Posted by Ilene on October 19, 2004, at 11:25:29
In reply to Re: Unlikelihood of remission » Ilene, posted by smith562 on October 19, 2004, at 3:03:07
> Hey Ilene,
>
> Sounds like your in a very frustrating position and suffering alot. Assuming you have tried all the medications out on the market (hopefully including Nardil and Parnate and combos of antidepressant with lithium or antiepileptic) you may want to consider ECT. Dr Steven Sackiem at Columbia has a treatment resistant program. I have heard at some points depression *can not* be helped by meds and ECT needs to use in order to make you responsive to meds again. Then after ECT he usually puts people on a TCA or effexor augmented with lithium with tremendous success.
>
> All this being said, ECT often isnt needed and many treatment resistant people respond to some sort of antidepressant/mood stablizer combo (most being in this bipolar spectrum category).
>
> Martha Manning wrote a great book on ECT (she being treatment resistant and a psychologist by training). She now is finally stable on zoloft, wellbutrin, lithium and depakote. So she was probably bipolar spectrum all along and wasn't depressed typically, but in a dysphoric mania.
>
> Hope this helped. There are new meds in the future too.
>
> SmithI haven't tried Nardil or Parnate yet. I'm taking a different MAOI called Marplan. Augmenting it with Cytomel (thyroid hormone) gave it enough of a kick for me to respond, but I can't take any more Cytomel because I became hypothyroid. I tried lithium when I was hospitalized last spring, but it made my feet swell and I was just uncomfortable with it. I tried Lacmictal. I'm taking Neurontin. I was going to ask about trying estrogen because I'm entering menopause, but got side-tracked when the docs gave me the "don't expect too much" lecture. This is actually as good as I've been in years, but it's not enough for me to fend off despair.
It's possible I'm somewhere on the biplar spectrum, but I've never been manic or even hypomanic.
I don't think ECT is considered unless a person is persistently suicidal, which I'm not at this point. At the same time I don't feel like I have much to look forward to.
poster:Ilene
thread:404563
URL: http://www.dr-bob.org/babble/20041018/msgs/404710.html