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Re: TMS, Ketamine, ECT ... last chance! PCB

Posted by SLS on June 10, 2020, at 19:07:11

In reply to Re: TMS, Ketamine, ECT ... last chance!, posted by PCB on June 10, 2020, at 10:10:50

Hi, PCB.

> Mainly 50 lbs gain weight. As a health care provider I know with my BMI about 29 to 30 I am at higher risk for hypertension, diabetes, cancer. My left hip has mild arthritis which will only get worse. And of course being fat reduces chances dating and advancing at work.

I totally get it unfortunately.

> Insomnia for which ambien barely helps

One of the problems with Ambien is that it has such a short half-life. It is used to initiate sleep, but doesn't do a very good job of keeping people asleep (sleep maintenance). Years ago, when nothing else worked to treat my insomnia while taking Parnate + desipramine, my doctor combined Halcion (the most potent benzodiazepine that has a very short half-life) to initiate sleep and Ativan to maintain it.

> Ankle swelling

Very common. Im glad I dont get that.

> Worry that so few people take Nardil, there will be a shortage one day

Yes and if you stop taking it now, my future is less secure. :-)

> I think we talked about this before, but Dr Fredrick Quitken The Godfather of Nardil told me that Nardil works 90% of the time but only 10% can tolerate it.

Wow. I didnt know that.

I was a patient of Dr. Quitkin. He and Michael Liebowitz were big proponents of Nardil for atypical depression and social anxiety.

> So TMS is making me worse, I all I have to choose between is Nardil and being fat, forever single, high blood pressure and diabetes or maintenance ECT with the inability to work at my high level job and this possibly of long term cognitive loss.

Linkadge made a rather important comment regarding dominant handedness. It reminded me how critical frequency and laterality are in TMS treatment outcome. Are there any left-handed people in your family? Giving TMS on the wrong side of the brain (for that individual) can make someone feel worse instead of better. There are several different types of TMS that have emerged. You might want to look into deep TMS (dTMS).

> And also, I have been on over 25 medication and the only ones I could not tolerate were despramine and Wellbutrin but to worsen of my panic attack. Of the other TCA, parnate, SSRI, lithium, SNRIs, depakote I had side effects but they were tolerable and I never complained. Nardil was really the first and only medication that I have had difficulties with and have tried to replace.

Have you responded well to a drug that later became ineffective?

I imagine you have tried Effexor already. What about Trintellix? Intrestingly, Trintellix can enhance cognitive function, even when there is no improvement in depression. Its worth trying.



Some see things as they are and ask why.
I dream of things that never were and ask why not.

The only thing necessary for the triumph of evil is that good men do nothing.

 

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poster:SLS thread:1110621
URL: http://www.dr-bob.org/babble/20200511/msgs/1110631.html