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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Psychquackery on August 25, 2003, at 8:59:57
I recently watched the acclaimed movie "One Flew Over the Cuckoo's Nest." I had heard all about this movie, how horrible it is, etc. I did find it to be a rather depressing movie and I could relate to it in many respects. The condescending attitudes of some of the mental health professionals and the poor patient-mental healthcare professional relationships came thru loud and clear. However much of the movie I thought was bunk, at least by the standards of the year 2003. One of which was how ECT was depicted in the movie.
In this movie which was released in 1975, ECT was portrayed strictly as a form of behavioral control. Misbehaving patients (McMurphy, the Indian Chief and the other guy who threw a fit) were sent to the locked ward where the shock room was. There they underwent ECT, without anesthesthia or oxygenation and were literally held down by hospital orderlys. I laughed at this part of the movie, as this is not how ECT is used in the modern era.
First of all, the laws regarding modern ECT in the year 2003:
1) ECT can NOT be used for behavioral control as depicted in One Flew Over the Cuckoo's Nest. Any use of ECT for this purpose is likely to land the ECT doctor in prison and to lose his license to practice medicine.
2) ECT can only be used to treat severe and refractory mood disorders for which drugs work minimally or poorly. Such as psychotic depression, acute mania, catatonic states, drug resistant major depression especially the melancholic subtype and sometimes refractory schizophrenia. Stringent entry requirements must be filled before a person can be accepted for ECT.
3) ECT is purely voluntary, except under extremely rare circumstances such as when a person has become an invalid and cannot feed themselves or go to the bathroom by themselves and is bedridden. In rare cases such as these, the person is appointed an attorney normally. Most cases of ECT nowadays are PURELY voluntary and the person can pull out at any time.
4) Unlike the ECT portrayed in One Flew Over the Cuckoo's Nest, patients are not given anesthisthia, muscle relaxants to keep them from convulsing all over the place and they are artifically oxygenated to keep blood oxygen levels from going down to dangerous levels.
In short, the ECT portrayal in "One Flew Over the Cuckoo's Next" and similar such movies bears little to zero resemblance to the present way ECT is used. Its not "mind control" its not behavioral control. Its just a method to save people from a life of severe, chronic disability when drugs dont work.
The money being wasted on research for such things as VNS, rTMS, etc. should be used to help overcome the tarnished image of ECT, so more individuals could get this outstanding treatment and avoid a life of pure hell.
Igor
Posted by utopizen on August 26, 2003, at 17:57:09
In reply to The poor depiction of ECT in the movies, posted by Psychquackery on August 25, 2003, at 8:59:57
I just saw Slaughterhouse V for the first time. It was the first time I ever saw a movie where the doctor made it clear that he was using an anesthetic ("you're going to sleep now, Billy.")
Even 20/20 pointed out how pathetic One Flew's depicition of ECT is... I wouldn't be so concerned, I don't think many actually believe that is a documentary or something.
Posted by lesliekay on August 27, 2003, at 23:42:39
In reply to Re: The poor depiction of ECT in the movies, posted by utopizen on August 26, 2003, at 17:57:09
ECT is completely different nowadays than it used to be. It is actually believed to be partially curative in some cases of major depression because current research shows that there are anatomical changes in the brain in patients with long term dysthymia or MDD. ECT has been shown to actually stimulate growth of the dendrites of the neurons that have wasted away in those patients. It also is the safest form of treatment during pregnancy,as well as the safest form of treatment of bipolar depression because it is the least likely to induce mania. I am a mental health professional as well as a patient, and believe me, I have seen miraculous things with ECT. I would not hesitate to do it myself. leslie
Posted by Nohope on August 28, 2003, at 4:06:43
In reply to The poor depiction of ECT in the movies, posted by Psychquackery on August 25, 2003, at 8:59:57
I thought ECT was very easy to tolerate. Pity it did not work for me.
Posted by Questionmark on August 28, 2003, at 22:57:29
In reply to Re: The poor depiction of ECT in the movies, posted by Nohope on August 28, 2003, at 4:06:43
> I thought ECT was very easy to tolerate. Pity it did not work for me.
i'm really sorry to hear that. Forgive me if you've stated this before, but can i ask what med classes you've tried?
i hope you can find something that helps soon.
Posted by Nohope on August 29, 2003, at 3:27:12
In reply to Re: » Nohope, posted by Questionmark on August 28, 2003, at 22:57:29
> i'm really sorry to hear that. Forgive me if you've stated this before, but can i ask what med classes you've tried?
> i hope you can find something that helps soon.
>I don't think I've ever written a list of medications I've been on.
