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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Trevpr on June 4, 2013, at 14:15:04
Hey everybody, so far I've had 6 ECTs and my 7th one is tomorrow. I'm starting to get worried because I haven't felt any significant changes! I've been getting bilateral ECTs, and my biggest symptom is a sense on emotional numbness, loss of libido, apathy, feeling like everything is "toned down" or "grey," compared to what it used to be, and difficulty/inability experiencing real sadness or joy or pleasure.
I am also on Parnate, but I have been experiencing these symptoms since the beginning! I've had these symptoms for a year and a half now! Anyone have any pointers or have had ECT and gotten all the sudden better after one of the later treatments?
Posted by alchemy on June 4, 2013, at 22:12:48
In reply to Electroconvulsive Therapy Treatment #6, posted by Trevpr on June 4, 2013, at 14:15:04
I received a good response after about 6 treatments, but I know that is considered pretty early.
Posted by Trevpr on June 5, 2013, at 1:21:15
In reply to Re: Electroconvulsive Therapy Treatment #6, posted by alchemy on June 4, 2013, at 22:12:48
So essentially it's normal to just not feel any different, and then all of the sudden after one of them feel something? How many does it usually take? How many should I do before giving up?
Posted by Jeroen on June 5, 2013, at 5:04:37
In reply to Electroconvulsive Therapy Treatment #6, posted by Trevpr on June 4, 2013, at 14:15:04
i don't think ECT is right for you or anyone
i am hearing too much negative stories about ECT then positive.
Lou is right about ECT and others too, it's too dangerous, if you have after 6 treatments no positive benefits, it might further damage you!
Posted by SLS on June 5, 2013, at 6:18:59
In reply to Electroconvulsive Therapy Treatment #6, posted by Trevpr on June 4, 2013, at 14:15:04
> Hey everybody, so far I've had 6 ECTs and my 7th one is tomorrow. I'm starting to get worried because I haven't felt any significant changes!
Have you felt any insignificant changes? Has anyone close to you noticed any changes?
The speed of response is variable. Some people begin to respond to ECT after a single treatment. Some people need 6 - 12. I would rather not guess as to how many treatments it would take for you to respond. Believe it or not, there isn't very much scientific inquiry into the speed of onset of response to ECT.
> I've been getting bilateral ECTs,
In the past, bilateral electrode placement has been considered to be the most potent method of ECT to treat depression, but it carries the heaviest burden of cognitive side effects. New methods of comparable efficacy are being developed that utilize right unilateral placement and bifrontal placement with varying values for stimulus parameters:
1. amplitude
2. shape
3. width
4. train frequency
5. directionality
6. polarity
7. duration
- Scott
Posted by alchemy on June 5, 2013, at 15:16:46
In reply to Re: Electroconvulsive Therapy Treatment #6, posted by Trevpr on June 5, 2013, at 1:21:15
> So essentially it's normal to just not feel any different, and then all of the sudden after one of them feel something? How many does it usually take? How many should I do before giving up?
It was quite a while ago, I think I started to feel a little better at 5. But I think the standard is about 10, so I responded quickly. I did get to a point where I felt better then I think I have ever felt. Unfortunately I didn't stay at that mood level but it did pull me out of a hellish depression.
Posted by Trevpr on June 5, 2013, at 23:14:00
In reply to Re: Electroconvulsive Therapy Treatment #6 » Trevpr, posted by alchemy on June 5, 2013, at 15:16:46
I really do appreciate your replies! Electroconvulsive Therapy isn't easy for anyone... Most of my low mood symptoms were mediated by Parnate, however, I still have no libido and still feel emotionally quite flat and numb. Is electroconvulsive therapy usually effective for that too? So far I haven't noticed anything really significant. I just had my 7th treatment today. Usually is it common to feel better the day of your last few treatments or do people usually only notice improvements the day afterwards? I guess some people only seem to notice real improvements from treatments 8-12... I just kind of find it odd that I would have 7 treatments and not notice much of anything? It was only during this last two that I've noticed any real short-term memory loss.
Posted by alchemy on June 6, 2013, at 19:12:16
In reply to Re: Electroconvulsive Therapy Treatment #6, posted by Trevpr on June 5, 2013, at 23:14:00
Very true, ECT is scary and you are brave. You are lucky that you haven't experienced any short term memory loss until this point. I wonder if that could be an indicator that it may take a few more.
What does your doctor say about the number of treatments it might take? I personally would give it 10 treatments to see if there is any improvement.
From your last description, it didnt sound like you were extremely depressed. It seemed like you were trying to get rid of some residual symptoms. Is this the case?
Posted by Trevpr on June 7, 2013, at 19:56:34
In reply to Re: Electroconvulsive Therapy Treatment #6, posted by alchemy on June 6, 2013, at 19:12:16
Yes, my main symptoms of low mood, insomnia, extreme anxiety, etc. all went away or were taken care of by Parnate, yet I still have some residual ones that have been bothering me since the very beginning of the episode.
It feels as though my emotions are rather flat relative to what they used to be like, my libido is very low, and I have other miscellaneous problems like that relating to emotional/hedonic dulling/blunting. It drives me nuts! I used to love my sensitive personality. I used to love daydreaming about a crush or being moved by a song. I used to love feeling love so intensely... Now it feels like it's all gone to stay... like I'll never be able to date again or find a mate or feel truly good.
Orgasms feel dull, laughter feels flat... Everything just feels colorless, though not necessarily "depressing."
