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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 3 to 27 of 27. Go back in thread:
Posted by poser938 on February 3, 2012, at 18:40:44
In reply to pdoc mentioned ECT today :(, posted by Roslynn on February 3, 2012, at 15:20:53
there is a patient assisance program for rTMS. at each office where the to rTMS is done, neurostar pays for 10 patients a year to have it done if they make les than $42,000 a year.
Posted by alchemy on February 3, 2012, at 18:58:03
In reply to pdoc mentioned ECT today :(, posted by Roslynn on February 3, 2012, at 15:20:53
if you are not overwhelmingly depressed and have a bunch of meds to try, ect shouldn't be the next move.
(i personally have found ect helpful when i am in a black hole to get out of it fairly quickly. (and then in a few weeks i go back to my gray hole))
Posted by softheprairie on February 4, 2012, at 1:49:27
In reply to Re: pdoc mentioned ECT today :(, posted by poser938 on February 3, 2012, at 18:40:44
Good to know! Thank you for the information.
> there is a patient assisance program for rTMS. at each office where the to rTMS is done, neurostar pays for 10 patients a year to have it done if they make les than $42,000 a year.
Posted by Zyprexa on February 4, 2012, at 3:20:02
In reply to pdoc mentioned ECT today :(, posted by Roslynn on February 3, 2012, at 15:20:53
ECT is what they gave me every time I would not take my meds. I find it better to just take them and get use to the sideffects. Find one that cures you and put up with sideffects. You will learn to put up with them. ECT did not help me and I've had tons. Most people on here say it does not work. It made me forget a lot. Have you tried zyprexa? Best med out there! Its generic too now, and the generic seems to work just as well. So far I've tried Teva. Ya ECT actualy made me worse in the end. I have not had any since 97, I started zyprexa in 98.
Posted by Jeroen on February 4, 2012, at 3:29:00
In reply to pdoc mentioned ECT today :(, posted by Roslynn on February 3, 2012, at 15:20:53
dump this doc as soon as possible
before he gets you do forced ECT!
Posted by bleauberry on February 4, 2012, at 5:22:15
In reply to pdoc mentioned ECT today :(, posted by Roslynn on February 3, 2012, at 15:20:53
Nardil, Parnate, Zoloft+Nortriptyline, Prozac+Nortriptyline, Prozac+Desipramine, Savella, anything with a stimulant added....I mean, if these haven't been tried, it seems insane to me to even mention ECT.
I've posted a lot about this topic over the years and months because I am an ECT survivor so if interested maybe search the archives for my experience and stance on ECT.
Posted by ed_uk2010 on February 4, 2012, at 7:54:13
In reply to pdoc mentioned ECT today :(, posted by Roslynn on February 3, 2012, at 15:20:53
>I thought I had a couple more medication options to try before ECT.
In general...
ECT appears to have a reasonable success rate for severe acute depressive episodes, with or without depressive delusions. Although ECT can provide short-term relief in some cases, there is obviously a risk of adverse effects and the relapse rate (after treatment has ended) is fairly high.
ECT is not often appropriate as a long-term treatment. A small number of patients have 'maintenance ECT' ie. regular ECT sessions over a long period of time to prevent relapse after the initial course of ECT. The safety and efficacy of this type of ECT is less clear, and it is hardly used at all in Europe.
So, most patient who have ECT will need medication after the ECT to prevent relapse. If you are in a crisis, it might be something to consider to get you out of a black hole. If you have other med options still to try and your depression is not so severe than you are at crisis point, I would go with the meds for now. As you mentioned, an MAOI could be appropriate, and is certainly worth discussing with your pdoc.
Posted by sailboat77 on February 4, 2012, at 13:23:02
In reply to Re: pdoc mentioned ECT today :( » Roslynn, posted by ed_uk2010 on February 4, 2012, at 7:54:13
I would be a bit concerned if your doctor is pushing ECT so early. Everyone reacts differently to ECT, but for me it did nothing to help my treatment-resistant depression. What did help me though were MAOI's. I'm currently on 60mg of Parnate and it has helped my mood.
I finished my TMS treatments about 2 weeks ago and it has been the single best thing when it comes to alleviating my depression. I must stress though that what works for one person may not work for another. The best thing you can do though is find a psychiatrist who you really like and feel comfortable with --- that was the turning point for me.
-Hope you feel better
Posted by Christ_empowered on February 4, 2012, at 15:50:27
In reply to Re: pdoc mentioned ECT today :(, posted by sailboat77 on February 4, 2012, at 13:23:02
Seriously. Your brain is too precious to go frying it.
Posted by sigismund on February 5, 2012, at 17:06:28
In reply to Re: pdoc mentioned ECT today :( » Roslynn, posted by ed_uk2010 on February 4, 2012, at 7:54:13
>ECT appears to have a reasonable success rate for severe acute depressive episodes, with or without depressive delusions.
My psych said this to me......
'When I was a med student, they told me that this was the gold standard. When I was a registrar I prescribed it. Later I taught med students the same thing. And you know what? I never saw anyone improved by it. They stopped complaining though.'
IMO, when you get to that stage, the industry no longer treats you as if you are fully human.
No double blind clinical trials here.
Posted by ed_uk2010 on February 5, 2012, at 18:04:54
In reply to Re: pdoc mentioned ECT today :(, posted by sigismund on February 5, 2012, at 17:06:28
>IMO, when you get to that stage, the industry no longer treats you as if you are fully human.
Like, you become depression rather than a person suffering from depression?
>....they told me that this was the gold standard.....Later I taught med students the same thing
Much clinical knowledge gets passed on in this way, evidence-based or otherwise.
