15 replies to this topic

[StrangeAeons]

So I know I've started several topics regarding my various "issues", but I think it would be nice to compile a list of medical treatments (specifically those only available through the prescription or referral of a doctor) for mood disorders refractory to normal psychiatric protocol. For the record, I have been diagnosed a great deal of things over the years and do not care to go into the details.
The general idea is to have a list of less-than-conventional medical treatments for people seeking help to suggest to an open-minded but scientific doctor. There are a great number of lifestyle changes and supplements that can also be implemented in a mental health treatment protocol, as well as psychotherapy; but I do not wish to focus on these factors. For all intents and purposes I am refractory to psychotherapy right now.
I've also left the category of "mood disorders" vague because, well, let's face it: there is no legitimate and scientifically verified model of pathophysiology for mood disorders wherein a discretely physiological feature unilaterally manifests as a specific mood disorder. I would appreciate it if any broad sweeping statements about a neurotransmitter level directly correlating to a mood disorder be avoided.
Here are a few things I have in mind:

• Low dose ketamine IV infusions have in some studies shown dramatic improvement for refractory major depression. The mechanism is theorized to occur via AMPA glutamatergic activity secondary to NMDA antagonism, but I'm skeptical. Still, in certain cases this appears to have made a dramatic difference.
• Low dose naltrexone protocols have been implemented for autoimmune disorders and certain cancers because the upregulation of endorphin activity is theorized to have immunogenic properties (I believe the model is a shift from Th1 activity to Th2, but I'm sketchy on this.) This would appear to both work via the inflammatory theories of mood disorders now surfacing, as well as via endorphins themselves for treatment of anxiety and anhedonia. Surprisingly, I have found little to no research on the use of LDN for mental health problems.
• Transcranial magnetic stimulation is FDA approved for unipolar depression, and it appears to function as a much less deleterious alternative to electroconvulsive therapy. The disadvantage is that you need to live near a treatment center, as the protocols I have seen call for weeks of consecutive daily sessions.
• MAOI's are avoided by doctors due to the dreaded cheese effect; foods rich in an enzyme called tyramine cannot be metabolized and subsequently induce a potentially fatal hypertensive crisis; though MAOI's are substantially less selective and more dangerous than current antidepressants, they are clearly effective and especially hold promise for atypical and refractory depression. This is of particular personal interest to me because the neuropsychologist who conducted my testing a year ago noted that he had only one case in his career similar to mine, and that this patient responded very well to MAOI's (a little too well to begin with, the dose had to be tapered down due to hypomania). My last psychiatrist dismissed the idea out of hand for vague reasons and I believe insinuated that he wouldn't do it because of sexual side effects.
• The emerging class of D1 dopamine agonists have fascinated me and I believe may yield enormous potential in the field of mental health. The specifc nature of the benefit, however, is somewhat difficult to surmise at this time. Sadly, the prototype drug of this class, dihydrexidine, has been around for a very long time and has been intermittently neglected due to its being difficult to manufacture; however, new chemical synthesis methods have been subsequently discovered. Additionally, computational modeling of structural-activity relationships has paved the way for development of agonistic ligands of this receptor with more favorable commercial and pharmacological profiles. It will be some years before a drug of this type hits the market, but I anticipate it will make a major impact on psychotropic medications; so I suppose this is less of a suggestion for current therapy and more of a suggestion to keep your eyes peeled.

Well, that's all I can think of for now, and I would appreciate input on what you think of these ideas, as well as any others that you know of.

[yoyo]

heh. you're hardly treatment refractory if you haven't tried an MAOI.

sexual problems from partnate have been much less than from any sri.

[bgwithadd]

Don' count out ECT for depression. It has a bad rap, but the form used today is nothing like in the 1800s. I don't think even one person has had their brain fried on the newer form that only zaps certain areas. It's been available since the 50s I think, but the other form was still used anyway for a long time. For depression, not much works better, and you don't get any other side effects aside from some possible memory loss of stuff right before each session. The wiki article on it dispells a lot of misconceptions. Over a million people use it regularly.

