Psycho-Babble Medication Thread 1106131

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Re: Maintanence ECT is effective, once every 8 weeks?

Posted by sigismund on September 16, 2019, at 1:49:30

In reply to Maintanence ECT is effective, once every 8 weeks?, posted by PCB on September 15, 2019, at 17:26:27

I think it pretty rare that people get treated the rest of their lives with maintenance ECT.

This a contested field.

My contrarian ex-psych used to say that they eventually learned not to complain.


 

Re: Maintanence ECT is effective, once every 8 weeks?

Posted by Lamdage22 on September 16, 2019, at 3:44:02

In reply to Re: Maintanence ECT is effective, once every 8 weeks?, posted by sigismund on September 16, 2019, at 1:49:30

I am not a fan of this either. I have seen substantial memory loss and not so substantial "improvements".

 

Re: Maintanence ECT is effective, once every 8 weeks?

Posted by Christ_empowered on September 16, 2019, at 8:15:22

In reply to Re: Maintanence ECT is effective, once every 8 weeks?, posted by Lamdage22 on September 16, 2019, at 3:44:02

the people ive seen it done to in private hospitals...its so incredibly lucrative for all the 'experts' involved, its no wonder any sign of 'relapse' = a recommendation for more, then a referral, blah blah blah.

where i live, the private psych wards and hospitals do shock and maintenance shock, and they even have their shock docs go around and give seminars on the wonders of hi-voltage electricity for psych problems. and then...

every now and then, a lawsuit pops up, minor media attention, a settlement. rinse, repeat.

 

Re: Maintanence ECT is effective, once every 8 weeks?

Posted by Lamdage22 on September 16, 2019, at 8:39:45

In reply to Maintanence ECT is effective, once every 8 weeks?, posted by PCB on September 15, 2019, at 17:26:27

I don't think you should believe the things that they say about ECT. I know of 10 people, none of them were glad that they did it and half of them were doing really bad. Brain damage-

 

Re: Maintanence ECT is effective, once every 8 weeks?

Posted by PCB on September 16, 2019, at 8:55:39

In reply to Re: Maintanence ECT is effective, once every 8 weeks? PCB, posted by sigismund on September 16, 2019, at 1:45:31

Hey sigismund!

Thanks for the post. So Nardil at full dose 60 mg gets me about 80% better and I had friends and socialized. But I gain 40 lbs, sexually impotent, MAOI diet, horrible insomnia and poor memory and then my friends disappear. I have reduced Nardil to 50 mg with lithium, lamictal augmentation and now have 30 lbs weight gain, insomnia, diet but my memory is better. I am about 70%, but no close friends. Hard to explain to people that I don't drink coffee, alcohol, go to bed by 10 o'clock, meditate, exercise, MAOI diet, can't sleep over due to insomnia. Its been 24 years now, so Nardil weight is starting symptoms of prediabetes, HTN and hip/knee arthritis

I did ECT 15 years ago and it work with no memory loss. Actually I did it because I would go on Nardil 60 mg then reduce to 45 mg because of side effects and Nardil stopped working. And now ECT is so much more improved. It should work for me now. My new doctor has a patient on long term maintenance ECT.

What do you think?

PCB

 

Re: Maintanence ECT is effective, once every 8 weeks?

Posted by PCB on September 16, 2019, at 9:06:50

In reply to Re: Maintanence ECT is effective, once every 8 weeks?, posted by sigismund on September 16, 2019, at 1:49:30

Dear sigismund,

I agree it is a scary topic. But reading the medical literature, ECT now is usually unilateral, low dose currents, current lasting only 45 seconds, they taper you off ECT with lower currents like medications, memory loss is rare, memory improvement with the resolution of depression happens in the majority of cases and maintenance is only every few months.

Readings say it's is sad, because after the STAR*D trial we know 33% do not respond to meds. And due to stigma, your right, only 0.16% of patients get ECT. They say it is cheaper and faster to start ECT if you fail 2 meds than to wait to respond to a 4 medication to work. And during that trial of the 3rd and 4th med, you brain is deteriorating.

What do you think of this (much improved ECT, cost effective, preventing further brain deterioration)

PCB

PS There is study of an 84 year man whom received over 400 ECT treatment at autopsy had no anatomy changes in his brain.

PSS. I was actually going to see this psychiatrist for a second opinion to ask to try Effexor or Lexapro augmented with Abilify. So I am not against medications

 

Re: Maintanence ECT is effective, once every 8 weeks?

Posted by PCB on September 16, 2019, at 9:12:19

In reply to Re: Maintanence ECT is effective, once every 8 weeks?, posted by Lamdage22 on September 16, 2019, at 3:44:02

Hey Lamdage22!

Good point. I really appreciate the post. Did those people you know get new ECT unilateral, low dose or old ECT bilateral, high dose ECT who had memory loss?