Posted by Meltingpot on June 8, 2013, at 12:06:41
In reply to Electroconvulsive Therapy Treatment #6, posted by Trevpr on June 4, 2013, at 14:15:04
Hi,
Sounds like your experience is similar to mine, I've just had treatment 7 and so far notice no difference. The last one was bilateral but prior to that was unilateral. I feel absolutely horrible after coming round from it but that tends to wear off. Memory loss doesn't SEEM to be too bad.
Denise
Posted by alchemy on June 9, 2013, at 0:46:44
In reply to Re: Electroconvulsive Therapy Treatment #6, posted by Trevpr on June 7, 2013, at 19:56:34
I am actually suprised that ECT is being used for the symptoms you decribed, which sounds like a mild depression. I assume you have also tried all other meds and ECT is all that is left to try?
I'm actually one of the few on this board who are pro-ect, but I have to say i'm not sure about it in this case. It sounds like it is frustrating to no longer feel how you did. I have never felt like you have. An orgasm is the least of my problems :)
From what I recall, ECT does not seem to be as effective in milder forms of depression. And if you havent exhausted trying all of the meds available, I personally wouldn't try another session.
Posted by Trevpr on June 9, 2013, at 1:51:17
In reply to Re: Electroconvulsive Therapy Treatment #6, posted by alchemy on June 9, 2013, at 0:46:44
Well what sort of treatments should I try?
SSRIs tend to blunt emotions, lower libido, and worsen orgasms
SNRIs aren't usually much better
Wellbutrin didn't do anything at all
Norepinepherine increasing meds such as Vivactil or Desipramine didn't do anything at all
Dopamine agonists made me feel worse
MAOIs take away low moods and flatten things out, but do not get me back to baseline
Stimulants are addictive, habit forming, form a tolerance, raise heart rate, and have a "crash" after each hour "high"
Abilify did not seem to be doing anything helpful (or anything at all)
Benzodiazepines make me feel relaxed but turn my libido and emotions down as a consequence
Recreational drugs in moderation such as weed or alcohol once every two months did not have any real positive effects. Benzos are more pleasant than alcohol and stims are more pleasant than weed. Alcohol and weed are pretty much rubbish.
Exercise doesn't seem to be doing much... Talking to a therapist only seems to help when my emotions are loose enough to come out (and aren't completely flat)... Spending time with friends and such prevents things from getting worse but isn't improving symptoms... Neither has any supplement, vitamin, amino acid, or health food
Posted by SLS on June 9, 2013, at 7:39:32
In reply to Electroconvulsive Therapy Treatment #6, posted by Trevpr on June 4, 2013, at 14:15:04
You may have dysthymia or a mild bipolar depression. Have you tried Lamictal or minocycline?
Perhaps yours is a more psychosocially driven depression. This doesn't mean that your symptoms are not somatic, however psychotherapy might be the best strategy to help somatic treatments give you a better quality and longer-lasting therapeutic response.
I would not go beyond 15 ECT treatments if there were no improvement by then. I would have a hard time justifying going beyond 12 treatments, but I know how desperately you want to feel 100%.
Dysthymia is a notoriously difficult condition to treat. If you do have dysthymia, you should probably begin to search for treatments deemed effective for that diagnosis.
How old are you now?
How old were you when your depression first emerged?
Were you subject to physical abuse/punishment, neglect, or bullying?
Was your depression more episodic or cyclic in the beginning?
Was your condition ever mistaken for ADHD?
You mentioned your having a dislike for stimulants. Which ones have you tried?
You mentioned your having a dislike for SSRIs and SNRIs. Which ones have you tried?
- Scott
Posted by ed_uk2010 on June 9, 2013, at 16:45:14
In reply to Re: Electroconvulsive Therapy Treatment #6, posted by Trevpr on June 9, 2013, at 1:51:17
Trev,
I must admit that I'm also rather unsure whether ECT is a suitable treatment for you. ECT can, in some cases, relieve the symptoms of severe depressive illness, usually at the cost of memory and cognitive disturbances. As I'm sure you know, ECT does not cure depression but produces a temporary reduction in symptoms which lasts for a variable amount of time after the treatment is complete. ECT is mainly used in a crisis situation. Maintenance ECT is only appropriate in extreme circumstances. Maintenance is with medication, which you are already on.
It seems that your severe depressive symptoms are under control. I am therefore unsure whether the risks of ECT are acceptable, given that any benefits are likely to be short term. Substantial memory loss has been reported.
The symptoms that you are experiencing (numbed emotions and low libido) may not be amenable to ECT. You could consider trying a different MAOI if you haven't already. Your doctor may wish to check your testosterone levels, although I suspect that it will be normal. Other blood tests such as thyroid function are also important. MAOIs and SSRIs tend to worsen the reduced libido which is already common in depression. Treating illness is often a trade-off. It's difficult.
So, what's your opinion? And what led your doctor to recommend ECT?
Posted by Trevpr on June 9, 2013, at 17:42:48
In reply to Re: Electroconvulsive Therapy Treatment #6 » Trevpr, posted by ed_uk2010 on June 9, 2013, at 16:45:14
The numb emotions prevent me from dating or truly enjoying life. I would like them to be eliminated. I love stimulants, but they quickly form a tolerance and make my heart rate go up and cause a crash when they wear off. I have to keep increasing the dose til overdose
Posted by ed_uk2010 on June 13, 2013, at 4:43:57
In reply to Re: Electroconvulsive Therapy Treatment #6, posted by Trevpr on June 9, 2013, at 17:42:48
>The numb emotions prevent me from dating or truly enjoying life. I would like them to be eliminated.
I understand, these symptoms are horrible.... but ECT only reduces depressive symptoms temporarily - hence its use in a crisis. Other treatments are needed to maintain the improvement.
How are you feeling now?
This is the end of the thread.
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