19 replies to this topic

[mono]

Hi all just wondering what the community here thinks of ECT treatment for resistant depression?

Is there actual evidence to back up the notion that ect causes brain damage, apart from the horror stories.

Of course my pdoc seems to think it is a safe option but I am quite concerned there may be some potentially long term and serious side effects, which he claims that there basically are none.

I did some reading and couldn’t find much scientific evidence to say either way how risky it really is.

[jack black]

have you explored all the alternatives. did you do CBT?

[mono]

Hmm, no not for depression.

[jack black]

supposedly CBT works better than AD drugs. for some, I believe. Are you a high neuroticism type? BTW, have you tried Deplin? it's approved for treatment resistant depression and relatively non-toxic.

[mono]

Right. Well the thing I was worried about was the brain damage from ect? Like how bad is it, or is it worth taking the risk. I’m not even sure depression is entirely my problem, nor should it be treated with ect. I have a more chronic fatigue and pain type illness and also feel like I have lost some hope after dealing with schizophrenia for the last ten years. I haven’t tried deplin, but I’ll have a look into it.

[mono]

P.S. My pdoc has already put me on now foods methylfolate with fish oil, b complex, zinc and NAC. So I feel pretty grateful for that. I was kinda hoping to find some studies that showed the potential dangers, like brain damage, that ect causes. Or, perhaps some guidelines from the community about how to proceed with it. Cheers

[Mind_Paralysis]

Well... as I understand it, ECT has been down-graded in how serious potential damage could be, hence why it has been MOVED UP in the treatment algorithms for Bipolar Disorder.

 

(a treatment algorithm is a mathemetically calculated and probability-checked order in which one uses various drugs/treatments, and their combinations - the computer tells you, using different parameters, what's the most plausible way to treat someone with an illness. Well, the more advanced, active ones - most used ones are only calculated once, and then you get a paper spread-sheet you can look at, to figure out in which order to test drugs on a patient that's not responding.)

 

But what actual diagnosis do you have? What form of Schizophrenia? Please list every official diagnosis you have, as well as which ones your Dr. suspects  you have.

 

Anyways, I just found this Presentation, which presents the most recent findings on ECT, side-effects and trials - if you are able and willing to, then have a read and decide for yourself.

 

https://www.rcpsych....5UteKessler.pdf

 

If your Dr. suspects that you have something like Fibromyalgia as well as Schizo', then I don't think ECT would work (some of your symptoms sound like that) - but ECT does help with depression among Schizophrenics as well.

 

 

EDIT:

 

My opinion: this, and other studies, have convinced me that ECT, when done correctly, by an expert, is safe and effective in the treatment of depression of various kinds. I would suggest giving it a go, if you have treatment-resistant depression.

 

 

Now, if you weren't SCHIZOPHRENIC, I would have suggested Ketamine infusion instead, but since you are, then that's out of the question: Ketamine is quite possibly the most dangerous compound on Earth for you Schiz's... it was the first drug used as a semi-reliable PSYCHOSIS-simulator, used to approximate the states a Schiz' can end up in, in order to test drugs that would break psychosis. It helped create some of the first antipsychotics.

 

You probably understand why I see this, otherwise impeccable, treatment for treatment-resistant depression as rather dangerous for your particular makeup, yes...?

Edited by Mind_Paralysis, 30 October 2018 - 12:17 PM.

[jack black]

P.S. My pdoc has already put me on now foods methylfolate with fish oil, b complex, zinc and NAC. So I feel pretty grateful for that.

 

Wow, this is an impressive stack and i'm taking most of that myself with benefits. Surprising this came from a MD or PhD type. You can also throw in low to mid dose lithium. What's your testosteron level? If low it can mimic depression and chronic fatigue.

[mono]

Wow thanks guys, this is some great advice I really appreciate it.

My first diagnosis was drug induced psychosis, my second diagnosis was schizo typal personality disorder and as far as I know that has not changed. My old pdoc once said he suspects it is schizophrenia.

Yeah I understand that about the ketamine. I have tried dxm before and I didn’t have any long term side effects lasting from it but I did have a weird psychotic trip, where all my symptoms became magnified. The same thing happened on ayahuasca which I thought was pretty strange.

I’ll check out the link on ect soon. Thanks a heap.

Yeah it is a nice stack i mean this pdoc has been great so far but I felt a bit let down when he was trying to encourage me to try ect. And that is right I have been diagnosed with fibromyalgia. I just started taking a 225mg tablet of lithium carbonate and so far my mood has lifted quite nicely from that.

