Posted by sweetmarie on March 28, 2001, at 11:35:39
In reply to Re: treatment resistant depression » sweetmarie, posted by SLS on March 28, 2001, at 8:48:10
> Hi Anna.
>
> > It [dothiepin] was the first anti-depressant I was prescribed, and it worked for me 100%. It worked so well that, in conjunction with my GP, I came off it after a year. The depression came back almost immediately (worse than before in fact), so I went back onto it. Unfortunately, it failed to have any effect at all 2nd time around, although I persisted with it (at all levels of dosage) for a further 18 months.
>
> > So, no I`m not still on it, but curse my folly in discontinuing it all the time
>
> I know you realize that you made a perfectly logical decision with the information you were provided; a decision driven by a very understandable desire to discontinue a drug, along with its side effects, that is no longer needed. It is also understandable that you should not want to "rely" on any drug to remain healthy. People with all sorts of illnesses want to be able to live without the drugs they are taking. Many of them petition their doctors to discontinue their medication. It is the responsibility of the doctor to council the patient as to whether or not they should and, ideally, to explain to the patient why. It seems that your doctor at the time did not possess the information regarding antidepressant continuation. At that time, perhaps psychiatry had not yet recognize the potential for post-discontinuation treatment-resistance. Perhaps it was, but your G.P. was without the expertise to remain current with psychiatric issues. Either way, your decision at that time made sense.>
> "What if...?"
>
> 20/20 hindsight provides an unfair advantage for those who have it in advance. I can look back 13 years ago and isolate a single decision made by my doctor that resulted in the loss of my late 20's, all of my 30's, and still counting. I can look back on some of my own treatment decisions that, in retrospect, could have prevented me from getting well. Still, I remember how human I was at the time I made these decisions, and try not to place too much weight upon my shoulders for the blame and guilt I feel for having made them.> > I know 12 drugs sounds like a big number. It is. However, compared to some of the people here, you have plenty more treatment possibilities ahead of you than you have had behind you. You should remain optimistic.
>
> I do not regard your decision to discontinue dothiepin as "folly", whether you were counciled properly or not. I wish that I had followed some of my doctors' advise instead of f____ing (follying) around. I try to learn from my past so that I can provide myself with a better chance of having a future.
>
>
> Sincerely,
> ScottDear Scott,
I appreciate your reponse to my post. You`re absolutely right of course: how could my GP have known that I would subsequently be treatment resistant - after all, it was the very 1st medication I had ever taken for depression. As you also point out, it`s doubtful that a GP would be up to scratch with psychiatric medications (after all, a good many psychiatric doctors aren`t either). There really isn`t much point in looking back and wishing it could have been different - as my mother says, it`s where I am now and the future that counts. As you know, mothers have an inherent knack of being `right` (hmmmm...) I do feel though, that it probably bodes well in the sense that I have responded in the past, so it can`t be completely outside of my capabilities (convaluted logic? - maybe).
I`m interested to know what you meant by a decision made 13 years ago, which screwed up your late 20s etc. What was that (don`t tell me if you don`t want to - I`m just curious). Up until 3 years ago, I hadn`t actually been treated by a psych doctor at all - I had always been treated by my GP (first of all in Cambridge where I used to live, and then by my GP here in Leeds). It wasn`t until 3 years ago (almost to the day) that my GP realized that I needed `proper` help. Although I know that this is a waste of time, I do find myself asking the question how come it took them so long to refer me on to a psychiatric proffessional. After all, I had been on quite a few different med with them (Dothiepin, Seroxat, Prozac, Favorin, Lustral, Reboxetine and Venlafaxine - all these spanning 7 years with no results at all). As it turned out, the psychiatrist I was referred to was a complete w****r (I feel very strongly about this man - he`s totally incompetent to say the least, and whilst I was `under` him - 18 months - he put me on Imipramine, and when that failed to work, he tried ECT and when that failed, he told me that there was nothing further he could do for me). Two other of my friends have left him (as I did), and one of them made a formal complaint against him. He`s still practising though. I don`t know quite why I`m telling you all this, except for the fact that I feel, as you obviously do, that much time has been wasted. It astonishes me that I wasn`t actually diagnosed treatment resistant until I came under the care of my current psychiatrist. The facts were all there ... Still, I guess now that it has been recognised, it can be properly treated. Also, having seen the specialist, the diagnosis is even more accurate, which I`m hoping will narrow the field even further. Hindsight is all very well, but it really ought to be something we learn from, rather than something we beat ourselves up over (which I do on a regular basis).
Anyway, I won`t go on any more. How is the Lamotragine situation (I could have got this wrong, but didn`t you say that you had started taking it)?
Cheers,
Anna.
poster:sweetmarie
thread:55847
URL: http://www.dr-bob.org/babble/20010327/msgs/57792.html