I did improve with ECT but start Nardil right after ECT. So I only know ECT was good for about 3 weeks until Nardil kicked in. And it did make Nardil work again

The studies say treatment resistant, refractory patient respond 70% of the time. Do you think this is incorrect?

What do you think?

PCB

 

Re: Maintanence ECT is effective, once every 8 weeks?

Posted by PCB on September 16, 2019, at 9:25:06

In reply to Re: Maintanence ECT is effective, once every 8 weeks?, posted by Christ_empowered on September 16, 2019, at 8:15:22

Hey Christ_empowered!

Wow! Those are scary stories! That is terrible. I live in a big city and there are 4 big hospitals who do ECT. All the website mention acute low dose unilateral ECT, but then starting medications. They all mention that they want patients off maintenance ECT by 6 months and on meds. I don't think it is lucrative for the hospitals. They could be using the space for ECT to do knee replacement, nose jobs that pay$50,000 to $100,000. I think ECT reimbursement is maybe low to the doctors. Actually here in the city, regular non ECT psychiatrist charge $500 per 1 hour session for therapy and medication. I think $500 once a week is more lucrative for psychiatrist than doing ECT. I think this is why there are very few ECT docs. I am actually having a hard time finding one.

That makes me sad to here what you have seen. What do think about this? Maybe people need to come to the city for ECT

PCB

PS But I would love to have responded to a medication. I don't want ECT, but feel it might be best treatment for me now

 

Re: Maintanence ECT is effective, once every 8 weeks?

Posted by Lamdage22 on September 16, 2019, at 12:11:53

In reply to Re: Maintanence ECT is effective, once every 8 weeks?, posted by PCB on September 16, 2019, at 9:25:06

I don't know which kind of ECT. I have never heard of anyone who benefitted. You are the first out of 10 people that I have met.

 

Re: Maintanence ECT is effective, once every 8 weeks? PCB

Posted by sigismund on September 16, 2019, at 23:47:43

In reply to Re: Maintanence ECT is effective, once every 8 weeks?, posted by PCB on September 16, 2019, at 9:06:50

My old psych said about old fashioned ECT.....

'I was told it was the gold standard. I told my students it was. I never saw it work. When we had the follow up we would ask the husbands (!) 'Is she able to keep the house clean? And perform her home duties? (sex).

Now that is from 50 + years ago. If you could be sure that it worked, as it must for some. ....

Some people can restart MAOIs without problem. Sometimes they stop working for unknown reasons. Some people think that if working it might be better to leave well alone.

The writer is David Fostor Wallace. From Wiki.....

Wallace's father said that David had suffered from major depressive disorder for more than 20 years and that antidepressant medication had allowed him to be productive.[25] Wallace experienced severe side effects from the medication[26] and in June 2007 stopped taking phenelzine, his primary antidepressant drug, on his doctor's advice.[25] His depression recurred, and he tried other treatments, including electroconvulsive therapy. Eventually he went back on phenelzine but found it ineffective.[26] On September 12, 2008, at age 46, Wallace wrote a two-page suicide note, arranged part of the manuscript for The Pale King and hanged himself from a rafter of his house.[71]

 

Re: Maintanence ECT is effective, once every 8 weeks? PCB

Posted by sigismund on September 16, 2019, at 23:53:55

In reply to Re: Maintanence ECT is effective, once every 8 weeks?, posted by PCB on September 16, 2019, at 9:12:19

>The studies say treatment resistant, refractory patient respond 70% of the time. Do you think this is incorrect?

Allow me to butt in. (And what do I know?) But yes, I would be astonished if this is correct.

But maybe it is?

 

Re: Maintanence ECT is effective, once every 8 weeks? PCB

Posted by SLS on September 17, 2019, at 19:00:16

In reply to Maintanence ECT is effective, once every 8 weeks?, posted by PCB on September 15, 2019, at 17:26:27

I guess you need to examine how many pounds you think 70% is worth.

Has anyone mentioned Parnate?


- Scott

 

Re: Maintanence ECT is effective, once every 8 weeks?

Posted by Stargazer2 on September 18, 2019, at 0:34:03

In reply to Re: Maintanence ECT is effective, once every 8 weeks? PCB, posted by SLS on September 17, 2019, at 19:00:16

Had ECT, failed 11 treatments. Made me a brain dead zombie and shattered my memory forever. Was so confused, got worse and worse. Was about 10 years ago. Unilateral. Got my records to review years later. Make sure you get yours too. Every session I got worse and they should not have continued. The MD was a real nutcase. I had Severe memory loss. I am sorry I had it. I would do Ketamine IV over ECT any day. Have been on every Med known since 1987. Had TMS. Best meds are MAOs for my chronic, intractable depression.
I am better today because of what I have learned over the years. Worked as an RN in ECT at large well known med Cyr and feel most pts did poorly but MD lied and said most had a robust response with only STM loss. Not true. He was fed motivated by $$$. If it worked for you before that is a good sign. I would proceed cautiously, get the best doc and hope for the best. Currently I take Nardil, Ritalin, Seroquel, DL Phenylalanine(my decision). My doc lets me do things he is not familiar with because I do better research than him.