I believe clinical trials of ECT have used a brief anesthetic without any procedure as a placebo control.
I fear ECT.
Posted by sigismund on February 5, 2012, at 18:54:23
In reply to Re: pdoc mentioned ECT today :( » sigismund, posted by ed_uk2010 on February 5, 2012, at 18:04:54
>Like, you become depression rather than a person suffering from depression?
Like you are ready for the scrapheap so it no longer matters. The contempt of the industry is not particularly subtle. If it works, that's great. But I don't think they are going to be too probing as to whether it really did work.
Posted by Phillipa on February 5, 2012, at 20:23:38
In reply to Re: pdoc mentioned ECT today :( » ed_uk2010, posted by sigismund on February 5, 2012, at 18:54:23
Sigi are you saying you taught psyciatric students that you are a doc? PJx
Posted by sigismund on February 5, 2012, at 23:25:55
In reply to Re: pdoc mentioned ECT today :( » sigismund, posted by Phillipa on February 5, 2012, at 20:23:38
No, PJ, that was my psychiatrist.
Posted by Zyprexa on February 6, 2012, at 6:14:01
In reply to Re: pdoc mentioned ECT today :(, posted by sigismund on February 5, 2012, at 17:06:28
> >ECT appears to have a reasonable success rate for severe acute depressive episodes, with or without depressive delusions.
>
> My psych said this to me......
>
> 'When I was a med student, they told me that this was the gold standard. When I was a registrar I prescribed it. Later I taught med students the same thing. And you know what? I never saw anyone improved by it. They stopped complaining though.'
>
> IMO, when you get to that stage, the industry no longer treats you as if you are fully human.
>
No they don't. They would wake me in the morning, put me on a gurny and wisk me off to the ECT room, stick morphine in my vain and I would wake later wondering what happened.> No double blind clinical trials here.
Posted by ed_uk2010 on February 6, 2012, at 7:39:11
In reply to Re: pdoc mentioned ECT today :( » ed_uk2010, posted by sigismund on February 5, 2012, at 18:54:23
>Like you are ready for the scrapheap so it no longer matters. The contempt of the industry is not particularly subtle. If it works, that's great. But I don't think they are going to be too probing as to whether it really did work.
Sigi, does your pdoc prescribe medication or use psychological treatments?
Posted by Roslynn on February 6, 2012, at 14:02:59
In reply to pdoc mentioned ECT today :(, posted by Roslynn on February 3, 2012, at 15:20:53
Thank you to everyone who replied. I should have added that yes I have tried many meds and combos but not the MAOIs. (and not rTMS)
I really don't understand why so many pdocs push ECT even if they have no financial tie to it. Is it the unwillingness to criticize any aspect of their own profession?
Posted by sigismund on February 6, 2012, at 16:27:45
In reply to Re: pdoc mentioned ECT today :( » sigismund, posted by ed_uk2010 on February 6, 2012, at 7:39:11
>Sigi, does your pdoc prescribe medication or use psychological treatments?
Both, though we don't really do the psych stuff. We just talk. He's not big on polypharmacy. I enjoy his company,and as he bulkbills it costs me nothing for 50 minutes.
Posted by Phillipa on February 6, 2012, at 18:42:31
In reply to Re: pdoc mentioned ECT today :( » ed_uk2010, posted by sigismund on February 6, 2012, at 16:27:45
Sigi you went to medical school and taught students then? PJx
Posted by ed_uk2010 on February 7, 2012, at 10:07:54
In reply to Re: pdoc mentioned ECT today :( » ed_uk2010, posted by sigismund on February 6, 2012, at 16:27:45
>Both, though we don't really do the psych stuff. We just talk. He's not big on polypharmacy. I enjoy his company,and as he bulkbills it costs me nothing for 50 minutes.
He seems like a good fit for you Sigi. Do you still take agomelatine?
Posted by sigismund on February 7, 2012, at 13:52:46
In reply to Re: pdoc mentioned ECT today :( » sigismund, posted by ed_uk2010 on February 7, 2012, at 10:07:54
>Do you still take agomelatine?
No, I stopped that. It was no longer helping me sleep. The dopaminergic effects were more long lived than the melatonin type effect.
I did try trimipramine in a low dose. Better than ami or doxepin. Much less bad. The sleep architecture thing with that seemed right to me. But still I felt zapped when I awoke.
Posted by atypical on February 7, 2012, at 15:10:50
In reply to Re: pdoc mentioned ECT today :(, posted by Roslynn on February 6, 2012, at 14:02:59
Try the MAOIs first!
Posted by ed_uk2010 on February 7, 2012, at 17:29:52
In reply to Re: pdoc mentioned ECT today :( » ed_uk2010, posted by sigismund on February 7, 2012, at 13:52:46
>The dopaminergic effects were more long lived than the melatonin type effect.
Have you tried plain melatonin capsules?
Posted by sigismund on February 7, 2012, at 18:14:27
In reply to Re: pdoc mentioned ECT today :( » sigismund, posted by ed_uk2010 on February 7, 2012, at 17:29:52
>Have you tried plain melatonin capsules?
Yeah, I take it though it doesn't do much.
I loved agomelatine in the beginning. For a little while I slept really well and awake feeling good.
Posted by ed_uk2010 on February 8, 2012, at 8:02:58
In reply to Re: pdoc mentioned ECT today :( » ed_uk2010, posted by sigismund on February 7, 2012, at 18:14:27
Maybe a sustained-release melatonin would be better? We have the brand Circadin here. It might help because normal melatonin is very short-acting.
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