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Dr. Bob is Robert Hsiung, MD,
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Posted by stargazer2 on September 18, 2007, at 8:55:46
In reply to Re: Forced to terminate current Pdoc after Nardil fail, posted by olysi79 on September 17, 2007, at 23:47:13
ECT is usually given intially 3 times a week until benefits are shown, then it is decreased to 2 times a week, then 1X a week, until a course of 8-12 treatments are given. Some people show no improvement and continued treatment is given until the MD or the pt (more often) say that is enough. After that, maintenance ECT is usually recommended 1x a month. The schedule is highly variable by individual and by MD.
I worked in a ECT dept and I saw many patients who did not have really good trials of medications undergo ECT. The ECT doctor was not an expert in medications and some pts did not get the benefit of expert medication management before ECT was recommended. The ECT doc was not experienced himself and I thought was a bit too eager to give ECT without offering any other alternative. Why would he even if a patient pushed for a longer med trial since ECT presented as the only option.
I was not overly impressed with the outcomes of ECT. I saw some people improve but many did not. Several went onto to commit suicide anyway.
As you can tell from reading many of the posts with MD's not experienced with medication combinations, ECT is probably suggested more often than necessary and if someone is suicidal and medication is not working, the belief is that ECT is the last chance they have. All I know is that when I was suicidal, Seroquel got me out of it and I would use it again rather than undergo ECT.Since I know alot about the procedure, I am very skeptical of it's efficacy. I think it can disrupt the brain enough to change someones' behavior very quickly, but I'm not so sure about it's long term success as a treatment for depression. At least with medications, side effects are mostly reversible but with ECT they are not. Again this is my opinion and not a suggestion that others feel this way. In some cases, ECT is all that is offered as a next step but I believe a next step should be to a psychopharmacologist and that step is almost always skipped.
Stargazer
Posted by cumulative on September 18, 2007, at 12:53:13
In reply to Forced to terminate current Pdoc after Nardil fail, posted by girlnterrupted78 on September 16, 2007, at 23:35:15
** How high did you go with the Nardil?
** Get a new doctor anyway; that guy's an idiot.
** Maybe someone who will augment MAOIs.
Posted by Kneeko on September 19, 2007, at 0:14:47
In reply to Olisy79, Excellent suggestions...ECT specifics, posted by stargazer2 on September 18, 2007, at 8:55:46
You worked in the ECT room and you are saying you were not very impressed with outcomes of ECT? What does that mean statistically?
Posted by tecknohed on September 19, 2007, at 6:29:25
In reply to Forced to terminate current Pdoc after Nardil fail, posted by girlnterrupted78 on September 16, 2007, at 23:35:15
Yes, find a good Psychopharmacologist, a Proffessor (of Psychopharmacology) if poss - that way any requests or suggestions wont have to go 'through' anyone else as you'll be with the top person themself & you wont have to wait for answers.
Sounds like your current pdoc has troubles of his own - the word 'apathy' comes to mind (and a few others!). He is only human after all.
Posted by stargazer2 on September 19, 2007, at 8:03:10
In reply to Re: Olisy79, Excellent suggestions...ECT specifics, posted by Kneeko on September 19, 2007, at 0:14:47
I don't know statistics but my overall impression was more negative than positive. For over a year I saw these patients come in over and over and I was not able to tell if they were any better, the outcomes were murky. Very few indicated that their depression had improved that much. It was a very hard place for me to work because I didn't feel the treatment was as positive as I had been led to believe. I think many underwent the treatment because they were not given any other hope other than ECT. They know it can help but know it may not either. It is used as a last option treatment.
I was particlarly unimpressed with the head MD. He seemed more concerned with numbers treated rather than individual outcomes. He did not push medication to any great level before going right to ECT. I did not see referrals to MD's with polypharmacology experience. He was very unskilled with medication management as I made an obvious recommednation to him to increase a medication that he did not increase as I would have expected a MD to do. Of course there was a financial incentive for him to do ECT and do it frequently. That was obvious to me as he pushed to treat more patients than I felt was safe.
You would have to read studies to get a sense of statistical outcomes. Or google patient who have had ECT for their views of how much it helped them.
Stargazer
Posted by linkadge on September 19, 2007, at 10:25:36
In reply to Kneeko, no stats just first hand observation w ECT, posted by stargazer2 on September 19, 2007, at 8:03:10
The stats on ECT are mixed. The sucess rate on ECT may be low, but this is still considered good as these people are highly treatment resistent.
It does have a very high relapse rate. My psychiatrist will not administer ECT (he won't give me details)
If you are going to ask a person their impressions of ECT, do it a year after they have it.
Linkadge
Posted by stargazer2 on September 19, 2007, at 15:42:28
In reply to Re: Kneeko, no stats just first hand observation w ECT, posted by linkadge on September 19, 2007, at 10:25:36
Maybe a post can be started for those who had ECT to get their feedback of it. Only I guess it would have to be somewhere other than here with medications, not sure though. I would be interested in seeing those results for my own knowledge and this is a great forum to get that information....Anyone here have ECT and can share their results here?
