Minimal improvement from medications or ECT

My mother is 73 years old and has been suffering from depression since she was first hospitalized in her twenties. She has been placed on MAOs,tricyclics, ssris, the newer antidepressants, and even amphetamines. There would be either no improvement, some improvement for a few days or weeks after which the medications would stop working, or untenable side effects. ECT has been tried with either no or short lasting improvement. Are there any other options?  Thanks.

[HFHS MD-JM]

Tim,

   The vast majority of people suffering from depression respond to medications(70-80%) and ECT(80-90%).  Psychotherapy is also a very important adjunct.  It does appear that your mother has had various trials of medications and had ECT.  Without knowing specifics about your mothers case it is impossible to make further recommendations.  When one has a refractory case of depression resistant to the standard protocols then atypical approaches can be attempted.  I assume that augmentation of antidepressants has also been tried such as adding lithium, buspar or combining medications with different mechanism of actions(ie WEllbutrin and an SSRI).  It may also be helpful to have a second opinion to make sure that this in fact is depression and that there are no complicating or contributing factors such as medical illness.  Please speak with your mothers treating psychiatrist for further specific options.  

Sincerely,

HFHS MD-JM

Keywords:  Depression