ECT

As I live in the UK where ECT is still widely used I wanted to ask anyone out there if it is used in America and how their mood was after receiving ECT. Thank you

[ILADVOCATE]

I know some people who have had long term memory loss from it (which is rare although short term memory loss is common) as well as one person who said it brought them out of a suicidal depression. It is used in cases of extreme treatment refractory depression. More of interest including to yourself is a procedure called trans cranial magnetic stimulation which appears to have less long term side effects than ECT and is effective. If this question is just out of interest that's what I can provide you with but if you or someone you know is considering ECT and really needs it (basically all known anti-depressents have failed and they are experiencing severe depression) I wouldn't talk a person out of it but I'd suggest finding out if that alternative is available in the U.K., even in study as it has less potential long term residual effects.

[therese83]

My father had two courses in the UK, (there are some UK people on this site)

It saved his life completely.  It worked very effectively for him, he was psychotic from schizophrenia, with a later diagnoses of bipolar added on top.

My mother saw it completely work for him, he was so much better after it and there is no point in aking if he had short term memory loss as in the preceeding weeks he didnt know who he was.

He did not have any long tem memory loss.

The only thing was that during the course as he started to improve he was afraid of it, which is a pity as it really helped him.  Maybe it was more primitive then?

Hope this helps

[ILADVOCATE]

Well that's complex. I wouldn't detract from your father's recovery but in the United States ECT is used only for treatment refractory depression. Treatment refractory schizophrenia if multiple antipsychotics don't work is usually treated with Clozaril. Of course your father may been given ECT before Clozaril existed or not responded to Clozaril or been ruled out as a candidate for it because of its severe side effects. As for people who have treatment refractory schizophrenia who don't respond to Clozaril I know about them. I am one. I was started on the experimental antipsychotic glycine in FDA study and I am documented as having made a full recovery. Glycine is a glutamate antagonist, a new form of antipsychotic in Phase II FDA study that will not cause tardive dyskinesia (which I have in advanced form from previous antipsychotics) or diabetes. A major provider agency will be making a statement about its incorporation as an adjunct antipsychotic (I am the first person to recovery with it as a primary antipsychotic) into psychiatric treatment. My case study will be published in a psychiatric journal online and I will make the results available. For the official study google "Dr. Javitt, glycine".
  If you are speaking about treatment refractory depression especially with suicidal ideations, that's one issue. But for treatment refractory schizophrenia, there are other options than ECT. I always feel a medication or even experimental treatment is better than what in some ways is an invasive procedure. You did the best for your father with what was available. But there are better options now and Clozaril has been proven to help on treatment refractory schizophrenia including on suicidal ideations. And the glutamate antagonists will be the treatment of the future. And I will print any of this information once its in the public domain or pm it to people as needed.

[LeftCoastChick]

ECT can be extremely helpful to many, not all though, but if I was in a position where that was a choice I would take it.  A woman in my support group had been hospitalized for 3 months and had 12  sessions done, it would work for her for 3-4 days then she would slip again, but that is a small percentage. I have a man in my support group that had 2 ECT's and he said it was a miracle, the meds worked after that, and he felt like a human being again. It's like restarting a brain, a jumpstart per se. I'm in Canada btw, and the guidelines for ECT have drastically changed as in the US , and it's a very humane treatment. Sometimes meds just don't work.

[ILADVOCATE]

Just curious though. In the United States ECT is indicated for treatment refractory depression. I haven't heard of any current usages of it in the United States for treatment refractory psychosis. Is it used in Canada for that? As for trans-cranial magnetic stimulation that's an FDA approved procedure now that is being used for psychosis. I think one drawback with ECT is that it needs to be done repeatedly or it wears off and with trans cranial magnetic stimulation the same thing. That's a given.
   I had posted I almost considered TCMS but because they didn't know what area of the brain to target as it was still in study at the time ruled it out but now that its approved and a known quantity if I were in the shape I was in then I would undergo it. ECT is complex because in some people it creates long term memory loss and although its not the rule its common enough to be more than a statistic and of concern. That has not happenned with TCMS but of course its not been in usage for as long but it didn't come up in any studies. However, now that its a FDA approved procedure (thus "safe and effective") if I had to chose I would pick that over ECT although I don't know its approval status worldwide but the FDA is fairly strict and some medications and procedures that the FDA doesn't approve get approved elsewhere but I haven't heard of the opposite happenning. And I know I sometimes post about things that are heavily experimental but this result for TCMS is from a source I think anyone could identify as factual and there are plenty of clinically confirmed results as well online:
http://www.nami.org/Content/ContentGroups/Helpline1/Transcranial_Magnetic_Stimulation_(rTMS).htm

[JaniceRuth]

Hi, thanks for your comments.
I have actually had ECT in the UK.  My question was more to do with how it was seen in the United States and other Countries.  It has a mixed bag of opinions in the UK and it seems in other countries as well.

Personally it was great for me.  I was extremely depressed and hospitalised at the time I received it.  No medication was working and my mood was so low that I would not get out of my hospital bed.  I spent 24/7 laid in bed.  I don't really remember agreeing to ECT as I was so ill but I must have signed the consent forms.  I can just vaguely remember going down for the treatment.  However, after around 12 sessions I was greatly improved and released from hospital.  I have not been hospitalised since although I have continued to suffer with depression on and off but not as extreme.