SG
Posted by sam123 on September 19, 2007, at 16:16:43
In reply to Post for ECT outcomes?, posted by stargazer2 on September 19, 2007, at 15:42:28
Posted by sam123 on September 19, 2007, at 16:23:36
In reply to Re: Post for ECT outcomes?, posted by sam123 on September 19, 2007, at 16:16:43
here is quite a bit more:
Posted by stargazer2 on September 19, 2007, at 17:27:05
In reply to Re: Post for ECT outcomes?, posted by sam123 on September 19, 2007, at 16:23:36
Thanks sam123 for sending those links.
I would like to hear specifically how those receiving ECT are doing 6,12,24 months out from their last ECT treatment. It's hard to know if ECT treatments are effective over the long term or just in the immediate post procedural phase.
Also it helps to have a dialogue with someone who has received ECT treatments in the recent past.
I am curious since in each of my really depressed moods, the thought of ECT comes up but I'm too afraid to ever think seriously about it for myself.
Stargazer
Posted by stargazer2 on September 19, 2007, at 17:27:14
In reply to Re: Post for ECT outcomes?, posted by sam123 on September 19, 2007, at 16:23:36
Thanks sam123 for sending those links.
I would like to hear specifically how those receiving ECT are doing 6,12,24 months out from their last ECT treatment. It's hard to know if ECT treatments are effective over the long term or just in the immediate post procedural phase.
Also it helps to have a dialogue with someone who has received ECT treatments in the recent past.
I am curious since in each of my really depressed moods, the thought of ECT comes up but I'm too afraid to ever think seriously about it for myself.
Stargazer
Posted by linkadge on September 19, 2007, at 20:08:57
In reply to Any recent ECT patients who can give feedback, posted by stargazer2 on September 19, 2007, at 17:27:14
ECT is used a lot in the elderly. Elderly people with severe mood disorders are probably less likely to be online to give a rating.
Linkadge
Posted by Phillipa on September 19, 2007, at 20:34:12
In reply to Re: Any recent ECT patients who can give feedback, posted by linkadge on September 19, 2007, at 20:08:57
Doesn't Phoenix girl occasionally post? I remember that name. Phillipa
Posted by sam123 on September 20, 2007, at 10:08:34
In reply to Any recent ECT patients who can give feedback, posted by stargazer2 on September 19, 2007, at 17:27:14
> Thanks sam123 for sending those links.
>
> I would like to hear specifically how those receiving ECT are doing 6,12,24 months out from their last ECT treatment. It's hard to know if ECT treatments are effective over the long term or just in the immediate post procedural phase.
>
> Also it helps to have a dialogue with someone who has received ECT treatments in the recent past.
>
> I am curious since in each of my really depressed moods, the thought of ECT comes up but I'm too afraid to ever think seriously about it for myself.
>
> Stargazer
Sigh. It is always but.....
I will make a note of that.
Posted by brooke484 on September 20, 2007, at 13:15:02
In reply to Forced to terminate current Pdoc after Nardil fail, posted by girlnterrupted78 on September 16, 2007, at 23:35:15
Have you thought about seeing a psychopharmacologist? If you want a list, you have to go to this web site http://www.ascpp.org and send them an email. They will send you a list for your state.
brooke
Posted by twinleaf on September 20, 2007, at 14:10:48
In reply to girlinterrupted78, posted by brooke484 on September 20, 2007, at 13:15:02
Is anyone with TRD considering TMS? I wouldn't dare undergo ECT, but TMS has been very helpful to me over the last four years. Each time, it helps a lot for a few weeks to months. Then, the effect fades away, and I have it done again. No side effects that I've been able to detect.
Posted by Phillipa on September 20, 2007, at 19:54:30
In reply to girlinterrupted78, posted by brooke484 on September 20, 2007, at 13:15:02
Thanks brooke just did it for me. Phillipa
Posted by brooke484 on September 20, 2007, at 20:18:49
In reply to Re: girlinterrupted78 » brooke484, posted by Phillipa on September 20, 2007, at 19:54:30
Good. That's how I found mine.
Posted by olysi79 on September 21, 2007, at 12:25:39
In reply to Re: Forced to terminate current Pdoc after Nardil » girlnterrupted78, posted by tecknohed on September 19, 2007, at 6:29:25
I am inclined to agree with tekno's statement... Some PDOCs tend to like to stick to "cookie cutter" cases, and do not necessarily have the tolerance or patience to take a more personalized approach in medicine. I personally do not want to allow these doctors to have my time or money. They don't dserve it as they are riding through the system in my opinion. Here's a little analogy... If you used the exact same business model to run each and every business in this world, would they all succeed? Absolutely not... a wierd analogy I know... but every one is different, hence a unique approach based upon research is needed in every situation.
Posted by florence on September 24, 2007, at 2:19:37
In reply to Any recent ECT patients who can give feedback, posted by stargazer2 on September 19, 2007, at 17:27:05
I had 12 ECT last year. Big mistake for ME.
