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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Denise1966 on July 7, 2005, at 8:55:20
Hi,
I know that this is probably a loaded question but I've taken many different antidepressants over the last four years and the side affects of some of them has been almost worse than the depression itself. For instance Mirtazapine (also known as Zipsin and Remeron) made me feel either zombie like or really agitated and anxious. Nardil (phenelzine), made me feel like I wasn't in this world at all, I got awful start up anxiety on SSRIs and felt very dopey on Effexor.
Does ECT have the same side affects and do they last, I know that there can be memory problems which can be lasting but what about all the other side affects one can get with drugs. Does anyone have any experience of getting these side affects with ECT?
Thanks..........Denise
Posted by SLS on July 7, 2005, at 9:53:49
In reply to ECT Side Affects Versus Medication Side Affects?, posted by Denise1966 on July 7, 2005, at 8:55:20
> Hi,
>
>
>
> I know that this is probably a loaded question but I've taken many different antidepressants over the last four years and the side affects of some of them has been almost worse than the depression itself. For instance Mirtazapine (also known as Zipsin and Remeron) made me feel either zombie like or really agitated and anxious. Nardil (phenelzine), made me feel like I wasn't in this world at all, I got awful start up anxiety on SSRIs and felt very dopey on Effexor.
>
> Does ECT have the same side affects and do they last, I know that there can be memory problems which can be lasting but what about all the other side affects one can get with drugs. Does anyone have any experience of getting these side affects with ECT?
>
>
> Thanks..........Denise
The only side effects suffered from ECT were those that appeared when unilateral treatments were changed to bilateral treatments. Bilateral treatments left me feeling disoriented and not like myself for at least a month after my last treatment. While driving, roads that I had travelled for most of my life became unfamiliar to me. I really did feel weird.If you want my opinion as to whether or not you should try ECT, I would only offer to you a very confident "maybe". Because my personal experience with it was not a horrendous one, and no one I know personally has described a horrendous one, I am less likely than others to condemn the treatment. I have heard some horror stories, though, that are hard to ignore. It is difficult to decide at what point to implement ECT relative to the failure of other treatments. Should one go to it after failing 20 drug treatments? 10? 5? Clearly, this is a judgment to be made by the patient in conjunction with the doctor.
I would really like to see you try Parnate + Lamictal first. How long were you on Nardil? How did lithium affect you?
The grass always looks greener on the other side of the fence. Agreed? It does not seem that you are so horrendously and vegetatively depressed that you must make extreme decisions out of acute need or desparation. Maybe give a few more treatment algorithms a chance? I think I would treat your illness as if you were suffering from bipolar depression without the potential for mania.
- Scott
Posted by Cecilia on July 8, 2005, at 6:01:22
In reply to Re: ECT Side Affects Versus Medication Side Affects? » Denise1966, posted by SLS on July 7, 2005, at 9:53:49
What`s always scared me away from ECT is that the main side effect-memory loss-can be permanent. Whereas with drugs, no matter how horrendous the side effects, usually once the drug`s out of your system the side effects are gone. I know that`s not always the case, some drugs can cause permanent harm, liver damage, TD etc. But after watching both my parents suffer with Alzheimer`s type dementia in the last years of their lives, memory loss scares me more than anything. Cecilia
Posted by linkadge on July 8, 2005, at 6:20:57
In reply to Re: ECT Side Affects Versus Medication Side Affects?, posted by Cecilia on July 8, 2005, at 6:01:22
Memory loss can be bad too if you are going to relapse. The memory serves to motivate us, and remids us of times we have faced similar challenges and succeeded.
Linkadge
Posted by iforgotmypassword on July 8, 2005, at 7:10:53
In reply to Re: ECT Side Affects Versus Medication Side Affects?, posted by linkadge on July 8, 2005, at 6:20:57
a lot of people never succeded facing whatever challenges these are. not to sound cold.
