Posted by Jumpy on November 12, 2002, at 14:36:50
In reply to Starting ECT -- any advice?, posted by cab on November 12, 2002, at 11:25:59
Hello,
Does anyone know whether one has to come off lithium before it starts? How about Paxil?
Well, having lithium in the blood stream during ECT may cause more memory problems, so most docs either stop it the day before a shock treatment or stop it altogether before ECT starts. Paxil maybe be used, but I assume if you are getting ECT, Paxil failed to help you. So you might as well taper off, unless your edoc and pdoc want to augment it with something else.
And are there recommended drugs for maintenance, after the course is done?
So far the only good study was with Sackeim at Columbia University. He looked at relapse rates for pamelor, pamelor + lithium and placebo. Pamelor/lithium was the best post ECT med. Sackeim mentioned in the paper that lithium post ECT didn't show any benefits in prior studies.
Max Fink states that you can't expect a medication that failed to help before treatment to help afterward. Finally, a harvard edoc told me he agrees with Fink, but usually he can find some combo (like effexor and remeron) that keep the patient in remission. If it doesn't, he will shock again and try another combo until he finds one that works. One women needed parnate, pamelor, ritalin combo post ECT to finally keep her in remission. Those drugs in combination are a big no no to convential psychiatry, but if you are treatment resistance ... you might need a heroic combo like that.
Any success stories with ECT, or just things I should know?
Sucess rate is 80 to 90% in general, but about 60 to 70 in treatment resistant folk. Although some ECT doctors claim they can get almost anyone out of a depression with ECT, the trick is keeping them out with the right meds or maintanance ECT. I think "Chloe" and "Geezer" are doing pretty well with ECT now.
> Thanks,
> CJumpy
poster:Jumpy
thread:127369
URL: http://www.dr-bob.org/babble/20021108/msgs/127390.html