Posted by susan C on July 29, 2001, at 22:01:12
In reply to TREATMENT RESISTANT DEPRESSION - INFO NEEDED, posted by sweetmarie on July 29, 2001, at 4:18:21
Hi, I have kept an eye for your posts, not too long ago, you sounded so sad. I am glad to hear the change and challenge in your 'voice'. Here are my contributions:
I am in the US
I have had been dx as 'chronic clinical depression' then bipolarII. I think it sounds like in UK they may say more quickly you are resistant on the GP level. Here I got referred to pdoc by Gynocologist when I was searching for answers to PMS in the late 80's and she discovered I was clinically depressed and referred me to pdoc who was the only one in town who dealt with the 'biochemical causes of depression' I never went to my gp for treatment. When I got exasperated with pdoc as not investigating enough after 12 years and him thinking my manic times were when I was 'doing good' (I live in small town) I changed pdocs. Now I travel 1 1/2 hours to see new doc.
After listening very carefully, and identifying genetic and possible seizure like disorder, my new pdoc started trials on AED. I have tried 4. The last was Depakote. Which has kind of worked. As a result, he has said, you have something, maybe not bipolar, but something isn't right with your brain. He doesn't think it is thyroid, it has a 5% chance of being MS. My pdoc suggested VNS as my symptoms indicate a possible seizure like disorder and that the VNR has been used successfully on 10,000 people with refractory Epilepsy. When I think about that, that is pretty impressive, considering how debilitating Epilepsy is. Depakote has kind of worked and I just posted a thread on starting Keppra, a new AED, levetiracetam. Earlier on this board I posted a query about left/right brain communication and studies that have been done on that and in general understanding how the brain works. http://www.dr-bob.org/babble/20010725/msgs/71977.html
We still have a black box here. There has not been enough study to say..if you have these symptoms and you do this then your brain changes this way. I think some day that may happpen. Question: have they done PET/MRI/SPECT studies on VNR patients? He said, based on my depression score (?) I would qualify for a trail of VNS at the University of Washington (State, in Seattle, WA) being directed by Dr. David Dunner. I have not investigated it, as I do not want to go through an operation. I want to try medications first. And like your pdoc, my pdoc says, there are always new ones to try.
In the other posts, descriptions of the illness and what treatment resistant means, may be different in UK that US. There are many sites (depressioncentral) that have the official DM something something.
I hope this has been of help. I am a little confused at the moment. Good luck with your article. Post it here, please?
> I am a UK `visitor` to this site.
>
> I belong to an organisation called `Fellowship of Depressives Anonymous` (FDA), which is a charity run by and for sufferers of depressive disorders (and their carers).
>
> As a sufferer of so-called Treatment Resistant depression, I am hoping to put together an article about this condition for submission in the Newsletter. I`ve been meaning to do this for a few months now, but have been too ill and haven`t got round to doing it. An article in the last Newsletter has decided me to finally write this article.
>
> The article is about the Vagus Nerve Stimulator, and it`s success for people with treatment resistant depression. I am aware of this treatment, and do not dispute it`s usefulness in the treatment of sufferers like myself (and would certainly not rule it out for my own treatment if it were appropriate).
>
> The aspect of the article which I am seeking to dispute is the assertion that a certain percentage of sufferers can not be helped AT ALL by medications - "As many as 30% of those affected fail to respond to either drugs or ... electro-convulsive therapy". The article ends by pointing out that the Vagus Nerve Stimulator is effective for 40% of those who try it, which leaves "...about 10 - 15% of patients with depression who respond to absolutely nothing."
>
> I am currently being treated at a specialist unit for patients with Treatment Resistant depression. Whilst the unit is careful to say that there are `no guarantees` that a medication (or combination of medications) or other form of treatment will `work`, the medical professionals - in particular the professor who is in charge of my treatment - are convinced that help can be found for ALL sufferers (which obviously includes the use of the Vagus Nerve Stimulator). For this reason, the professor prefers to refer to this condition as `difficult to treat` depression rather than `treatment resistant` depression, a term which suggests that NO treatment will ever be found.
>
> It has been my experience that there IS a medication/combination of medications/other treatment options (VNS, ECT etc.) for everyone. As a sufferer of TR depression, I have done much research into the condition. By this I mean that I`ve read books, articles, spoken to other sufferers, trawled the Net and spoken with psychiatric proffessionals. The result of this has been that depression CAN be treated, but the uncertainty centres around `What?` (treatment) and `When?` (will this be found).
>
> What I am looking for is input from fellow Dr Bob web-goers on this condition. Specifically:-
>
> * Those who have proved difficult to treat, and their understanding of their condition;
>
> * What medical professionals have said;
>
> * Information gained from other `difficult to treat` sufferers (possibly from being in hospital/support groups etc.)
>
> * Information gained from literature/articles/internet research. I`d be particularly interested in any websites.
>
> I am going to approach my professor for a `quote` on the subject when I go back to hospital (tomorrow) so that I can include it. Meanwhile, ANY info would be TOTALLY gratefully received.
>
> Thank you so much for reading this incredibly long post. I hope you can help.
>
> Ta,
>
> Anna.
>
> p.s. Obviously, I also want to hear from those who have been told that they are `hopeless cases`, and about who exactly has told them that. I could be completely wrong, and there are those of us who are `hopeless cases`, but this is not what I have gathered, and - more importantly - I refuse to accept it and admit defeat.
poster:susan C
thread:72327
URL: http://www.dr-bob.org/babble/20010725/msgs/72426.html