Posted by Psychquackery on July 30, 2003, at 21:38:51
In reply to Sorry, posted by linkadge on July 30, 2003, at 21:02:10
> You are taking something that has scientists have absolutely no idea how works and you are trying to assign meaning and science behind it that just doesn't exist.
HUH? No Im not Im just repeating what Ive read. That the seizure is the CRITICAL part of ECT. No seizure...no good antidepressant effect. Seriously Linkadge...go ask ANY psychiatrist...anyone anywhere if ECT will work if they just pass electricity thru the brain without inducing a grand mal seizure. I guarantee you the answer will be the same wherever you go. That "ECT" of that sort (no seizure) is essentially worthless.
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> The reason they call it ElectroCONVUSIVETherapy is because thats what the procedure is, and thats how they've been doing it. Just because they've been doing it a certain way, with a certain procedure, does not mean the whole shibang is necessary.No...its because they have discovered that the seizure itself is the mechanism which causes profound brain changes, which decreases depression, mania, psychosis and even parkinsons. And a seizure is a convulsion. Thats a hard fact. They arent just passing an electric current thru your brain for no good reason, the shock docs are doing it to VERY SPECIFICALLY elicit a grand mal seizure. That is the sole objective of ECT...why do you have trouble understanding this basic fact?
Do you have a deep seated basic fear of ECT? Is that why you deny the basic facts surrounding ECT?
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> For instance we can induce seizures quite safely using a magnesium restricted diet and glutimate receptor antagonists. This is one approach that has been used to try and replicate the effect of ECT. It produces full Grand Mal seziures. The stradegy was abandoned because it did nothing for depression. ( only induced memory loss. )Sounds silly to me. It was probably the magnesium restricted diet that created depression. Magnesium deficiency is known to create depression all by itself.
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> Insulin shock therapy is again a totally different procedure that we separately don't understand. We cannot say that it works in the same way as ECT if we don't really know how ECT works now can we???No...its actually very similar to ECT. The only difference is HOW the seizure is created. With ECT electricity is used, with insulin shock...its the insulin injected into the body that creates a grand mal seizure. The end result is the same...a grand mal seizure. The end objective is the same...a grand mal seizure.
LOL Man you dont understand anything, do you?
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> You are inserting information into the equation that just never existed. You ask any of the top scientists why ECT works and they'll tell you they don't have a clue.Thats not true. They have ideas how and why it works. If you read Max Fink's stuff he firmly believes ECT works mainly by "profound neuroendocrine changes" deep inside the brain. Around the thalmus and pituitary gland area. These changes are created by the seizure. No seizure and these changes simply do not occur...its just a hard fact. Get Fink's books and read it for yourself!
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> We know some of the results of it though.
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> - Both ECT and rTMS decrease gluticorticoid
> expression
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> - Both ECT and rTMS upregulate NGF, BDNF, GDNF
> and other nerve growth factors in rat brain.
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> - Both ECT and rTMS alter 5HT1a/b autoreceptors.
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> - Both ECT and rTMS alter norepinephrine
> expression.
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> - Both ECT and rTMS increase bloodflow to left
> prefrontal lobe.
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> - Both ECT and rTMS have effects on substance P
> NK-1 receptor expression.And ECT does all of the above much more potently than rTMS does and ECT creates a more robust recovery than rTMS does. It is a HARD FACT linkadge, that bilateral ECT has the highest percentages of FULL REMISSION from psychotic depression of any treatment available in psychiatry. There have been so many studies to back this claim, I couldnt list them all. Go to Medline and look up "psychotic depression AND bilateral ECT" if you dont believe me.
You wont find the same results with rTMS. Go find one medline study that says rTMS has high full remission rates for psychotic depression or for bipolar mania. You wont find a single one Linkadge. And if by some small chance you do find one, it wont be replicated.
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> Infact find a observable brain alteration induced by ECT that is not also induced to a certain degree by rTMS.
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> If you think that ECT is the only way that we can safely evoke seizures these days, that is just not true. If scientists really thought that ECT's sole mechanizm was through inducing a seizure then the direction of our research would change completely. We would've abandoned this direction completely. Not only are many (specific) pro-convulsant drugs useless for psychiatric conditions, they also induce short term memory loss - so go figure - that accounts for one side effect.Well Linkadge, so far as I know convulsive therapy is currently revolving around two modalaties. Regular ECT...er the perfection of it. And the Magnetic Stimulation Therapy, which is just a spinoff of rTMS. In other words, even the rTMS researchers who once believed rTMS would have the same effectiveness as ECT have now realized rTMS just doesnt cut the mustard for severe mood disorders. So theyve decided to try and use magnetism to induce seizures. DUH!!
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> Many scientists simply think that the seizure is just a marker, that certain neronal stimulation has been reached. How do you know that the theraputic effect is not reached moments before the seizure? There is no way to know (yet at least)The seizure is the marker. Thats exactly right. And without it, you aint got nothin. All that money you just spent with the shock doc is worthless if they dont give you a nice big ole grand mal seizure!
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> How can you say rTMS is a weaker version of ECT when we don't know how either work? Again, you're inserting info into the equation. Most people who use rTMS agree that it is still in its intfant stages. I would agree with you when you say at 'this time', it is less effective than ECT, because that's just the statistics. For instance, certain frequencies facilitate neurotransmitter release, and other frequencies impede neurotransmitter release. Scientists are basically just poking around and recording what happens.rTMS IS a weaker version of ECT! Its much weaker than ECT. I even have had rTMS researchers frankly admit to me to my face its weaker. Thats why it doesnt have any side effects. Thats why it doesnt need anesthesthia...its WEAK!
Again...go on medline and try and pull up a rTMS study where they solidly concluded that rTMS is as effective for severe psychotic depression and/or bipolar mania as bilateral ECT is. You wont find any. And thats the bottom line, my friend.
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> I know you want to make it into some solid and fully researched/understood procedure, but it is just not.Sure its not understood to the degree we'd like. But I think its a little bit better understood than you have stated on here. They do know the basics of it. Again, go read Max Fink's books, go read Medline. Compare rTMS versus ECT on Medline for severe mood disorders.
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> Some researchers believe that the sucess of ECT is based on its ability to modulate gluticorticoid expression. The drug RU-486 is the only drug to be fast-tracked for a psychiatric condition. It has extreme efficacy in severe and debilitating psychotic depression (Even in persons where ECT has failed)Max Fink says that the way ECT works is by inducing a grand mal seizure that stimulates deep brain structures and creates neuroendocrine changes. Thus the anti-cortisol thing. ECT has been doing the RU-486 anti-cortisol thing for over fifty years! And it does it better than anything.
Keep in mind that the people who claim RU-486 works as good as ECT for psychotic depression are connected to the pharmaceutical industry. It may or may not be true that RU-486 is effective as ECT. I personally doubt it will come true, although I do believe RU-486 will probably eventually have some uses in psychiatry. But as or more as effective as ECT? I seriously doubt it.
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> Could it be that this is the common mechanism. (A mechanism that is equally pronounced in both ECT and rTMS). You cannot say no - because we don't know.Its not equally pronounced Linkadge. If it was as equally pronounced youd be reading that rTMS was as effective for psychotic depression as ECT on medline. And you wont do that. Cause those studies simply dont exist, because the researchers KNOW that it wont work as good for really severe, nasty mood disorders.
The bottom line (this is a hard fact BTW) is that no somatic treatment for psychotic depression has as high a full remission rate as bilateral ECT does. Hard fact, my friend.
>Igor
poster:Psychquackery
thread:246432
URL: http://www.dr-bob.org/babble/20030728/msgs/246889.html