MAOIs also shouldn't be considered an outlandish alternative, either. For all the panic, they have a lot fewer side effects than most antidepressants and only a small number of people ever get a hypertensive crisis at all from them, let alone die. You could always carry a calcium channel blocker with you in case of emergeny and if you're not an idiot it should be easy to avoid any truly large dose tyramine stuff (stay away from cough syrup!). Using deprenyl for MAO-I would likely have good results, though it's not widely tested at high doses. There's also emsam, which should not need dietary restrictions because it doesn't enter throught he gut. After trying PEA, I don't see how it's possible to be depressed on high dose MAO-B inhibitor. Should also help with ADDlike symptoms a lot. My guess is more drugs along this vein are on the way. Usually when people don't respond to tricyclics or ssris they respond well to MAO-I and the reason is probably due to low phenylethylamine/high MAO-B levels.

Also, don't rule out lithium. You don't have to take so much that it blots out your emotions, your dose can be adjusted. The dangers here are almost as overstated as with MAOIs - only people on extreme doses usually have any real trouble. Some people are on 2000mg a day. You could probably get a lot of antidepressant effect at 300mg a day of lithium bicarbonate, and you'd have virtually no chance of danger at that level - probably not even any side effects.



I'd take traditional stims over some new dopamine agonist, though. The devil you know and all that, especially since dopamine receptors seem so fragile. I'm also not particularly sure why people are so into the idea of ampa stimulators like modafinil unless you have narcolepsy.

You can also try PDE4 inhibitor or forskolin to up your cAMP, which can help a lot with depression. Avena sativa seems to have some good effects for me on both concentration and mood (also with vasodilation).

There's also kanna, which seems to have a sort of unique mode of action. It's listed as an SSRI on wikipedia but its effects sound more like a stimulant or mao-b inhibitor. Maybe like nicotine except with vasodilation instead of vasoconstriction. I'd not be surprised if it hit some of the nicotinic acetylcholine receptors. I'd like to try it, but it seems to be kind of expensive and I have so many other things in my system I don't think I need to be carefula bout adding stuff.

You can also try beta blockers or especially guanfacine to reduce anxiety and clear up your thoughts (guanfacine works great for me as far as anxiety goes and is also supposed to be effective for ADD symptoms). It does more than that, though, and its benefit is that it should work whatever your ailment is - whether it's ADD, depression, bipolar, or schizophrenia or 'other'. The problem with all this mood stuff is it's very difficult to definitively say exactly what someone has and especially with ADD and bipolar they are just blanket labels that probably can be caused by a hundred different issues - any of which you could have more than one of and can overlap the others.

There's also low dose ecstasy and low dose hallucinogenics to consider. Even low dose opioids. Not approved uses, but you are asking for the desperation level solutions. At low doses there should be no real health issues or psychadelic effects. You could make your own psilocybin or opium poppies, and even MDMA. I'd not be surprised if 'disphoric' kappa opioid receptors agonists at low doses had a big positive effect on people at LOW doses. Salvia uses that method of actiona nd is legal, but it would be difficult to find it in any kind of form to get low concentrations, though I think it comes in oral decoctions.

In the same vein, you can try acacia rigidula extract. It has a lot of ethylamines that are similar to MDMA, meth, amphetamine, PEA, mescaline, etc. but is legal. None of them have been isolated and widely used but it seems to have a stimulant effect and it probably has some other effects on mood that may be positive in low doses.

[OneScrewLoose]

I will be trying LDN in the next few days for autoimmune issues and treatment-resistant anxiety. I'll tell you how that goes.