Started out on the tricyclics and irreversible MAOIs many years ago - that's all that were around then. Yes they helped with depression, but the side effects were a nightmare. Did Prozac when it first came out, followed by every SSRI that came along (hoping that it was 'the one' - of course never was). Generally fewer side effects than earlier meds but terrible sexual problems. Tried the atypicals when they came out: serzone, remeron etc etc. Imported stuff like moclobemide and tianeptine. Modafanil and Adafanil (sp?). Tetracyclics like mianserin. All these were steps sideways instead of forwards: basically I had to pay for better effects with worse side effects. Done about as much alternate stuff as I can: St John's Wort, gingko, 5-HTP,NADH, phosphatidylserine, L-tyrosine, phenylanaline - I know there's more there, I just can't recall... Lithium (terrible for me), Lamictal (not bad for sexual problems, but very anxiogenic). Tried some atypical antipsychotics, but just got sedated and numb.
Then ECT - very few side effects + very few effects. Extremely disappointing.
Now on Reboxetine for 1 week. Feels like I've downed 50 cups of coffee; still waiting for positive benefits. If this fails, I have buprenorphine in mind. If that fails, I have no ideas left.
Posted by Liligoth on August 29, 2003, at 20:02:04
In reply to Re: » Questionmark, posted by Nohope on August 29, 2003, at 3:27:12
>
> > i'm really sorry to hear that. Forgive me if you've stated this before, but can i ask what med classes you've tried?
> > i hope you can find something that helps soon.
> >
>
> I don't think I've ever written a list of medications I've been on.
>
> Started out on the tricyclics and irreversible MAOIs many years ago - that's all that were around then. Yes they helped with depression, but the side effects were a nightmare. Did Prozac when it first came out, followed by every SSRI that came along (hoping that it was 'the one' - of course never was). Generally fewer side effects than earlier meds but terrible sexual problems. Tried the atypicals when they came out: serzone, remeron etc etc. Imported stuff like moclobemide and tianeptine. Modafanil and Adafanil (sp?). Tetracyclics like mianserin. All these were steps sideways instead of forwards: basically I had to pay for better effects with worse side effects. Done about as much alternate stuff as I can: St John's Wort, gingko, 5-HTP,NADH, phosphatidylserine, L-tyrosine, phenylanaline - I know there's more there, I just can't recall... Lithium (terrible for me), Lamictal (not bad for sexual problems, but very anxiogenic). Tried some atypical antipsychotics, but just got sedated and numb.
> Then ECT - very few side effects + very few effects. Extremely disappointing.
> Now on Reboxetine for 1 week. Feels like I've downed 50 cups of coffee; still waiting for positive benefits. If this fails, I have buprenorphine in mind. If that fails, I have no ideas left.
>
>Hi Nohope, I answered your bupe questions elsewhere but forgot to add your name in the subject line (still new to this). Anyway, just wanted to say there is hope! Like you I had tried everything except the ECT & that was looming on the horizon as I was in a very severe depression. Then I tried the bupe & it was truly miraculous - within 1 day I felt just about normal again! Over the next few weeks it has just continued to improve me. It may well be worth a try - have other pain killers made you feel better? That would give you a reliable indication that the bupe would work for you.
Posted by Nohope on August 30, 2003, at 1:09:45
In reply to Re: » Nohope, posted by Liligoth on August 29, 2003, at 20:02:04
Hi Liligoth.
Thanks very much for your posts. It is great to see that buprenorphine works so well for you. I hope that the benefit lasts - isn't tolerance an issue for these drugs?
I don't think I've ever tried strong pain killers (opiates/opioids). I seem to have a high tolerance to physical pain (probably I'm just distracted by mental pain all the time). Also, I've successfully avoided the dentist for many years.
I'll give the Reboxetine a fair chance, but if it fails, buprenorphine seems to be my last throw of the dice.
Best,
Nohope
> Hi Nohope, I answered your bupe questions elsewhere but forgot to add your name in the subject line (still new to this). Anyway, just wanted to say there is hope! Like you I had tried everything except the ECT & that was looming on the horizon as I was in a very severe depression. Then I tried the bupe & it was truly miraculous - within 1 day I felt just about normal again! Over the next few weeks it has just continued to improve me. It may well be worth a try - have other pain killers made you feel better? That would give you a reliable indication that the bupe would work for you.
Posted by juanantoniod on August 31, 2003, at 21:48:40
In reply to Re: » Liligoth, posted by Nohope on August 30, 2003, at 1:09:45
I am sorry to hear that you've had so many trials and tribulations (literally) but I wanted to ask you, is Reboxetine available in the U.S., or did you import it?
Antonio
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