Posted by SLS on August 23, 2001, at 19:10:33
In reply to Re: Think You Wanna Do ECT? » SalArmy4me, posted by Adam on August 23, 2001, at 13:23:14
> I'm not sure what this thread is about, but I'm giving maintainance ECT some serious thought, since I stopped taking selegiline about a week ago. I have, since then, felt unexpectedly wonderful. I liked selegiline a lot, and may go back to it, but I realise I am currently enjoying some residual antidepressant effects without having an antidepressant drug in my system.Adam, you might be experiencing a positive withdrawal rebound improvement. I have had similar brief improvements upon discontinuation of tricyclics and MAOIs. In fact, I have become seriously manic upon the discontinuation of Nardil. They generally last for a week or two.
I am sad to learn that your remission has not continued robustly. Perhaps the selegiline patch that you had so much success with will soon become available. I know nothing of its status.
In 1991, I received a course of 15 ECT treatments over the course of 5 weeks. The first six were unilateral left; the remaining were bilateral. I experienced a mild improvement after the fifth treatment that lasted for about half a day. In a recent communication with Max Fink, he deemed my treatments inadequate such that no conclusion could be made regarding its efficacy in my case. My doctor will bring it up from time to time just to remind me that ECT remains an option, but I doubt I am a good candidate for success. It is good that you remember how your prior treatments affected you with respect to its positive effects on mood and its negative effects on cognition to judge well its desirability for you at this time. I found that the bilateral treatments were much, much more disruptive to cognition and memory. There is some thought that high-dose right unilateral ECT is about as effective as bilateral, but with reduced cognitive side-effects. Low-dose unilateral provides for less cognitive disruption, but is significantly less effective.
Maintenance treatment is most often necessary as relapse usually occurs within a few months.
I think you might have participated in a thread last year involving this article:
http://archpsyc.ama-assn.org/issues/v57n5/ffull/ytm0500.html
If you do go back to selegiline, don't forget to include lithium in your list of augmentation strategies. One of my doctors had quite a bit of success with Parnate + lithium.
Good luck.
- Scott
poster:SLS
thread:76099
URL: http://www.dr-bob.org/babble/20010822/msgs/76159.html