[StrangeAeons]

Probably going to start MAOI's within the next few weeks. Parnate (tranylcypromine) looks to be the most favorable among them to me, though I suppose the distinction is minimal within the different class. Also, here's why modern psychiatrists suck:

Of more than 400 psychiatrists surveyed
in 2000, 93 percent indicated
that SSRIs were their first-line treatment
preference (36). Respondents
perceived that SSRIs were more effective
than tricyclics and MAOIs,
even for severe depression. In another
provider survey, even when asked
to switch medications for patients
whose illness was refractory to an adequate
trial of an SSRI, most clinicians
chose to use newer antidepressants;
only 10 percent chose a tricyclic and 1
percent chose an MAOI (37).

Talk about banging your head against a wall.

Edited by StrangeAeons, 14 July 2009 - 12:41 AM.

[Boondock]

Talk about banging your head against a wall.

Absolutely. But then, if they keep prescribing the SSRIs they get invited to such nice all-expenses lunches, don't they?

It sounds like you've done the right thing by grabbing the bull by the horns and doing the research yourself. Best of luck with the MAOIs.

[accurate_atheist]

Ah I always wanted to be register at this site, once I was a scientist who researched aging, even lef, used to take a lot of drugs named here, today I have PTSD, OCD, paranoid delusions (of course major depression with epilepsy) Don't rule out Selegiline(L-Deprenyl) - it slowly builds up energy, plus finding libido + more antioxidant enzymes and life extension, However I think one should dose by age, in the 25-45 yrs maybe 1-2mg 3 times a week, 45+ may be daily and 60+ may be 5mg daily. It has desmethyl and L-amphetamine and L-Meth metabolites so go slow. I'm in the first group and have refractory depression. People taking estrogens DRAMATICALLY INCREASE BIO-AVAILABILITY , EVEN TO A POINT THAT MAO-B SELECTIVITY IS LOST- so be careful about that. As a teenager I had once forged a strip of nitrazepam (now a date rape drug), in the 22 yrs that followed I haven't felt or slept the same. Let's forget psych wards. Latest was 14 day coma in a hospital where I crashed and burnt due to benzo, opiate, amphetamines(basically all illicit stuff including ketamine- the dosages become more and more trust me) and I blame it on those "non-benzo" hypnotics of the Ambien kind, don't use them prolonged, there's no study, we don't really know why Ambien causes euphoria. The best doctor in the state saved my life (clinically dead with convulsions for a few hrs) and he withdrew anti-epileptics and haloperidol and put me on 40mg Prozac, 50mg Zoloft, 50mg Elavil, 30mg Remeron and Lorazepam and Fluxanol. He (83 yrs old) said you can self-medicate by valproate and/or lithium and if you use Selegiline not more than 5mg a week, bur remember that drugs used to treat BIPOLAR DISORDER ARE MEANT MORE FOR BIPOIAR MANIA THAN BIPOLAR DEPRESSION EXCEPT LAMICTAL- and I still have sleep issues, BY EXPERIENCE I KNOW THAT YOU BECOME OVER-SENSITIVE TO MELATONIN DURING MAJOR DEPRESSION, so even 300mcg can work. I've read sites that say Paxil has made their loved one into zombies and led them into divorce. I think they forget EACH SSRI HAS A DISTINCT PHARMACOLOGICAL PROFILE, they'r taking too far, it's a really bad idea to stop antideps suddenly, people may have a genuine problem of altered neurotransmitters and need that stuff, doing Paxil or Remeron doesn't mean it's a cult of crack userTalk to your doc about LAMOTRIGINE - it really really has an impact. To an extent withdrawing antideps, don't suffer cold-turkeys for nothing, I haven't invented this - Make a syrup of say 100/250 ml drug, say 10mg/5ml, everyday take 1 or 2 tsp as you need, just after use make it upto 100/250ml after use, shake well , use vitamin colors and if another person you trust can give you the drug, even better. YOU'LL ONE DAY HAVE ALMOST NO MOLECULES OF THE DRUG - MANIPULATE THE PRINCIPLE yourself, I've withdrawn even illicit stuff this way. To an extent my depression is getting better.