I’m also on noopept w/ alpha gpc and while it has given me a mild anxiety which has passed now it’s also been helping with my mood and cognition.

I’ve been checked on testosterone before and it came back a little higher than average. This was many years ago so it might be worth checking again.

Edited by mono, 30 October 2018 - 10:10 PM.

[mono]

P.S. I have been thinking of myself as a schizophrenic for some time, but you have reminded me that there is a significant difference between scizotypal. It represents different avenues for treatment. Thank you for that reminder.

Have you guys seen this: http://www.clrp.org/...ulsiveShock.pdf

I’m not sure what to make of it.

[jack black]

wow, sounds like the ECT is a scam?

i was always weary about giving sub-lethal shocks and hoping for the best. i think it only worked short term when amnesia made the patients forget they had depression, but didn't treat underlying problem that later resulted in depression again.

[Mind_Paralysis]

wow, sounds like the ECT is a scam?

i was always weary about giving sub-lethal shocks and hoping for the best. i think it only worked short term when amnesia made the patients forget they had depression, but didn't treat underlying problem that later resulted in depression again.

 

Scam? No, not at all. The more recent study I posted, which is something like 10 years later, shows that it works quite well.

 

Look, a very close friend of mine has a close relative with severe, severe Schizophrenia - he's never as happy, active or symptom-free as when he's had ECT - it's the only thing that works consistently for his symptoms, any other time he's pretty much completely incapacitated by his illness.

 

ECT works, but that doesn't mean it doesn't have side-effects, and that one should use it lightly.

[ryukenden]

ECT is most effective treatment for resistant depression. We have treated many patients with severe depression by using ECT. It has 70-80% response rate. Long term memory problems could be possible but the risk is minimal and usually memory problems are short-lived. If you're concerned about memory problems, you can try unilateral ECT.

 

Before ECT, you may want to try combination therapy OR antidepressant plus CBT.

[mono]

So the consensus here is that ect is generally considered a fairly safe treatment, when it is considered necessary. Interesting.

I am currently on combination therapy with mirtazapine, duloxetine and lithium. I am seeing a psychologist but haven’t tried the straightforward CBT approach.

Thanks for sharing.

[ThreeKings12341]

ECT is most effective treatment for resistant depression. We have treated many patients with severe depression by using ECT. It has 70-80% response rate. Long term memory problems could be possible but the risk is minimal and usually memory problems are short-lived. If you're concerned about memory problems, you can try unilateral ECT.

 

Before ECT, you may want to try combination therapy OR antidepressant plus CBT.

 

do you know if the patients had flat affect /blunted affect and were helped by ECT?

 

would very much appreciate an answer

[ryukenden]

do you know if the patients had flat affect /blunted affect and were helped by ECT?

would very much appreciate an answer

Yes, flat affect can be due to depression and once they get better, they have more reactive affect.

[mono]

So how does it actually work? What is the hypothesis behind its working?
I’m reading an article that suggests ect brings out changes in increased BDNF levels and an effect on all major neurotransmitters.
So it seems this is a positive kind of thing, as opposed to the previous article which suggested the relief of depression comes from the amnesia of forgetting one is unwell which sounds horrible!

Edited by mono, 07 November 2018 - 01:50 AM.

[richards2324]

ect is horrible mono I lost my emotions completely from it they came back but not being able to feel anything is horrible. each ect I felt about 2 months better. after 8 I was about a year and a half better. so I mean you have to do a decent amount of them if your treating something severe. the first 8 I did I just had mild memory problems mainly just with normal functioning and remembering things that quickly subsided by the 5th ect. there was a lady on YouTube that couldn't function at all because of her memory problems. I seen you post in another post In which you already had the ects so I guess it's too late. in my experience ect works by increasing dopamine.

[mono]

Yes it is true I already had my ECT treatments and they were unsuccessful. I am left with some mild memory problems but it is nothing that really effects my level of functioning so I'm not too worried. It would seem over time my memory has improved anyway. I am on Effexor now and I seem to be responding, so things are looking up.

[mono]

Just a small update on this topic. I did go ahead with the ECT and had over 20 treatments before the doctor decided it wasn’t going to work.

I wanted to report that I did actually suffer from some fairly irritating memory issues and there were times where I could barely remember what I had done each day.

I wouldn’t ever do it again because I couldn’t imagine losing my memory like that if I had to keep doing ECT to continue feeling better. Sometimes I think the medical industry is geared to keep us unwell because of how damaging most of the available treatments can be.

What I have found helpful is meditation and the process of connecting to the inherently blissful nature of consciousness.