope, even in the darkest of times. :)

Edited by magpie

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That's founds familiar. Yes, that longevity, yes, "what haven't we tried" conversations with my psychiatrist.

I was fortunate(?) that a good and lasting combination of medications was found while I was being assessed for ECT, 

I've now had several years with depressive illness in remission.

I'm not ready to say "cured", yet, or see if we can taper the meds down.

 

Chris

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Latuda 20 mg helped my treatment resistant depression and DBT

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Have you looked at tricyclics or MAOIs? They are often helpful directions to try for treatment resistant depression.

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I don't think I've seen TRD on my charts. The one from my last hospital stay was Major Depressive Disorder, Major Episode, Recurrent. That may be essentially the same as TRD for all intents and purposes. I certainly hit all the checkmarks for TRD in the DSM-IV. 

 

Mostly, as you know, it sucks. I don't know anyone that likes the med-go-round. My gdoc helped me try a couple of SSRIs and then moved me to Effexor - but simultaneously referred me out to a pdoc (long wait lists, of course). Through the pdoc and hospitalizations I got cocktails. You didn't talk about your med history. Sometimes cocktails seem to work even when the individual meds are not terribly effective.

 

 

Have you looked at tricyclics or MAOIs? They are often helpful directions to try for treatment resistant depression.

 

 

This is a good question you should think about before going down the route of ECT (you may choose to try ECT first, but always consider all your options). I know others on here have had very good success with ECT. My pdoc has talked about it, but we decided to try MAOIs first. That with lamictal and abilify seem to be helping some. Too early to tell how much (at least, I hope).

 

It sounds like there may still be some avenues to try. Don't give up - TRD just means your depression is resistant to treatment, not that it can't be treated.

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I have treatment resistant depression also. I'm now on a good cocktail now and much, much better than I have been in years. Hang in there. Basically, the skeleton of my magic cocktail is antidepressant + anticonvulsant + atypical antipsychotic. You will find your magic cocktail too. Also, ECT is not a bad choice and is a lifesaver for many people.

Did any ADs work for you at all, or only in combination with the other meds?

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I've been on tricyclics, Elavil specifically, SSRI, SNRI, atypical antipsychotic, uhh I think one was anti seizure but also for depression?? I'm more hesitant about MAOI than ECT to tell the truth!

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I have treatment resistant depression also. I'm now on a good cocktail now and much, much better than I have been in years. Hang in there. Basically, the skeleton of my magic cocktail is antidepressant + anticonvulsant + atypical antipsychotic. You will find your magic cocktail too. Also, ECT is not a bad choice and is a lifesaver for many people.

Did any ADs work for you at all, or only in combination with the other meds?

 

For me, personally, not really. Celexa had/has the largest effect, but my ADs really help me only with anxiety. Abilify and Tegretol are the heavy lifters for me for depression.

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Hi, I have treatment resistant depression for four years. I've been on over 10 drugs and NONE have worked for me. I've been hospitalized twice. Started ECT a little less than a month ago. five treatments in. Feel AMAZING. Run, don't walk to ECT. I'm willing to get these for life if it means feeling this way. I feel naturally happy.

Check out my threads in the ect forum.

Edited by hopeless

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I've been on tricyclics, Elavil specifically, SSRI, SNRI, atypical antipsychotic, uhh I think one was anti seizure but also for depression?? I'm more hesitant about MAOI than ECT to tell the truth!

 

Why? If you don't mind my asking. I was hesitant about MAOIs too, but they're shown to work really well for TRD. Comparable to ECT as I recall.

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Because of the potential for fatal combinations, I'm a pretty spacey person and I could very likely forget not to eat something. Plus I've heard sooo many good things about ECT

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I have TRD. Been on every antidepressant in every possible combo since 1994. Am on Wellbutrin, Cymbalta, Latuda, Lamictal, and Topamax now, plus Adderall and Trazodone for a sleep disorder. I am okayish, though being on Latuda (an antipsychotic) has made me pretty miserable because it's made me gain weight. (Previously I was on Abilify, another antipsychotic, which was responsible for most of the weight gain.) Body image issues are a huge issue for me, so I've finally reached the point where I can't tolerate the side effects of a drug. It also raised my LDL cholesterol—a very bad thing for me since heart disease runs in my family.