[accurate_atheist]

This is my experience with life long depression and antidepressants(ADs), if you think a drug works real I think we can name it in this forum. Do forgive spell and typos.What I feel- If you have a refractory depression, Please give any antidepressant enough time to work. Effexor XR for example alleviates depression in 4-8wks but my sleep became better in 10-18 wks. Though we have strived for a quicker acting AD, I think we're not that successful. Of course an anxiolytic addictive drug works at once but there are pros and cons, tramadol or dirty harry opiates can't be you're friends that'll be so for a decade. Although taking Effexor 225mg (above 150 Noradrenaline effects join in Serotonergic ones, above 375 also dopaminergic, but this I can't tolerate like many others), a 25mg sertraline I can't withdraw causing vertigo and tinnitus. If you have a good doc you'll know that Lithium and Valproate (or topiramate, phenytoin ,pregabalin, carbamezapine or oxa derivative, gabapentin) are really meant for bipolar manic rather than bipolar depression. There is an exception- Lamictal can work miracles. Low dose anti psychotics that feel good are Amisulpiride(solian), sulpiride and Ziprasidone. I'm rather against using non-benzo hypnotics like Ambien, Lunesta - they cause a rebound agitation and insomnia. For sleep amitriptyline(5-25mg), Doxepin (10mg), Mirtazapine(7.5-15mg), Trazodone (25mg) though the last can cause agitation due to a serotonin agonist metabolite mCPP. Benzo's clonazepam, lorazepam seem to provide sleep in anxiety, shorter acting ones cause more rebound you know. Xanax and Frisium are relatively anxiolytics without toomuch sedation. Antihistamines the Benadyl/Unisom or Hydroxyzine(Atarax) cause unrestful sleep somewhat like alcohol. Talking of augmentation Buspirone and another 5HT2 and D2 partial agonist Ablify works pretty well, Flupenthixol also shows benefit in a week. Low dose Theoril(not Chlorproazine/Thorazine) isn't too bad. Olanzapine is against bipolar mania, high dosages of Quetiapine are mood darkening. I have not found Risperidone to be much useful. Olanzapine once precipitated Neuroleptic Malignant Syndrome(I was using Cloimipramine and Fluoxetine as prescribed) Clozapine has little data on long term benefits, however, trust me, an overlooked antihistamine serotonin antagonist has a similar receptor profile, it's the appetizer Cyproheptadine. It's anti-ACTH too. Theanine is difficult to obtain, but good old Ginkgo, Kava help by increasing noradrenaline. St. Johns wort combines a weak MAOI with uptake inhibition, severe depression I feel responds more to TCA (Many TCA's like Trimipramine are no longer used as is the tetracyclic anxiolytic antidep Mianserin)and sometimes TCA + MAOI(but be very careful, Cloimipramine cannot be used it's a very strong SSRI). Fluoxetine has a very long half life, 5HT2C antagonist and some effects on DA and NE release, Fluvoxamine works well in OCD though it's a rather "pure SSRI", decreases melatonin clearance as does Paxil, Celexa and Cipralex. Paroxetine has anticholinergic effects and particularly hard to withdraw, but it's a quick help for mixed anxiety depression. Sertraline has substansial dopaminergic uptake inhibition used as monotherapy around 200mg a day. Below 150mg Venlafaxine is more or less an SSRI. Paxil and Citalopram(and S isomer) are substrates of the Pgp enzyme that uptakes them into the brain. Celexa and Cipralex gives a quicker relief of Panic disorder. EACH SSRI IS DIFFER IN THEIR PHARMACOLOGY. I cannot tolerate long term Bupropion, the GI effects don't go away, nefazodone is not sold here. Tianeptine (Stablon) is rather mysterious in the way it works, I never have given it the long trial I have given Prozac or Paxil(mechanistic opposites). Moclobemide is a good reversible MAO-A but you cannot mix SSRI's if you still fear death. Duloxetine (Cymbalta) >=60mg is a balanced SSRI and NARI, it too takes sometime to work.Reboxitene(>4mg) work's well in diminshed energy espicially the latter brightens mood like Atomexitine (NARI) and is not abused like Ritalin as the former doesn't fiddle with dopamine much. I feel sensitivity to melatonin really increases during MDD, when I had to take 6mg, only 300mcg decreases my sleep latency. Never forego a chance to have a low dose (even 5mg a week) Selegiline, it builds up a desmethyl and L-amph and L-meth metabolites(The D-meth is the dreaded crystal). Using estrogens dramatically increases bio-availability of some antideps so tell this to doc. Deprenyl (selegiline) even in doses that are not MAOI-B inhibiting increases DA release, upregulates antioxidant enzyme production, increases libido and numerous studies show it can extend lifespan. Modafinil generally feels well but it has a huge addiction prob (see below)

