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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 38. This is the beginning of the thread.
Posted by deniseuk190466 on May 30, 2007, at 13:25:13
Apart from my memory that is?
I mean I don't feel alive half the time, I don't look forward to anything, I keep working in order to stop myself pacing the walls of my flat but that's about it. I don't feel any joy in anything. I mean it will either work or it won't and if it doesn't work then hopefully I will always have the Zyprexa to fall back on for this anxiety that I get.
Antidepressants help to the degree that I can fake it better but I don't really feel the way I used to or the way I think other people feel about life.
The Zyprexa helps a hell of a lot and I'm really grateful for it, it helps me to enjoy some things it's just not the same as feeling alive and looking forward to things, living etc.
The only thing that would worry me about ECT is that it would impair my memory so much that I wouldn't be able to work again but I could always do charity work or something.
I just want a few years freedom from this incessant ruminating and feeling down and scared every day.
Denise
Posted by Phillipa on May 30, 2007, at 15:31:09
In reply to What have I got to lose by having ECT, posted by deniseuk190466 on May 30, 2007, at 13:25:13
Denise think there is a chat board on people who have had ECT. Have you googled it? I would if I were you. Love Phillipa
Posted by OzLand on May 30, 2007, at 22:30:03
In reply to What have I got to lose by having ECT, posted by deniseuk190466 on May 30, 2007, at 13:25:13
Denise
There is no guarantee that ECT will relieve your depression. Has your doctor recommended ECT? I have not met anyone who has not had at least some memory problems. Lcat10 feels like her brain is swiss cheese.
Posted by LlurpsieNoodle on May 31, 2007, at 10:02:49
In reply to Re: What have I got to lose by having ECT » deniseuk190466, posted by Phillipa on May 30, 2007, at 15:31:09
denise,
I think that you have a lot to lose by placing all your eggs in one basket. Regardless of whether that basket is psychopharmacology, psychotherapy, alternative treatments, ECT.There is good empirical evidence that a combination of therapy and medication helps more than either alone at treating and preventing recurrance of depression.
I'm sorry that I don't know much about your case. Have you tried therapy? For how long? How was your relationship with your therapist?
The reason why I suggest therapy is because a good therapeutic relationship can help you understand what your strengths are (I bet you have a lot of strengths, since you write well, and said that you are working. If you're considering ECT, you certainly deserve to give therapy a really good chance. If for nothing else, a therapist can help you understand your reasons for considering ECT, and help you figure out for yourself what you motivations (conscious and unconscious) are.
ECT has worked wonders for many people who are otherwise incapacitated. It is a fairly extreme treatment, however, and carries risks. Memory loss seems like 2 words until you spend some time with someone who doesn't recognize you 30 minutes after having a lengthy conversation with you. Until you are driving and forget what your errands were. Until your boss tells you to do 3 things and you can barely remember one of them.
I'm not anti-ECT. I just had the opportunity to spend several days with a woman who was having the procedure. She still seemed like herself, but couldn't remember me at all. (I had to show her a picture that she had drawn and signed of me- very cute, by the way)
Or a very educated scientist, who couldn't even remember some of the basic aspects of his own research. A year after his procedure I spent an evening with him and some friends, and he remembered some of them, didn't remember me (no sweat) but after a long conversation, he didn't remember me the next day either, and was constantly complaining about how his memory was shot to hell.
I would urge you to get all the opinions you can- interview patients, or get to know them online. Get in touch with a psychologist, or see someone who has seen you in the past. Get your pdoc and GP on board. You will need ALL of these people to help support you both BEFORE and AFTER the procedure. Better get it together before you have ECT.
And whatever you decide, I hope that it is an educated, considered decision. ECT has saved lives, and you deserve to have the richest life you can. You're going to need a real team effort to help you, though.
Psychobabble can be part of the team, though
happy thursday :)
sorry if I'm too tough on you. I just don't want you to get hurt.
-Ll
Posted by linkadge on May 31, 2007, at 10:56:11
In reply to Re: What have I got to lose by having ECT » Phillipa, posted by LlurpsieNoodle on May 31, 2007, at 10:02:49
I agree with above.
