Psycho-Babble Medication Thread 1110955

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Off TMS 2 Week Update!

Posted by PCB on June 22, 2020, at 7:44:00

My last TMS was exactly 2 weeks ago. I think the TMS induced depression is gone! This morning my mind is clear, energy is back and interest in life back! I am sooooo lucky!

 

Re: Off TMS 2 Week Update! » PCB

Posted by SLS on June 23, 2020, at 12:02:04

In reply to Off TMS 2 Week Update!, posted by PCB on June 22, 2020, at 7:44:00

> My last TMS was exactly 2 weeks ago. I think the TMS induced depression is gone! This morning my mind is clear, energy is back and interest in life back! I am sooooo lucky!

That's great!

Big smile! :-)

Would you be able to describe what type of TMS you received (rTMS versus dTMS), how many weeks, how many times a week, and the pulse settings? I am very interested to know if I don't continue responding to my present treatment.

Thanks.


- Scott


 

Re: Off TMS 2 Week Update! » PCB

Posted by Hugh on June 23, 2020, at 13:16:53

In reply to Off TMS 2 Week Update!, posted by PCB on June 22, 2020, at 7:44:00

> My last TMS was exactly 2 weeks ago. I think the TMS induced depression is gone! This morning my mind is clear, energy is back and interest in life back! I am sooooo lucky!

Are you feeling better than you did before you started TMS, or are you back to feeling the same?

 

Re: Off TMS 2 Week Update! » SLS

Posted by PCB on June 23, 2020, at 19:59:04

In reply to Re: Off TMS 2 Week Update! » PCB, posted by SLS on June 23, 2020, at 12:02:04

> Would you be able to describe what type of TMS you received (rTMS versus dTMS), how many weeks, how many times a week, and the pulse settings? I am very interested to know if I don't continue responding to my present treatment.
>
> Thanks.
>
>
> - Scott

I did 2 sessions of L unilateral rTMS for 20 minutes initially. As before, I experienced some agitation. I was feeling my girlfriend should have been treating me better and I felt a little more confident (maybe 10% change). I told the pdoc both days and she changed me to bilateral TMS with right sided stimulation for 20 minutes and left theta bursts for 3 minutes. I completed 3 sessions of bilateral. About 20% of my depressive symptoms returned (sleeping all day, cognitive clouding, anhendonia).

If I wasn't dating this woman, or if I felt this woman could tolerate me being possibly severely depressed for 6 weeks (my baseline), I would have finished the rTMS. I think maybe 25 percent chance I would have responded and been able to lower my nardil dose.

Now I was doing it to get off nardil. I though I would taper off nardil and then start a new med like Trintellix and if that didn't work, start TMS. The TMS pdoc said she wanted me on nardil and start a taper nardil at 2 weeks of TMS therapy. I was surprised to hear that. I have never heard of TMS being use to taper someone off a medication that is working, but patient can't tolerate the side effects. So that could have been a reason to for TMS making me worse. When I go too high on any medication, I feel worse. So maybe the addition TMS was almost "too much" medication.

The tech said they have dTMS machine but hardly every use it due to the risk of seizures.

Good luck SLS!

 

Re: Off TMS 2 Week Update! » PCB

Posted by SLS on June 24, 2020, at 9:59:36

In reply to Re: Off TMS 2 Week Update! » SLS, posted by PCB on June 23, 2020, at 19:59:04

Hi, PCB.

Thanks for taking the time to answer my questions. I never heard of bilateral TMS. Wow.

Quick thought: Many people who took Nardil and responded to it discontinued it prematurely. When they relapsed, the choice was an obvious one - just restart Nardil. The problem is, it didn't work for them ever again.

This seems to happen more often with Nardil than with Parnate.

Good luck to you, too.

:-)


- Scott


> > Would you be able to describe what type of TMS you received (rTMS versus dTMS), how many weeks, how many times a week, and the pulse settings? I am very interested to know if I don't continue responding to my present treatment.
> >
> > Thanks.
> >
> >
> > - Scott
>
> I did 2 sessions of L unilateral rTMS for 20 minutes initially. As before, I experienced some agitation. I was feeling my girlfriend should have been treating me better and I felt a little more confident (maybe 10% change). I told the pdoc both days and she changed me to bilateral TMS with right sided stimulation for 20 minutes and left theta bursts for 3 minutes. I completed 3 sessions of bilateral. About 20% of my depressive symptoms returned (sleeping all day, cognitive clouding, anhendonia).
>
> If I wasn't dating this woman, or if I felt this woman could tolerate me being possibly severely depressed for 6 weeks (my baseline), I would have finished the rTMS. I think maybe 25 percent chance I would have responded and been able to lower my nardil dose.
>
> Now I was doing it to get off nardil. I though I would taper off nardil and then start a new med like Trintellix and if that didn't work, start TMS. The TMS pdoc said she wanted me on nardil and start a taper nardil at 2 weeks of TMS therapy. I was surprised to hear that. I have never heard of TMS being use to taper someone off a medication that is working, but patient can't tolerate the side effects. So that could have been a reason to for TMS making me worse. When I go too high on any medication, I feel worse. So maybe the addition TMS was almost "too much" medication.
>
> The tech said they have dTMS machine but hardly every use it due to the risk of seizures.
>
> Good luck SLS!
>

 

Re: Off TMS 2 Week Update! » SLS

Posted by PCB on June 24, 2020, at 12:26:59

In reply to Re: Off TMS 2 Week Update! » PCB, posted by SLS on June 24, 2020, at 9:59:36

> Hi, PCB.
>
> Thanks for taking the time to answer my questions. I never heard of bilateral TMS. Wow.
>
> Quick thought: Many people who took Nardil and responded to it discontinued it prematurely. When they relapsed, the choice was an obvious one - just restart Nardil. The problem is, it didn't work for them ever again.
>

The pdoc said bilateral was to help my anxiety. But I was not anxious (even though that is my main mood problem with some depression and a family history of bipolar). The literature reports some pt have increased anxiety with the beginning of left frontal rTMS similar to antidepressant initiation. I think the pdoc would have cycled me next to right sided rTMS only which as you probably know is good or better for both unipolar and bipolar disease, but I think an off label indication. I think because it is not FDA approved/cleared for bipolar, pdoc dont start right away with right sided. Now clear bipolar patientS will often say, Amazing, it only took two sessions and the depression was gone. And now I come in for one dose every few months if Im starting to slide into depression. I talked to a patient who responded like this. Here is one if you want to see the video (its in the McMullen video series which some people love or dont care for) ..... https://youtu.be/v1P4Jx1Ndnk

I did have poop out with Nardil after going back and forth from 60 mg with weight gain, impotence and insomnia then back to 45 mg with severe depression returning but side effects gone several times over 2 years. I think my trace of bipolar was the cause of my poop out. From my readings, I thought the only solution was ECT and lucky it did get Nardil (the only med to work for me except imipramine/lithium) working again. With 450 of lithium, I have been able to lower Nardil to 50 and never have had poop out again (but I was scared this TMS 5 sessions was pseudopoop out .... but right sided TMS probably would have worked) which I think points again to my some trace bipolarity in me. Although I know many argue that low dose lithium is good for unipolars too.


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