Two world class hosptials in northern Ohio perform it.One will not do it if you have a thyroid disease cuz it doesnt work. The other one will do it on thyroid pts.
My pdoc was running out of ideas. I didn't think very clearly-- thought it might "zap" me back to life... It didn't.
I was very familiar with both hospitals and thought the psych dept was far better at the one that DID do ECT on thyroid pts. I used to work at the other place yrs ago while I was in college and also had a bad experience w/psych dept there yrs later.I have complained of fatigue for yrs. Taken tons of psych meds and others. Basically researched for yrs and finally diagnosed myself with Hashimoto's autoimmune thyroid disease- the leading cause of underactive thyroid.
Tips on this site helped me tremendously; wish they were updated- (over 10 yrs old!)Ironically, a young man of about 30? was coming back for maintenance ECT; his parents said it "helped" him. He also had a thyroid disease but his dr was letting it burn itself out- an old way of thinking.....So he was not taking thyroid medicine.
Sorry, wish I could say the $15,0000 was better spent. But it confirmed my belief that I was not on enough thyroid replacement. IMO, like Noa said yrs ago on this site- ADs don't work if you have thyroid disease; maybe it holds true with ECT and thyroid disease,too.
I know a few guys that had much better success with ECT than females.
I was told that I had to take an AD after the treatments finished,too. And I had to stop Klonopin the night before the ECT treatment cuz the dr was having trouble inducing a seizure.
florence
> Thanks sam123 for sending those links.
>
> I would like to hear specifically how those receiving ECT are doing 6,12,24 months out from their last ECT treatment. It's hard to know if ECT treatments are effective over the long term or just in the immediate post procedural phase.
>
> Also it helps to have a dialogue with someone who has received ECT treatments in the recent past.
>
> I am curious since in each of my really depressed moods, the thought of ECT comes up but I'm too afraid to ever think seriously about it for myself.
>
> Stargazer
Posted by stargazer2 on September 24, 2007, at 9:02:37
In reply to Re: Any recent ECT patients who can give feedback, posted by florence on September 24, 2007, at 2:19:37
Florence...so, you would not recommend ECT for anyone with thyroid disease?
I was recently put on Synthroid, not because I have a thyroid condition but because it is felt that a TSH which is in a low normal range can affect depression. My level, 2.5 (norm range 0.5 to 5) which was considered normal by my psychiatrist and OB/GYN was evaluated by an Endocriologist nurse practioner who started me on Synthroid to get the TSH closer to 1, which she thought could help with my resistent depression. It has been about a month now on .25 mcg Synthroid
and my depression is under control but I was started on Nortriptyline 50 then, along with the Nardil I was already on. It's hard to know if Synthroid or Nortriptylinne is the med that is helping more than Nardil alone.Another PB'er sent me a babblemail indicating that she was not really helped by ECT and her memory is still affected almost a year later.
I'm still not sure I would ever have ECT even if I was suicidal but you never really know what you will do when you are at that point. I was brought out of a severe suicidal depression with Seroquel which I now believe I can use if I get to that point again.
I am not convinced that ECT does anything except major nervous sytem disruption which is used to get someone out of a major depression quickly but not necessariy keep them out and unless maintenance ECT is given.
I had memory difficulties with Lamictal but once the medicine is stopped the memory quickly returns not like ECT with long term memory issues for so many.
Not too many people are responding to this post although some people do not want to be "vocal" about their ECT experiences. You can babble me directly if you have strong views pro or con ECT and can give me your opinion.
Thanks for any feedback.
Stargazer
Posted by blueboy on September 24, 2007, at 15:32:17
In reply to Fflorence/others w ECT experience, + / -, posted by stargazer2 on September 24, 2007, at 9:02:37
I've never had ECT myself. I would definitely have it if I were suicidal enough, i.e. I'd try it before I'd kill myself.
My pdoc, who is good, says that ECT is very successful in a lot of cases. It's important to get it from somewhere that is up-to-date and knows about sine waves and stuff.
Also, read "The Bell Jar" by Sylvia Plath (a writer who committed suicide). She said that getting ECT -- and this was in the 1950's -- made her feel like she had been living in a vacuum, and all of a sudden the lid was taken off and she could breathe again. Since it's a very good book and was written after treatment, at least ONE person obviously was helped by it, and didn't have her brain/memory damaged beyond repair.
Posted by Phillipa on September 24, 2007, at 20:42:58
In reply to Re: Any recent ECT patients who can give feedback, posted by florence on September 24, 2007, at 2:19:37
Florence what do you mean that ad's don't work with hasimotos as I have it???? I don't understand but always suspected it. If not too much would you babblemail me? Thanks Phillipa need more info on this and what you did to get better.
Posted by reese7194 on September 26, 2007, at 18:57:38
In reply to girlinterrupted78, posted by brooke484 on September 20, 2007, at 13:15:02
Posted by reese7194 on September 26, 2007, at 18:58:15
In reply to girlinterrupted78, posted by brooke484 on September 20, 2007, at 13:15:02
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Dr. Bob is Robert Hsiung, MD,
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