Internet Forums about AD-what some feel- A 22 yr old girl, married 3 yrs and 6 months pregnant suddenly thinks her husband hates her and the baby and has relations with other women. He has become a cruel monster, once she had madly loved him, now she wants yet cannot divorce. So she thinks it's ALL due to the SSRI he takes and once that can be withdrawn all will be well. So she documents how she imparts(cruel and unusual punishment to me) a dose reduction of 0.1mg each day from 20mg to 0. I suggested that discontn of SSRIs without medical advice often causes relapse of depression and anxiety, maybe "Remeron" or "Serzone" or a drug that (though > 15 million take even me, I still love mama) she finds not so zombifying should be used. She complains to the forum moderator to cancel my registration (moderator thinks since it's an anti-antideps site my views are pro-Prozac) , I'm happy that I know who's really going psycho! but I'll be restrained giving views to unscientific people.

Personal experience- An 23 yr old girl had been prescribed Modafinil 200mg/day to help refractory depression(with Cymbalta 60mg). She had just got her 1st story book published and had come to invite for a party. The party went well and she danced on the table, but what surprised us were she threw off her clothes during the dance. She admitted taking 2000mg modafinil, reminds me of many modafinil ab/over users this site. It's like having alcohol and Valium and jumping on the bed not to sleep, it's bad, you are releasing 5HT, NA and DA and increasing their turnover but you ain't increasing their production, so one day you have used up all those transmitters and you'll crash and burn with a refractory depression.

[StrangeAeons]

Okay, firstly, I recommend you consider more cohesive sentence structure and better formatting. No offense, but your posts are a bit of an eyesore to read. Secondly, you're going a million miles a minute in your posts, and a great deal of it is actually redundant information that could be stated more succinctly without quoting a lot of anecdotes. I don't give anecdotal evidence any credibility on this forum unless it's something truly remarkable-- and even then I merely take it under consideration.

I have given all the drugs I've taken a fair trial, with perhaps one or two exceptions. I have tried selegiline, I have tried Paxil, I have tried Modafinil, I have tried duloxetine, I have tried lamotrigine... and plenty others; actually most of the one's you've mentioned in your rambling posts. The profiles of SSRI's may be somewhat distinct, but the distinction between the SSRI's is rather minimal relative to the difference between any of them and something like MAOI's, ECT, or Ketamine infusions. We're talking about radical differences in mechanism and degree of response rather than simply more favorable profiles in between mood disorders of similar severity.

I don't care for selegiline, it doesn't help me and it isn't relevant. It's not indicated for mood disorders except as EMSAM, and is primarily effective at doses where it loses even MAO-B selectivity.
I take little stock in herbals. What little data there is on them doesn't really suggest they're superior to even the front-line antidepressants, so there's little reason to believe they'd be effective in a refractory case.

You must understand, there are a million things that might work, but seeing as I've already gone through a pretty hefty quantity of these, I have to have reason to believe that they should work. Classical MAOI's are the best option in this regard, followed by ECT. Being cautious of ECT, new or no, I intend to try some sort of augmentation with MAOI's first, then proceed to things like LDN, then IV ketamine, then TMS. After that is ECT, and finally if that fails we go on to ibogaine; but I have a hard time believing I'll have to move beyond MAOI augmentation, probably with Provigil or Mirapex.

