Posted by bleauberry on May 26, 2009, at 5:36:51
In reply to Advice on next steps, posted by glenni on May 25, 2009, at 22:00:37
As an ECT survivor, I strongly emphatically (banging the fists on the table) recommend to stay far far away from that. Pretend it doesn't even exist. It is not an option. In literature it appears promising. In the real world, not. Of the half dozen people I went through ECT with, the efficacy rate was 0%. In cases where it does work, relapses are almost guaranteed (80+
%) and happen very quickly (within days or weeks, sometimes a few months). Memory loss is more severe than you are told. It is not temporary as you are told. Entire blocks of my life are gone, haven't returned 3 years post-ECT, congnitive function was damaged significantly, and the 3 month period leading up to ECT and the 3 month period following ECT do not exist. Zero memory.The only benefit I can say ECT has is that it erases so many memories that you kind of get a new start. Many of those bad times and bad memories are gone, along with any good ones. People here have noticed unusual perplexing new symptoms following ECT, such as super sensitivity to meds and the inability to tolerate meds.
Total cost for 12 treatments was $22,000. I had to pay $6,000 of that. Insurance got hit with the rest. If you are going to spend that much money, buying a new car is more likely to help your depression than ECT.
MAOIs have an extraordinary track record. Within a slightly modified diet (not nearly as strict as you are told), they are quite safe.
Go to psychotropical.com to read what Dr Gillman has to say about MAOIs. He has used them in over 1000 patients. Extremely good information to debunk any hesitations or misinformation your doctor may have pertaining to Parnate or Nardil. Print it and take it with you to your appointment.
Second to MAOIs he found the combinations of Zoloft+Nortriptyline to be very good, when either alone did not work.
Outside of that, at this stage of the game is becomes more and more important to reconsider the diagnosis. Is this unrecognized Lyme disease? Is this unrecognized yeast overgrowth? Is there a history of amalgam fillings in the teeth (mercury toxicity)? Is your 24 hour 4-sample cortisol curve in a normal range? Are thyroid freeT3 and T4 in optimal ranges?
I couldn't quite understand whether you are taking all the meds you listed at the same time, or whether you had tried them at various times? If they are all in your present cocktail, all I can say is that is way too much meds. Even in the STAR*D clinical study where they had a higher than 80% remission record, the most meds given at any time were 3, but ususally only 2. It is a matter of the right meds, not how many. If a med isn't producing, it should be dropped and relpaced, not piled onto with other meds. I see that here all the time, where people and their doctors pile one loser on top of another on top of another. Geez, no wonder they feel so bad. No wonder the meds won't work. How could anyone possibly feel improvement when they have so many worthless failures in their bloodstream. That one med not working might actually be preventing other good ones from working. Get the non-perfomers out of the picture.
Duloxetine by the way is, anecdotally, a rather poor antidepressant.
So what kind of med works when ECT doesn't? Well, I can think of three. Parnate. Nardil. Milnacipran. Yeah, Milnacipran got this ECT failure feeling surprising improvement rather quickly. It is a new med approved for Fibromyalgia in USA, but is an antidepressant with a solid track record in the rest of the world. It is called Savella in USA.
No ECT.
Yes MAOI.
Maybe Savella.
Maybe Zoloft+Nortriptyline.
Yes limit meds to 3, drop the underperformers.
Revisit the diagnosis, looking for causes of brain impact originating below the neck.
psychotropical.com
poster:bleauberry
thread:897683
URL: http://www.dr-bob.org/babble/20090524/msgs/897742.html