 

My psych also mentioned TMS. I'm going to start on Sept. 9th and I'm pretty damn excited about it. I never took it seriously as an option before because I thought insurance didn't cover it but a lot of plans do now. It's worth investigating. I too was freaked about MAOIs, and they wouldn't have solved my weight gain issue. My goal with TMS is to get off all the add-on meds and just stick with the antidepressants. I was used to those side effects. Weight gain and high cholesterol? No thanks.

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sylvan, I did discuss stimulants with pdoc. I wasnt dx'd with ADHD till I was 24 which is ridiculously stupid because all the signs were there as a kid plus my dad had it, but whatever lol. Anyway her concern is because I have a severe anxiety disorder that is easily exacerbated, she worries a stimulant could make it worse. And I tend to get really destructive when my anxiety is bad.

 

J718, it made me chuckle that I've been on every med you mentioned except 3. Lamictal actually worked the best for me in terms of length...took it for 2 years before it stopped working. Most meds last me 9-14 months. Abilify was great the first time I took it, second time I took it couple years later it was like a different drug. Made me so sick.

 

Do you mind if I add you as a friend? I'd like to be able to watch your posts and see how your TMS goes :)

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I have TRD. Been on every antidepressant in every possible combo since 1994. Am on Wellbutrin, Cymbalta, Latuda, Lamictal, and Topamax now, plus Adderall and Trazodone for a sleep disorder. I am okayish, though being on Latuda (an antipsychotic) has made me pretty miserable because it's made me gain weight. (Previously I was on Abilify, another antipsychotic, which was responsible for most of the weight gain.) Body image issues are a huge issue for me, so I've finally reached the point where I can't tolerate the side effects of a drug. It also raised my LDL cholesterol—a very bad thing for me since heart disease runs in my family.

 

My psych also mentioned TMS. I'm going to start on Sept. 9th and I'm pretty damn excited about it. I never took it seriously as an option before because I thought insurance didn't cover it but a lot of plans do now. It's worth investigating. I too was freaked about MAOIs, and they wouldn't have solved my weight gain issue. My goal with TMS is to get off all the add-on meds and just stick with the antidepressants. I was used to those side effects. Weight gain and high cholesterol? No thanks.

Cholesterol does not cause heart attacks, despite a half century of false information. Ask your doctor for an NMR Lipoprofile. Then look at the low density lipoprotein count. Make a note of the small, dense LDL particles, which can oxidize easily and get under the epithelial cell layer of the artery wall, initiating plaque formation (the LDL and passenger cholesterol will become damaged--> oxLDL and oxysterol). The immune system response with macrophages and foam cells will really get the plaque formation going, along with calcium deposits. Especially if you have high vitamin D (yeah,that one surprised me, too). Anyway, a traditional cholesterol test is not very useful. Is the LDL the harmless type-A variety? But if you are going to relying on it, the best indicator (for atherosclerosis) is low HDL. And it makes perfect sense if you know how this all works. Your doctors typically are not the sages you think when it comes to this stuff, btw. They have very limited training in nutrition and how it causes metabolic syndrome, and are likely to put you on a statin if your conventional cholesterol test comes back 'bad.' A terrible idea, pushed on them by big pharma (sorry, San).

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I have TRD. Been on every antidepressant in every possible combo since 1994. Am on Wellbutrin, Cymbalta, Latuda, Lamictal, and Topamax now, plus Adderall and Trazodone for a sleep disorder. I am okayish, though being on Latuda (an antipsychotic) has made me pretty miserable because it's made me gain weight. (Previously I was on Abilify, another antipsychotic, which was responsible for most of the weight gain.) Body image issues are a huge issue for me, so I've finally reached the point where I can't tolerate the side effects of a drug. It also raised my LDL cholesterol—a very bad thing for me since heart disease runs in my family.

 

My psych also mentioned TMS. I'm going to start on Sept. 9th and I'm pretty damn excited about it. I never took it seriously as an option before because I thought insurance didn't cover it but a lot of plans do now. It's worth investigating. I too was freaked about MAOIs, and they wouldn't have solved my weight gain issue. My goal with TMS is to get off all the add-on meds and just stick with the antidepressants. I was used to those side effects. Weight gain and high cholesterol? No thanks.

Does TMS treat mania and mixed episodes, or just depression?

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