[accurate_atheist]

This quiz is not for minors>That's it I quit, I'm gonna unregister because life is short to hassled by you. You don't even know I'm a boy or a girl let alone age that you're being critical, what do you know about sentence and grammar that my openoffice package word doesn't know already.If I wanted to know more of english I'll take a GRE. This makes me feel even worse, there are millions of depression sites to join to feel good. I'm not lucky enough for bipolar that I'll have mood swings like you. I'll end with a "it's not you, it's me" theme. It's a quiz called USE YOUR HEAD TO PREVENT DEMENTIA- IT'S ABOUT GUESSING WHO I AM FROM 20 QUESTIONS
1> What's my name? I Decline say, you'll google and find out
2>Sex: Take a Guess
3>Marital Status: Single (can be divorced or a widow)
4>Can I write in English-many say so
5>Have I tried killing meself?- Several times
6> How did I try?> IV alcoholic barbiturate (240mg) with 120mg clonazepam and 500mg opiates.
7>Have I been to asylums and why?- For Poly substance abuse
8>What drug feels good? I'd say dirty Harry and codeine. IV Ketamine is best for hallucinations, it's way past LSD, with that you atleast know it's party.
9>What did I hate there[in asylums]? Nurses hold sadistic contests about incest to body hair.
10>What have I learnt from suicidal attempts?- I'm rather difficult to kill, I'll need more stuff next time
11>How am I ill? I think inherited, mom had ulcers and never slept, post menopause, 200md Sertraline and 75mg Doxepin a day by the same doctor who saved my life. Father is suicidal, I've attempted killing many people
12>Do I write stories- Yes
13>Are any writing works published- Yes in NY
14>What happened onlast suicidal attempt? Became paranoid delusional, ER put me on Phenytoin,Procyclidine, halpoperidol,propranolol- that good doctor stabilised me saying I'm not psychotic, it's just depression, so take Prozac 40mg, Flupenthixol 0.5mg, Mirtazapine 45mg, Lorazepam 4mg, Amitriptyline 50mg and Doxepin 25mg, Sertraline 50mg
15>Has anything improved- Yes last 6months I never tried to kill me
16>Plot of published story-(can't give away the name else you'll google) A very bright girl in a stoically drab portrait becomes an addict before she spirals into despair in a trailer park from age 13 to 26. Won First work award , internet awards are basically useless
17>How many stories? Anthology of a dozen on the net, writimg "paper boats" now.
18>Do I feel abused? Very much and mononcle (my uncle) took over our residence and threw us out. Being poor or rich doesn't mean you'll live short.
19>What does doc say I have? Clinical major refractory depression lasting nearly 20 yrs. Nothing else
20> Plot of another story(can't give away name as usual)> A thirties girl 'M' gets fed up with her life as a part-time marijuana seller and poet. One day police finds her in a room with walls filled with odd rhymes "Eat me frozen, eat me hot, eat me swelling with desire, eat me lukewarm" In an ER they can't locate a vein to draw blood so she suddenly pierces her chest with the syringe to draw blood and sings "Don't try this at home."

[thisismadness]

re. ketamine injections for anti-depression.
the k drips into you at a particular rate for 30 min.
5 treatments cost 2500. Administered by an anaesthesiologist so that's why its costly. I've had two so far --the first did nada. [By 'did nada' I mean after the dose wore off--during the dose is pleasant.] With the second it's quite possible that something has shifted for the better. I'm cautiously optimistic for the rest. Evidence: daily spontaneous crying has not occurred since the second treatment.