 

Re: Maintanence ECT is effective, once every 8 weeks? Stargazer2

Posted by SLS on September 18, 2019, at 11:34:00

In reply to Re: Maintanence ECT is effective, once every 8 weeks?, posted by Stargazer2 on September 18, 2019, at 0:34:03

Hi, Stargazer2.

How would you compare Nardil to Parnate?


- Scott

 

Re: Maintanence ECT is effective, once every 8 weeks?

Posted by PCB on September 18, 2019, at 18:04:40

In reply to Re: Maintanence ECT is effective, once every 8 weeks?, posted by Lamdage22 on September 16, 2019, at 12:11:53

Hey Lamdage22,

Thanks for the post. I keep reading about famous people who said they did well like Dick Caveat, Kitty Dukakis. And for me it got Nardil to work again. But I also have read about a lot of people on the internet whom said it helped but they had many side effects. I am really surprised I am the only one you have heard has done well. I am so use to being the one whom never responds, is alway depressed and has failed all but Nardil.

I wish there was some honest statistics about the efficacy of ECT. I would hate to find out that the ECT community has been lying to the pubic for years.

Thanks again

PCB

 

Re: Maintanence ECT is effective, once every 8 weeks?

Posted by PCB on September 18, 2019, at 18:15:00

In reply to Re: Maintanence ECT is effective, once every 8 weeks? PCB, posted by sigismund on September 16, 2019, at 23:47:43

Thanks Sigismund!

Wow! Again I am surprised to hear that many people state ECT is ineffective. If it is true, to lie to convince helpless depressed individuals to get ECT for such little profit make me nauseous. And to publicize that it does not cause memory impairment should be illegal if not true. I am really confused but such opposite opinions.

I actually dreamed several nights ago that a friend called me and I picked up the phone. I had finished ECT several months ago and had my normal weight, diet and sexual function back. And we just went to a bar a had a drink and laughed. I has been 20 years seen I did that and I hope I have not been mislead about ECT.

Would it be amazing to just have a week of a normal persons life?

PCB

 

Re: Maintanence ECT is effective, once every 8 weeks?

Posted by PCB on September 18, 2019, at 18:21:43

In reply to Re: Maintanence ECT is effective, once every 8 weeks? PCB, posted by sigismund on September 16, 2019, at 23:53:55

I found this figure in a few medical journals, but many sources about ECT did not list the efficacy. But once again, for physician to lie to entire public in mainstream medical journals with misleading ECT stats makes me sad. I can't believe they would risk huge lawsuits and losing their license to inflict ineffective and damaging treatment to patients. This would easily be one of the biggest malpractice suits ever.

Thanks again sigismund. Make me sad to think I might have a possible solution to my 24 years of depression that it was all a lie

PCB

 

Re: Maintanence ECT is effective, once every 8 weeks?

Posted by PCB on September 18, 2019, at 18:29:11

In reply to Re: Maintanence ECT is effective, once every 8 weeks? PCB, posted by SLS on September 17, 2019, at 19:00:16

Hey SLS,

Off Nardil, I am about 30 lbs lighter. That would definitely halt any diabetes and HTN for about 20 years. It might stall the joint arthritis for a while, but some of the damage is already done.

So I think 3 weeks of acute ECT and maintenance every 2 months is far better that a life of diabetes and HTN (of course which lead to heart attack, stroke). I would start ECT tomorrow to avoid a hip replacement, years of insulin and disability of heart disease.

But it sounds like everyone at pbabble is stating I may have been mislead. And ECT is not effective and actually damaging. Really confused!

Thanks for the post!

PCB

 

Re: Maintanence ECT is effective, once every 8 weeks?

Posted by PCB on September 18, 2019, at 18:42:11

In reply to Re: Maintanence ECT is effective, once every 8 weeks?, posted by Stargazer2 on September 18, 2019, at 0:34:03

Wow again! Why has there not been a huge class action lawsuit again the ECT manufactures, ECT doctors and ECT literature. Stargazer, has anyone you worked with or in the ECT community ever though about going to the authorities or simply leaked your knowledge to someone in the law field. You should be compensate for you medical injuries and maybe it could prevent the 100,000 patients a year who get ECT from getting brain damage on top the already horrific depression they have. I am so sorry for what you have been through.

I like you have had to read all the research journals to come up with every medication and dose for my psychiatrist to prescribe me. I feel like I am wasting my life reading these studies and determining if the drug doses were appropriate and outcomes were statistically significant. As I posted before, I would love to have just one week of a normal life

Thanks

PCB

 

Re: Maintanence ECT is effective, once every 8 weeks?