I saw some before and after ECT cases and it was enought that I cannot sit and say I think it is a good idea.Memory is who we are and all we have.
ECT may help one problem but create a whole host of others.
Linkadge
Posted by rvanson on June 1, 2007, at 1:14:10
In reply to What have I got to lose by having ECT, posted by deniseuk190466 on May 30, 2007, at 13:25:13
> Apart from my memory that is?
>
> I mean I don't feel alive half the time, I don't look forward to anything, I keep working in order to stop myself pacing the walls of my flat but that's about it. I don't feel any joy in anything. I mean it will either work or it won't and if it doesn't work then hopefully I will always have the Zyprexa to fall back on for this anxiety that I get.
>
> Antidepressants help to the degree that I can fake it better but I don't really feel the way I used to or the way I think other people feel about life.
>
> The Zyprexa helps a hell of a lot and I'm really grateful for it, it helps me to enjoy some things it's just not the same as feeling alive and looking forward to things, living etc.
>
> The only thing that would worry me about ECT is that it would impair my memory so much that I wouldn't be able to work again but I could always do charity work or something.
>
> I just want a few years freedom from this incessant ruminating and feeling down and scared every day.You have a condition called Adhedonia, just like I do.
I have considered ECT, but after many years of observation, very few people have long lasting relief of depressive disorders from ECT and they almost always have long lasting memory issues and other horrible side-effects after ECT.
I never have had all that much luck with the meds either but ECT is not an option I would consider after all these years.
Of course, it is your body and mind to do with what you will.
You could be one of the lucky people that do have a great reponce to ECT, but as actor Clint Eastwood playing detective "Dirty Harry" once said, "Do you feel lucky"?
I never had that kind of luck.
Just my .02 centavos.
(BTW, I wish you well in whatever decision you make. Its a horrible Dx and we have to do what we can to make life tolerable, don't we?)
Posted by kaleidoscope on June 1, 2007, at 13:33:40
In reply to What have I got to lose by having ECT, posted by deniseuk190466 on May 30, 2007, at 13:25:13
Hi Denise,
ECT would be a last resort for you. There are plenty of meds you haven't tried.
I think you should try another TCA. Maybe clomipramine (Anafranil) - it's one of the most powerful ADs.
Ed
Posted by deniseuk190466 on June 1, 2007, at 15:39:30
In reply to Re: What have I got to lose by having ECT » deniseuk190466, posted by Phillipa on May 30, 2007, at 15:31:09
Hi Phillipa,
I've been to the ECT.org site if that is the one you mean? and I've been checking the site out and asking questions over the last six years but I suppose no matter what I read about ECT it's not really going to answer my question which is "would it work for me, would I have memory problems from it?"
Is ECT.org the site you refer to?
There are a lot of horror stories on there, a lot of people on there who are very anti-ect and yet there are a few people on there who say it worked really well for them and I can't help think well maybe it will work for me.
Have you ever considered it yourself Phillipa?
Denise
Posted by deniseuk190466 on June 1, 2007, at 15:45:29
In reply to Re: What have I got to lose by having ECT » deniseuk190466, posted by OzLand on May 30, 2007, at 22:30:03
Thanks Ozland,
I know there is no guarantee that ECT will help my depression and my psychiatrist has not recommended it, in fact she says it might lift my mood for about a month and then I would be back in the doldroms again with a few less brain cells. But I'm not sure what I have to lose anymore and if I had unilateral then the risks wouldn't be so great. I know I probably sound like I'm deluding myself but sometimes deluding myself is the only thing that keeps me going.
I know LCat said it has left her memory really messed up but she still is able to work and she did say that her depression isn't so bad.
Denise
Posted by kaleidoscope on June 1, 2007, at 15:48:58
In reply to To Phillipa, posted by deniseuk190466 on June 1, 2007, at 15:39:30
Given that you originally responded well to dothiepin - which is probably one the less effective TCAs, trying a different TCA seems logical. Clomipramine may be particularly effective.
