Posted by linkadge on August 18, 2020, at 6:51:13
In reply to Re: Anyone have ECT? » Hugh, posted by PCB on August 18, 2020, at 6:11:09
Random musings here ...
ECT does have a high relapse rate. This is admitted by even the strongest proponents of ECT. There was a study suggesting that the nortriptyline + lithium combination extended the time till relapse. Actually when nortriptyline was administered alongside ECT, it also reduced cognitive side effects.
As for rTMS, I wouldn't say that nobody responds without also taking antidepressants, but there is plenty of evidence suggesting that rTMS can hasten or improve the response to antidepressants. As some know, I build my own rTMS machine about 20 years ago (don't do this). It actually worked well (but I got concerned about demyelinating my brain or something). It improved my sleep wake cycle dramatically (powerful drive to easily fall asleep at night for at least a month afterwards). I then attempted to stop the citalopram. Although I did this, and wasn't 'depressed', I was quite a bit more irritable. From what I've read rTMS is probably more dopaminergic than serotonergic (which is why it might augment SSRI meds). The rTMS has the strongest effect on my apathy / anhedonia. It probably had pro-cognitive effects as well. I remember I hadn't played the piano in years (loss of interest) and I sat down and played several complicated songs perfectly.
Ketamine seems to have serotonergic and dopaminergic effects (as well as modulating glutamate, gaba, opiates etc). It's really a multi-mechanism drug.
Side note here - I really think more of you should order some agmatine. Seriously, it's like 14 bucks on amazon, and I have been noticing some serious improvement. I'd like to hear some reports (positive or negative). In mice, it works as well as ketamine (some overlap in actions).
Linkadge
poster:linkadge
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URL: http://www.dr-bob.org/babble/20200711/msgs/1111756.html