[StrangeAeons]

I'm going to ignore the inane postings of the guy with English as a secondary language because they're not remotely pertinent, cohesive, or even fair. Bipolar? Really? Thanks for coming on my thread, reprimanding me because "I don't know you" and then positing a diagnosis.
As per the ketamine, thanks for the info; I hope you get better, and if you've gotten even a marginal benefit at less than halfway through I think cautious optimism is fair. Interestingly enough my father's an anesthesiologist, though he would never in a million years treat me. This is rather unfortunate, but I've asked about prescriptions before and he's been rather adamant in spite of it being clear that I've both done my research and that the doctors treating me are stumped.
Regardless, this thread is no longer pertinent to me because I can finally state with a fair degree of certainty that I have established a mechanism for my woes, that being perinatal iron deficiency. I am finally secure in asserting this after seeing my gastroenterologist on Friday, who acknowledged that I probably have some sort of congenitally impaired absorption of iron.

[alexd]

I am bipolar two. It took a while for me to find medicnes that work. Currently

Modafinal 50mg daily in two parts.
Wellbutrin xl 150mg
Deplin 7.5 mg
NAC N Acetyl Cysteine.

The Deplin is interesting and I suggest you google it. It is l methylfolate. Turns out there are people who to very degrees have difficulty digesting folic. Insufficent amounts of the final step which is l methyfolate, results in limited response to many anti depressents. For me it allowed me to cut the amounts of medications in half. I was surprised that it worked. It is a Glaxo product.

I found out about the NAC due to finding a test that indicated that it was helpfull with people suffering from bipolar depression. It really leveled things out. I take 600mg a day. Do not open a capsule and put under tongue. It is a sulphur compound and and tastes hideous.

Provigil works well for me . I take very low doses. I probably would like to increase the dosage by about 20% but the stuff is pricey. Nuvigil the new isomer from Cephalon does last longer but after about a week or so I started to rapid cycle quite a bit. I really like the intitial intensity it kicks in with but at least for me it is wrong.

About 3 gms of fish oil.
s as distantly close as I can get.


Two caps of Baracopa which afte a period of 4 weeks does seem to help memory. I noticed when I stopped taking it.

Lamictal was great calm as can be and I had a photographic memory. Unfortunately I am allergic to it. It was enough in itself and outside of that what I take now is as good as it has gotton. Good luck.

Edited by alexd, 06 September 2009 - 02:58 AM.

[castrensis]

Transcranial magnetic stimulation is a decent option if pharmaceuticals fail to treat depression. I actually have a friend who goes for regular ECT sessions for her refractory mood disorder with good results & tolerance of the procedure. Cranial Electrotherapy Stimulation (CES) is also FDA approved for the treatment of anxiety, depression & insomnia & involves microcurrents of electricity rather than the big shot of juice ECT gives every couple weeks; Alpha-Stim is the only device I'm aware of that is manufactured for this purpose. I think the coolest option, by far, is Vagal Nerve Stimulation therapy initially used for refractory epilepsy (& much preferable to severing the corpus callosum!) but is FDA approved as a treatment for refractory depression.

Just an FYI for folks checking this thread for alternative options.

Edited by castrensis, 06 September 2009 - 03:49 AM.

[Ben]

who acknowledged that I probably have some sort of congenitally impaired absorption of iron.

Have you had any luck with the iron interventions, if you've had any?

[StrangeAeons]

I had parenteral iron infusions and my labs are now back in a reasonable range, though serum Fe is still on the lowish end. The repletion was useless for mood; the damage down by iron deficiency that early on in life is not reversed by iron repletion.

Don't get me wrong, I want this thread to stay open for everybody else to discuss their knowledge and experience, but I believe in my particular case it's somewhat less pertinent.

On another note, I think Deplin is a really interesting treatment, and it's a shame that it's patented because it would terrific if there were a cheap supplement that could also reduce the cost of antidepressants by lowering the dosage. I'm glad you've found a cocktail that works for you, and it's a reminder that often times it's not any one thing that will do the trick.
Castrenesis, it's good to hear that ECT can be effective nowadays without side effects and I've heard a lot about how modern ECT is much more advanced; CES sounds like an especially cool offshoot of this method, and though I'm not familiar with it I'm inclined to think it would be more effective than TMS. Vagal nerve stims are definitely cool, but per my (limited) understanding it's really only effective for unipolar depression.