For some people it works, I have talked to other people who have received this treatment and they swear by it, whilst others think it is totally barbaric and should be stopped altogether.

My feeling is.  If it works, and it did for me, then I'm happy to give anything a go that improves a condition that can often be so debilitating.

Thanks again for your comments.

Janice

[therese83]

Yes I didnt mention my father's treatment was 40 years ago, maybe there was no clozaril then.

[Hensley258]

Here in the States it is also used. It's not that uncomon here.

Generally it is reserved for people that are Refractory and have not responded fully to even MAOI, but Psychiatrist will offer it here to even less severe sufferers.

I don't think it's barbaric. Severe treatment resistant depression is barbaric.

I have actually considered ECT for myself as my condition is very refractory like yours.
I just couldn't find enough people that said it really helped for me to take the plunge.

ECT is one of these things that either works or it makes people even worse. It's almost like there is no in between with it. This fact scares me about ECT.

It could be a life saver for me or it could be the death of me. No way to tell until one tries.

I must say that your are one of only a few I have heard from that have benifited from it.
Most I talk to that have had several round sof ECT, always say "NO DON'T DO IT!!!"

So I guess in the end all my research into ECT has ended up a dead end. I just can't get any consistant feedback on if it would work for me.

Therfore I keep on the medication band wagon in hopes that something better will come along. "sigh" it is a daily struggle of monumental torment.

I am very happy that you did get results from ECT. It's nice to hear a positive about the proceedure. Gives me hope ya know.

I have been in regular contact with a suffer much like us that is currently in ECT treatment. Unfortunatly he didn't take it well and is even worse now. This scares me which is why I just couldn't do it. At least not yet anyway.

There is a very new FDA approved treatment called Transcrainial Magnetic Stimulation. It was finnaly approved by the FDA just one month ago. The triple blind studies show it to be just as effective as ECT, but completly without any of the invasive side effects and risks of ECT. No anistesia is required and it does not work by inducing a Grand Maul Sezure like ECT.

It looks very promising to replace ECT, but only time will tell just how effective it really is.
Currently the actual machine to perform the proceedure is very new and most Psychiatrist have not yet jumped on the bad wagon and invested in the $500,000 Device.

It is a pretty elaborate machine and I'm not even sure if any insurance companies will cover it's cost. It is done in the Psychiatrist office in a series of 30 sessions that take 30 Minutes each.

This will have to become a real cash cow for Psychiatrist to even make the initial investment so I expect it will be a year or two before it is avalible in most large city practices.

[ILADVOCATE]

As for TCMS I feel that cost should never be a factor in treatment unless its something like brand vs. generic. I remember when I temporarily had no coverage my physician prescribed a different antibiotic that was much cheaper but could potentially make me nauseous but had no dangerous effects. I put up with it. On the other hand if it was a matter of ECT vs. TCMS I would certainly choose TCMS. The issue isn't whether psychiatrists would want to use it because if a new procedure is safer and just as effective then surely they will as most psychiatrists don't perform ECT anyway, just specialists in the field. But if its a matter of insurance coverage then the more important issue is not whether it can be covered overall but whether it can in an appeal. I won my appeal of the Zofran for Medicare Part D. It was "off label" which they generally don't cover but because it was for a life threatening disorder (I've discussed that the tardive dyskinesia in me had advanced towards respiratory spasms) they approved the exemption.
  I can't think of any psychiatric disability more life threatening than treatment refractory depression with a person with suicidal tendencies and if TCMS is safer than it should be covered just as much as ECT. The essential matter though if the various forms of coverage will not cover it under any circumstances and now that its FDA approved that's unlikely. I guess they will have to do a head to head study of the two procedures which would be a Phase 4 study and I'm sure that will be done. Right now I know that Medicaid which can pay for supplements will not pay for my glycine. On the other my psychopharmocologist informed me that once the case study is published that its worth appealing and I intend to. I trust psychiatrists overall. I do not trust the insurance industry. And they sometimes clash. But as for TCMS what has to happen to kick start it is people who undergo the procedure and have made a good recovery and not experienced long term effects need to testify about it. The more public awareness there is, the more likelihood of it being used more as psychiatrists become more familiar with it and insurance companies having to conceed and provide coverage. Worked the same with any other procedure. I personally know someone who testified before the FDA for Orap to remain on the market under the Orphan Drug Act when it was the only known treatment for Tourrette's Syndrome. And thanks to his work it did.

[JaniceRuth]

Hi
Thanks again for your comments.  ECT is I believe entirely down to an individual.  I wonder if I had really been aware of what was happening at the time if I would have agreed to this treatment - who can say.  Everyone has to make up their own minds!  There is good and bad in all treatments, some work for some and visa versa.  Given the same set of circumstances again and the fact that it worked for me I would like to think I would say yes to ECT again.

Reading your comments on medicare etc makes me thankful that here in the UK we have the National Health Service, where everyone, no matter whether they are rich or poor is entitled to exactly the same treatment and options.  

Good luck all.