Posted by PCB on September 18, 2019, at 18:44:37

In reply to Re: Maintanence ECT is effective, once every 8 weeks? PCB, posted by SLS on September 17, 2019, at 19:00:16

Hey SLS,

Forget to mention, I suggested Parnate to pdoc many years ago. Like wellbutrin and desipramine, it really worsened by anxiety and panic. I could only tolerate 40 mg. No improvement

PCB

 

Re: Maintanence ECT is effective, once every 8 weeks? PCB

Posted by SLS on September 19, 2019, at 10:31:16

In reply to Re: Maintanence ECT is effective, once every 8 weeks?, posted by PCB on September 18, 2019, at 18:29:11

Hi, PCB.

> But it sounds like everyone at pbabble is stating I may have been mislead. And ECT is not effective and actually damaging. Really confused!

I'm confused, too. Historically, there has been a lot of research on ECT, but don't see a convincing consensus. My experience with ECT is that it was ineffective and produced worrisome cognitive side effects. However, my depression has been characterized by memory impairment and slowing of thoughts. It is difficult for me to know if ECT produced persistent impairments.

I am reluctant to make any recommendations. I would hate to persuade someone to avoid a treatment that ultimately would have worked for them. I am encouraged to hear that ECT made your drug treatment work better.


- Scott

 

Re: Maintanence ECT is effective, once every 8 weeks?

Posted by Stargazer2 on September 19, 2019, at 22:08:03

In reply to Re: Maintanence ECT is effective, once every 8 weeks? PCB, posted by SLS on September 19, 2019, at 10:31:16

Hi SLS. Only took Parnate once w/o much effect. Best MAO for me was Marplan before the reformulation in the mid 90s. I never got back to that level of stability ever again.
Only take Nardil now. I usually stick with one before it completely fails but maybe Parnate would work better.
What in your opinion does Parnate do that Nardil doesnt?

My recommendation for ECT is if you had it and it worked by all means try it again. My memory loss was pretty substantial and all I heard prior was that it would be STM and transient. Not true for me. Also looking back if memory was such a critical concern why was no memory testing done prior to the treatment and afterwards. If it were a concern any reputable doc would do a baseline assessment and 6 mos followup.
I ultimately, at my own request, had 2 neuro/psych assessments done but that really should be the standard of care. Like I said the doc doing it at a prestigious(?) medical center in CT denies long term memory impairment but wouldnt memory testing, pre and post ECT, be the only way to determine that? If they really cared.

 

Re: Maintanence ECT is effective, once every 8 weeks? (nm) PCB

Posted by pedr on September 24, 2019, at 11:44:29

In reply to Maintanence ECT is effective, once every 8 weeks?, posted by PCB on September 15, 2019, at 17:26:27

 

Re: Maintanence ECT is effective, once every 8 weeks?

Posted by bleauberry on October 18, 2019, at 15:54:14

In reply to Maintanence ECT is effective, once every 8 weeks?, posted by PCB on September 15, 2019, at 17:26:27

I had ECT. It was 12 bilateral sessions over 4 weeks.

I actually felt something close to remission on the final treatment, but was actually worse up until that time. I also had terrible memory loss so the only way I could know what happened during that month was by reading my daily notes.

I had already relapsed again within a few days. It didn't stick. ECT generally doesn't stick. It generally requires follow-up treatments.

I strongly oppose ECT for the vast majority of functional people, no matter how bad their mood disorders are. The literature makes it appear a lot more effective and a lot safer than it actually is. I call my brain Swiss cheese brain after ECT. It has big holes in memories.

I strongly support ECT for developmentally challenged. It can make the difference between living in an institution and living in a half way house or a regular home.

My spouse is very experienced in day care for severely challenged adults and Downs syndrome. Some of them remained at least functional as long as they got their weekly or monthly ECT followups. ECT kept them in the game of life. But ECT for us psychiatric patients I think, in my experience, my opinion, is overblown.

And it's really expensive. I had good insurance at the time. But even just the co-pay I had to pay was over $20,000. The shot of barbiturate to put you out, all by itself, was close to $100, just for that.

As an ECT survivor, I cannot recommend it to the general population. If someone wants to do it, that's fine, I made that decision myself. I'm just saying, don't expect miracles. And if you get a miracle, don't expect it to stick. And be prepared for some permanent random memory losses.

 

Re: Maintanence ECT is effective, once every 8 weeks?

Posted by Zyprexa on October 20, 2019, at 10:39:29

In reply to Maintanence ECT is effective, once every 8 weeks?, posted by PCB on September 15, 2019, at 17:26:27

I have had many ECTs at the beginning of mental illness, didn't make the meds work better or not need them.


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