Posted by deniseuk190466 on June 1, 2007, at 16:11:57
In reply to Re: What have I got to lose by having ECT » Phillipa, posted by LlurpsieNoodle on May 31, 2007, at 10:02:49
LI,
Thanks for your response, the psychiatrist who I am seeing is not recommending it, in fact she is against it but I just keep thinking what have I got to lose
I'm not putting all my eggs in one basket, I've tried lots of medication and I am seeing a Cognitive behavioural therapist because I know I should try anything but to be honest I'm not sure where the therapy is going or how it is going to help. I've had my third session and so far I've not had any great insights. I do know what my strengths and weaknesses are already and don't need them pointing out to me.
Part of me just wants to try every possible tool, treatment to beat this thing and ECT is one of them. But then maybe I would have it and rue the day. I really don't know. I also thought if I have Unilateral ECT then at least the memory risks aren't as great.
Anyway, thanks for responding.
Denise
Posted by linkadge on June 1, 2007, at 17:05:49
In reply to Ozland, posted by deniseuk190466 on June 1, 2007, at 15:45:29
**she says it might lift my mood for about a month and then I would be back in the doldroms again with a few less brain cells**
Thats because she knows what she is talking about! ECT has a very high relapse rate.
I think people unjustly put ECT on some big pedistal. There is a logical fallacy that because ECT is so controversial and so potentially dangerous that there has to be something magic about it.
Linkadge
Posted by Honore on June 1, 2007, at 18:02:43
In reply to What have I got to lose by having ECT, posted by deniseuk190466 on May 30, 2007, at 13:25:13
It's not just your memory that you have to lose. At least if you responded at all the way LCat did, you also could lose part or even much of your ability to create memories-- ie not only your past, but your ability to create a further past out of your future.
This is to one extent or other-- and only if you had that response--
but I think perhaps you're underestimating the value of your memory-- as well as perhaps ignoring the different aspects of memory that might be lost, or partly eroded.
Honore
Posted by Phillipa on June 1, 2007, at 20:34:59
In reply to To Phillipa, posted by deniseuk190466 on June 1, 2007, at 15:39:30
Denise yes that is the site. And no ECT for me. Love Phillipa
Posted by rvanson on June 2, 2007, at 1:41:42
In reply to Re: What have I got to lose by having ECT, posted by deniseuk190466 on June 1, 2007, at 16:11:57
> Thanks for your response, the psychiatrist who I am seeing is not recommending it, in fact she is against it but I just keep thinking what have I got to lose
>
> I'm not putting all my eggs in one basket, I've tried lots of medication and I am seeing a Cognitive behavioural therapist because I know I should try anything but to be honest I'm not sure where the therapy is going or how it is going to help. I've had my third session and so far I've not had any great insights. I do know what my strengths and weaknesses are already and don't need them pointing out to me.
>
> Part of me just wants to try every possible tool, treatment to beat this thing and ECT is one of them. But then maybe I would have it and rue the day. I really don't know. I also thought if I have Unilateral ECT then at least the memory risks aren't as great.
>
> Anyway, thanks for responding.I agree with you about CBT and general therapy pretty much being a waste of time, but it helps lots of people and it wont affect your memory like ECT.
BTW, have you tried any of the non-FDA approved European/Australian/Canadian medications like Solian or Mannerix/Aurorix, yet?
Both these medications affect dopamine levels or response, to one extent or another and that seems to be a part of the puzzle when dealing with adhedonic (non-sadness, no real joy or pleasure) depression, as I think that you are burdened with.
These have been of considerable benefit to me when all else fails (which, with the standard typical non-dopamine reactive SSRI type med's in the USA, is too often) if I can find a decent source to obtain them from, that is.
Posted by Deniseuk190466 on June 2, 2007, at 16:31:38
In reply to Re: What have I got to lose by having ECT, posted by rvanson on June 2, 2007, at 1:41:42
Rvanson,
Thanks for the suggestions.
