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Re: SLS » Denise1966

Posted by SLS on July 4, 2005, at 12:55:08

In reply to SLS, posted by Denise1966 on July 4, 2005, at 11:46:06

Hi Denise.

To recall with 20/20 hindsight my decision making process regarding ECT is tempting. Since it didn't work, I wish I had never had it. I don't know the degree to which it has produced long-lasting impairments in memory. Memory impairment is a primary symptom of my condition, and occured prior to ECT. My memory and cognitive function are worse now than prior to my having had ECT, but my depression has grown worse overall. Bilateral ECT really produced a significant change in my cognition and memory that the unilateral did not. Still, I wouldn't rule out having ECT again. Max Fink, MD, told me that the type of treatments I had in 1991 have since been refined and are more efficacious. He also hinted that RU is better than LU, but there are some who select hemispheres based on dominance. He really wanted me to buy his book to have my questions answered.

I'm not sure what to make of DBS yet. VNS received good press when it first became available. It doesn't appear that VNS is living up to the original excitement it produced five years ago. I have seen some amazing demonstrations with DBS used in Parkinsons Disease. I think with DBS, they will eventually discover which types of depression are most likely to respond to it. I have to do a bit more investigating to decide if bipolar depression has a higher or lower rate of success. I don't know how to interpret your symptom cluster. It has features that seem more typical than atypical or possibly a mixture of the two. You might respond better to TCA and MAOI than to SRI. I would certainly explore MAOI before going for ECT.

Do you feel better in the morning or in the evening?

Do you feel significantly better for short periods when something good happens?

Do you ruminate incessantly over things?

What happened to Wellbutrin?

As far as combinations are concerned, I don't see that you have combined one or more antidepressants with complementary mechanisms of action. That leaves a whole world unexplored.

SRI + Remeron
SRI + Wellbutrin
SRI + TCA

I'm still unclear about lithium. How did it affect you?


I am currently taking:

Lamictal 150mg
Parnate 80mg
nortriptyline 100mg
Abilify 10mg
Trileptal 900mg

Hopefully I'll get to increase the dosage of Trileptal to 1200mg by this time next week.


- Scott

 

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