Posted by Denise1966 on July 8, 2005, at 7:24:47
In reply to Re: ECT Side Affects Versus Medication Side Affects? » Denise1966, posted by SLS on July 7, 2005, at 9:53:49
Hi Scott,
I've made my mind up, I'm going to give ECT a try and the sooner the better because I'm sick of feeling the way I do and then having to wait six weeks or so to see if a new drug will help and then when it doesn't increasing the dose for yet another six weeks and then when that doesn't work adding something else and so it goes, on and on and on.
I had two fairly good, bearable years when the 40mg of Seroxat was helping somewhat but the good effects seem to have died off and I have to do something. So have come off the Seroxat in the hope that the psychiatrist will put me back on Nardil for a month, then even if the Nardil doesn't work hopefully it will do something so that the Seroxat will work again. I'll take the Zyprexa every now and again to keep me going.
Either way, no matter what I do with the drugs I'm going to have ECT, I'll be sure to make sure they give me Unilateral though.
I'm so scared that the ECT won't work if it doesn't then I'll give the lithium a proper try on top of an SSRI.
If that doesn't work then the next thing is Deep Brain Stimulation or VNS if I can find out if they're doing the Deep Brain Stimulation in the UK.
I really don't think I have bipolar, I have absolutely no real motivation to do anything apart from smoke, walk around aimlessly and obsess about what I'm going to try next.
If I'm still feeling this way in about a years time I think I'll just jump off a cliff.
Thanks for your advice Scott, hope you're feeling better with the trileptal.
Denise
Posted by SLS on July 8, 2005, at 9:23:32
In reply to Re:To SLS, posted by Denise1966 on July 8, 2005, at 7:24:47
Hi Denise.
I support you fully in your decision to undergo ECT.
I guess the main question at this point would be regarding the laterality and dosage of the treatments. The only thing that seems to stand out in the literature right now is that right unilateral high-dosage is as effective as bilateral, but with a greatly reduced risk of cognitive impairments. I hope it works for you. There is no reason why you should have to suffer for one moment more.
Trileptal seems to be heading in the direction of complete failure. I just saw the doctor yesterday, and he is allowing me to raise the dosage from 900mg to 1200mg. Right now, I don't feel a thing. I am quite demoralized.
- Scott
Posted by ed_uk on July 8, 2005, at 13:21:40
In reply to Re:To SLS » Denise1966, posted by SLS on July 8, 2005, at 9:23:32
Hi Scott,
What is your opinion RE bifrontal ECT for depression?
~Ed
Posted by SLS on July 8, 2005, at 13:57:42
In reply to Re:To SLS » SLS, posted by ed_uk on July 8, 2005, at 13:21:40
> Hi Scott,
>
> What is your opinion RE bifrontal ECT for depression?
>
> ~EdI knew someone would ask that.
I really don't know enough about it. I have read only one short abstract on it. The claim was that it was somewhat less effective compared to bilateral (bitemporal) and somewhere in between to unilateral with respect to side effects. It might not have any advantages to high dosage unilateral.
- Scott
Posted by ed_uk on July 8, 2005, at 14:21:20
In reply to Re:To SLS, posted by SLS on July 8, 2005, at 13:57:42
Hi Scott,
>The claim was that it was somewhat less effective compared to bilateral (bitemporal) and somewhere in between to unilateral with respect to side effects........
I remember reading that!
I also read this............
Psychol Med. 1993 May;23(2):349-60.
Therapeutic advantage of bifrontal electrode placement in ECT.
Letemendia FJ, Delva NJ, Rodenburg M, Lawson JS, Inglis J, Waldron JJ, Lywood DW.
Department of Psychiatry, Queen's University, Kingston, Ontario, Canada.
Fifty-nine patients suffering from a major depressive episode, for whom electroconvulsive therapy (ECT) was clinically indicated, were randomly assigned to one of three electrode placement groups for treatment with brief pulse, threshold-level ECT: bitemporal (BT), right unilateral (RU) or bifrontal (BF). Comparison of these groups in terms of number of treatments, duration of treatment, or incidence of treatment failure, showed that the bilateral placements were superior to the unilateral; comparison of Hamilton, Montgomery-Asberg, and visual analogue scale scores showed that the bifrontal placement was superior to both bitemporal and unilateral treatment. Bitemporal treatment showed therapeutic results intermediate between BF and RU. Because BF ECT causes fewer cognitive side effects than either RU or BT, and is independently more effective, it should be considered as the first choice of electrode position in ECT.