I've heard that mannerix is an MAOI and that it has very weak antidepressant effects. I've already tried Nardil (supposed to be stronger) and it didn't work and I'm loathe to do another switch from lexapro to another MAOI.
As to Solian, istn't that Amilsupride? I do take Zyprexa now and again (another anti-psychotic) wouldn't Amilsupride have the same affect as Zyprexa?
Denise
Posted by Tomatheus2 on June 2, 2007, at 23:01:22
In reply to Re: What have I got to lose by having ECT » deniseuk190466, posted by Honore on June 1, 2007, at 18:02:43
> It's not just your memory that you have to lose.
I tend to agree, even though I've never had ECT myself.
In 2001, Mind (a mental health charity in England and Wales) conducted a survey of 418 individuals who had received ECT, one third of whom found the procedure to be helpful. A wide range of side effects were reported.
Short-term side effects (in order of frequency):
* headaches
* drowsiness
* confusion
* loss of past memories
* dizziness
* disorientation in time or space
* difficulty concentrating
* inability to remember new information
* suicidal tendencies after the treatment
* apathy
* inability to recognise people
* loss of reasoning ability
* fear and anxiety
* feelings of helplessness
* sense of betrayal
* visual problems
* loss of previous skills (reading, music, languages)
* sleep problems
* feelings of worthlessness
* neck or back pain
* loss of creativity
* epileptic seizures
* sexual difficulties.Permanent side effects (also in order of frequency):
* loss of past memories
* difficulty concentrating
* fear or anxiety
* inability to remember new information
* feelings of worthlessness
* feelings of helplessness
* sense of betrayal
* loss of previous skills
* loss of creativity
* suicidal tendencies after the treatment
* loss of reasoning ability
* sleep problems
* confusion
* apathy
* headaches
* inability to recognise people
* disorientation in time and space
* personality changes
* neck or back pain
* visual problems
* sexual difficulties
* drowsiness
* muscle ache
* dizziness
* nausea
* epilepsyConsidering that I've been experiencing memory and concentration difficulties for some time, I don't think that I would ever choose to receive an ECT treatment myself. However, some individuals (approximately one third, according to Mind) do report benefiting from ECT, so I think it should remain available as a treatment option.
Tomatheus
Source: http://www.mind.org.uk/Information/Booklets/Making+sense/ECT.htm
Posted by rvanson on June 3, 2007, at 1:03:51
In reply to Re: What have I got to lose by having ECT, posted by Deniseuk190466 on June 2, 2007, at 16:31:38
> Rvanson,
>
> Thanks for the suggestions.
>
> I've heard that mannerix is an MAOI and that it has very weak antidepressant effects. I've already tried Nardil (supposed to be stronger) and it didn't work and I'm loathe to do another switch from lexapro to another MAOI.
>
> As to Solian, istn't that Amilsupride? I do take Zyprexa now and again (another anti-psychotic) wouldn't Amilsupride have the same affect as Zyprexa?
You are correct that Solian and Amisulprid(e) are the identical medicine/chemical. In lower doses, Solian can help boost or aid the effects of anti-depressants and the adhedonia conditions.In the higher dose range it acts as an anti-psychotic medication much like Zyprexa and brings on drowsiness for me and others.
I have tried Zyprexa in the past and found it much too sedating to tolerate, even at the lowest dose ranges.
As for Mannerix (Moclobemide) it is indeed a MAOI but is a "reversible" one. It acts on epinephrine (adrenaline), norepinephrine (noradrenaline), serotonin, and lastly dopamine.
Unlike the standard MAOIs, Nardil and Parnate, the side effects of Mannerix do not normally include cardiovascular complications (hypertension) with encephalopathy, liver toxicity or hyperthermia after consumption of a restricted medication or food.
I have found that in combination with a small dose of certain SSRI's that this combination of Mannerix/SSRI works very well for me, for a time.
Unfortunately, the effects don't last for as long as I have hoped, and I feel somewhat edgy with the extra norepinephrine in my system, but for a while I feel almost "normal" again after 25 years of feeling like an outcast of society, due to adhedonia.
