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Any success or failures with rtms, tms, deep brain stimulation? 

Meds just don't seem to work well for me. My depression is chronic with dips and peaks and my cognition is impaired heavily. 

I do remember being knocked out violently at 5yo and 8yo, not sure if that caused some sort of brain damage. Ugh another day if this shit...

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I tried TMS. I did 4 sessions. It hurt. Felt like a woodpecker with a ball peen hammer going at my temples. Even after they turned down the machine repeatedly. I gave up, it was too painful to be worth the effort. I couldn't imagine doing it 5 days a week for 4-6 weeks.

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I agree about the woodpecker sensation, that was how I described it at the time. However they tuned it so that it wasn't so bad. I did something like 38 or 42 treatments, which is A LOT of effort when you have severe depression. Unfortunately it did absolutely nothing for me.

I also have TRD so I'm in the same boat. I even tried ECT and that also did nothing. Sigh.

The best responses I've had so far are to stimulants+<something>. Nardil+adderall/ritalin was amazing but no PDoc in NYC will take you seriously if you request it. Nardil by itself made me so bad I put myself inpatient. Typical - I know there's a solution for me but no-one will give it to me. Sigh again.

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@sming out of curiosity have you had your CRP (C reactive Protien) levels checked. You could have this chronic inflammation thing which might explain why you dont respond to meds. Try taking an anti inflammatory. see if that reliefs some depression.

https://www.sciencedirect.com/science/article/pii/S0006322306012728

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5050394/

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9 hours ago, sming said:

The best responses I've had so far are to stimulants + <something>. Nardil+adderall/ritalin was amazing but no PDoc in NYC will take you seriously if you request it. Nardil by itself made me so bad I put myself inpatient. Typical - I know there's a solution for me but no-one will give it to me. Sigh again.

Curious why no one will prescribe the combo that helps you? Is the combination of Nardil + stimulant that is contraindicated? Using a stimulant as an add-on is the only thing that seems to give me a lift up also. I have otherwise had little to no benefit from antidepressants alone.

I had been considering rTMS but the cost makes it impossible.

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Nardil is an MAOI and they are risky to take with stimulants, particularly amphetamines. I haven't tried Nardil but my pdoc did eventually let me have low-dose Ritalin when I was taking Parnate. It was better than nothing, but I do prefer the adderall derivatives. 

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16 hours ago, Blahblah said:

Curious why no one will prescribe the combo that helps you? Is the combination of Nardil + stimulant that is contraindicated? Using a stimulant as an add-on is the only thing that seems to give me a lift up also. I have otherwise had little to no benefit from antidepressants alone.

I had been considering rTMS but the cost makes it impossible.

Yeah they're contraindicated. If you start at a super-low dose and work your way up and monitor your blood pressure, you're good to go though. It just makes me want to cry - literally.

BTW all my dTMS was free due to a "scholarship" I got at TMS Centers of America https://hprtc.com/ . I thought it was a scam (nothing is really free in America) but they're totally legit. Owned by an altruistic billionaire who wants to spread the word about TMS (and make a buck eventually). Give them a call.

15 hours ago, Geek said:

Nardil is an MAOI and they are risky to take with stimulants, particularly amphetamines. I haven't tried Nardil but my pdoc did eventually let me have low-dose Ritalin when I was taking Parnate. It was better than nothing, but I do prefer the adderall derivatives. 

Ditto. Ritalin was good, adderall/Vyvanse was best. When I was actually prescribed it I was super-careful, I had my own blood pressure cuff and all that stuff, I recorded the time and dose of everything I took etc. etc. I was a model patient but in the end he stopped prescribing it, he just wasn't OK with it. Triple sigh.

Since then I've managed to get some stims off the internet whilst on Nardil but it's unreliable in several respects - not recommended.

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17 hours ago, aspillane said:

@sming out of curiosity have you had your CRP (C reactive Protien) levels checked. You could have this chronic inflammation thing which might explain why you dont respond to meds. Try taking an anti inflammatory. see if that reliefs some depression.

https://www.sciencedirect.com/science/article/pii/S0006322306012728

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5050394/

I believe so. I've had full metabolic panels done several times and several "off the wall" ones. Everything comes back "perfect", which is always so demotivating. I have chronic abdominal pain and even had a surgeon open me up and look inside me for causes and he also reported that everything looked "perfect". Upon awakening after the procedure and being told this, I cried for about half an hour in front of everyone. I so wanted him to have found a cause, even if it was something serious. "Functional pain" they call it - pain that they can't explain.

Sadly I'm already on 15mg Percocet which contains acetaminophen so I should have seen some benefit if it was inflammation in the brain I guess? That said, my three Percocet doses are the only things that lift my mood these days and they don't lift my mood more than vanilla Oxycodone did (which doesn't contain acetaminophen). Thank you for the suggestion though, keep them coming if you have any more.

Pete

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Do you think the other meds you're on (Lithium and Lamictal) are helping? Sometimes if you tweak your combo/doses from time to time, that could help? That really sucks that the previous combo was a winner and no one will prescribe it. I wonder if there are any similar alternatives to that combo, that pdocs would consider?

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So recently I have been reading on supplements to help depression. Laughable I completely understand. However I recently stumbled upon a synthetic naturally occurring chemical called S-Adenosyl methionine (sam-e).  I reluctantly took sam-e today knowing full well it wouldn't help my depression. (because why the fuck would some random ass supplement help.) and to my surprise it seemed to have lifted the curtains of my depression. Not a cure all, but I have literally been debilitated by my depression for years, with minimal help from countless drugs, and this was a very nice lift today. Now keep in mind sam-e is supposed to take atleast 1 week to 3 weeks to really work, and this was literally my first day taking it, but something is telling me it's not Placebo, as I am not too prone to the Placebo effect. Too lazy to post all details on sam-e, do a quick Google scholar search, it has studies for being a possible augmentation or stand alone pill for depression and a number of other ailments. Could this be what I have needed for years??

 Ps. Slightly worried about possible serotonin syndrome as I am on fetzima, and abilify, however both are at lowest doses and my depression was so bad that I was willing to try anything. Maybe not maoi's yet :P

Edited by aspillane
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