What do you think? I think it's important to note that the ECT was 'threshold-level'.
~Ed
Posted by linkadge on July 8, 2005, at 15:39:37
In reply to Re: ECT Side Affects Versus Medication Side Affect, posted by iforgotmypassword on July 8, 2005, at 7:10:53
"lot of people never succeded facing whatever challenges these are. not to sound cold."
-----------------------------------------------I guess what I'm suggesting is that the day can be much harder to navigate with a significantly impaired memory. This could set one up for relapse into thoughts of helplessness.
Linkadge
Posted by SLS on July 8, 2005, at 19:48:41
In reply to Re:To SLS » SLS, posted by ed_uk on July 8, 2005, at 14:21:20
Hi Ed.
My initial reaction to this study is that it was a very early and hopeful investigation of a new procedure. I think it might have been too optimistic.
- Scott
Posted by Sebastian on July 8, 2005, at 20:08:24
In reply to ECT Side Affects Versus Medication Side Affects?, posted by Denise1966 on July 7, 2005, at 8:55:20
The only side-effect I remember, belive it or not of ECT is memory lose and distorted reality. Lack of emotion and lack of being able to think.
Posted by ed_uk on July 8, 2005, at 20:38:56
In reply to Re:To SLS, posted by SLS on July 8, 2005, at 19:48:41
>I think it might have been too optimistic.
Me too.
~Ed
Posted by KaraS on July 9, 2005, at 16:31:35
In reply to Re:To SLS » Denise1966, posted by SLS on July 8, 2005, at 9:23:32
"The only thing that seems to stand out in the literature right now is that right unilateral high-dosage is as effective as bilateral, but with a greatly reduced risk of cognitive impairments."
Does the same hold true for people who are left-handed?
Posted by SLS on July 9, 2005, at 17:23:53
In reply to Re:To SLS » SLS, posted by KaraS on July 9, 2005, at 16:31:35
> "The only thing that seems to stand out in the literature right now is that right unilateral high-dosage is as effective as bilateral, but with a greatly reduced risk of cognitive impairments."
>
>
> Does the same hold true for people who are left-handed?
That's pretty sly of you.;-)
There was a time when the hemisphere chosen for ECT was the dominant one. The studies now make no distinction. They seem to go for the right side without consideration of dominance. My first 5 or 6 treatments were LU, thereafter BT for a total of 15 treatments at 3 per week.
- Scott
Posted by KaraS on July 9, 2005, at 23:39:44
In reply to Re:To SLS, posted by SLS on July 9, 2005, at 17:23:53
> > "The only thing that seems to stand out in the literature right now is that right unilateral high-dosage is as effective as bilateral, but with a greatly reduced risk of cognitive impairments."
> >
> >
> > Does the same hold true for people who are left-handed?
>
>
> That's pretty sly of you.
>
> ;-)
>
> There was a time when the hemisphere chosen for ECT was the dominant one. The studies now make no distinction. They seem to go for the right side without consideration of dominance. My first 5 or 6 treatments were LU, thereafter BT for a total of 15 treatments at 3 per week.
>
>
> - Scott
>
Good to know if I ever decide to have ECT. Thanks.K
Posted by pulse on July 12, 2005, at 16:58:14
In reply to Re:To SLS, posted by SLS on July 8, 2005, at 13:57:42
i've had 2 full series of (12 sessions) of bilateral (bitemporal), with no headaches, NO memory loss, temporary or otherwise, and what felt like complete remission by the 3rd treatment, both times.
*no side effects AT ALL*
i attribute most of this to my ect doc's knowing what he is doing. when i had to have another doc, 1 unilateral, with its pounding headache, was all it took for me to walk out ama. ymmv.
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