Perhaps for you or some others here, you may have a better, longer lasting response to such a combination of medications.
Its a shame that these medications are not available through US doctors, as the FDA has not approved them for use here.
Posted by kaleidoscope on June 3, 2007, at 5:26:18
In reply to Re: What have I got to lose by having ECT, posted by Deniseuk190466 on June 2, 2007, at 16:31:38
Hi Denise
So have you ever tried clomipramine (Anafranil)? I think of it as a hard-core antidepressant.
Posted by linkadge on June 4, 2007, at 6:31:57
In reply to Re: What have I got to lose by having ECT, posted by Tomatheus2 on June 2, 2007, at 23:01:22
The reason why the "success rate" is so high, is that they probably try to assess depressive symptoms right after treatments.
At this point people probably don't remember depressive symptoms, nor much else.
You can't legally drive yourself home, but you can give an accurate assesment of your condition (?)
Linkadge
Posted by LlurpsieNoodle on June 4, 2007, at 10:41:21
In reply to Re: What have I got to lose by having ECT, posted by linkadge on June 4, 2007, at 6:31:57
That's an interesting point, Link
Especially since a lot of clinical interviews and diagnostic tools seem to focus on functioning within the last week or so. If you can't remember very much, one's mind has a funny way of filling in gaps, based on present functioning, or based on what the interviewer seems to be suggesting.
The human mind is our most flexible organ. It can bend time and physics...
Posted by Sigismund on June 5, 2007, at 17:35:45
In reply to Re: What have I got to lose by having ECT » linkadge, posted by LlurpsieNoodle on June 4, 2007, at 10:41:21
People think what they want to think.
When my mother had it I'm sure the doctor thought it worked.
I didn't.
My sister did.
Things improved when she got cancer and was put on low dose morphine.
But I would think that, wouldn't I?
Posted by linkadge on June 6, 2007, at 10:36:35
In reply to Re: What have I got to lose by having ECT, posted by Sigismund on June 5, 2007, at 17:35:45
Thats the thing. Doctors can often have selective vision for "recovery".
I remember going into the doctors office after a month on effexor. The doctor said I looked much better, and was glad I was doing so much better.
Did he ever once ask me if I actually *felt* any better? No.
If he actually "asekd" he'd find out I actually felt terrable.
Linkadge
Posted by deniseuk190466 on June 6, 2007, at 15:01:17
In reply to Re: What have I got to lose by having ECT, posted by rvanson on June 3, 2007, at 1:03:51
Rvanson,
Thanks, I had considered before Mannerix and an SSRI but I doubt very much that my psychiatrist would go for the idea. When you say small amount of SSRI, how small?
Also, re the Zyprexa, I also get a lot of anxiety with my depression and the Zyprexa helps a lot with that. Maybe amisulpride would too who knows.
Denise
Posted by rvanson on June 7, 2007, at 4:23:28
In reply to To Rvanson, posted by deniseuk190466 on June 6, 2007, at 15:01:17
> Rvanson,
>
> Thanks, I had considered before Mannerix and an SSRI but I doubt very much that my psychiatrist would go for the idea. When you say small amount of SSRI, how small?
>
> Also, re the Zyprexa, I also get a lot of >anxiety with my depression and the Zyprexa helps >a lot with that. Maybe amisulpride would too >who knows.I too have anxiety/insomnia along with my adhedonic depression. I use Xanax for that and it has kept me alive for many years now.
As to the Mannerix/SSRI med combo, I have used Celexa in a 5mg dose along with the Mannerix.
The Celexa seems to give it a boost in its anti-adhedonia effects, as well as helping with the jitteryness/anxiety side-effects.
I agree that most doctors are not going to want to try this combonation, so I have self-medicated for many years now, with a script for the Xanax from a doctor.Mannerix is not FDA approved in the USA, so finding a Pdoc here that will Rx it has proven futile over the years.
Life is too short to wait for politics and science to catch up with treating a condition as serious as the kind that we suffer from, IMO.
Have you made a decision on the ECT treatment as of yet?
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