IS ECT required?

[swathij]

i have been suffering from severe depression,using antidepressants for 3 months and recovered almost 80% but my doctor is insisting for ECT saying that i didnt recover completely, is it really required?

[swathij]

thanks a lot all of u for ur replies.

[Hensley258]

TMS was finnaly granted FDA approval in October 2008.

Looks like they finnaly have it prefected. I think the biggest issue with TMS was finding the exact area of the brain to target and the power setting used.

Looks like they have got it solved now and it is proving to be even more effective than ECT without any of the nasty side effects.

Problem now is that TMS is still in it's infancy and most doctors have not invested in this VERY expensive machine. It takes 30 sessions of TMS to produce a response. This is done outpatient and the person can go right back to work after every session.

The triple blind studies look good for it's efficacy. We shall see.

[ILADVOCATE]

Generally ECT causes short term memory loss but it can cause long term memory loss. I do know one person who stated it helped them but they had made repeat attempt to commit suicide and everything else had been tried. So as a treatment of last resort they might use it but you are not to that point yet. I personally never considered ECT but I almost went into a study for Trans Cranial Magnetic Stimulation before I recovered from schizoaffective disorder (with the experimental antipsychotic in Phase II FDA study glycine that I am on) but it was so experimental with each person they were targeting a different part of the brain for each person so at that point I opted out. Once that's better understood it looks like a procedure that may provide the help ECT does without the risk of long term cognitive confusion and memory loss. That's not to detract from the few people who needed it who had treatment refractory depression and were suicidal. But you are not at that point. You really need to go through all available anti-depressents if the current ones aren't helping and if they don't work obtain a consult to a mood disorders specialist to try anti-depressents that are approved medications but used off label for depression. The website "Depression Central" is an excellent resource and one that is run by a mood disorders specialist (albeit one I'm not associated with).
   Regardless you said "you recovered 80%". I'm not sure what that percentage means but it would indicate you are doing better and after only 3 months of being on an anti-depressent. Why would they consider it at that point? I noticed the country you live and I believe its more widely used there. Sometimes too frequently (in the U.S. there are strong regulations around its use). But I would suggest you explain that you do not feel its a neccessary option at this point and see how your recovery on the anti-depressents continues and if one doesn't work out try another because there are many available anti-depressents and many good options.

[Hensley258]

Don't do it!

You say that in 3 months of treatment that your about 80%?

That is damn good and DOES NOT WARRENT ECT!

DO NOT subject yourself to ECT unless you first know the facts.
ECT is not something that should be tried after only 3 months into someones treatment.

ECT should only be considered as an ABSOLUTE LAST RESORT.
I find it sad that after only 3 months of treatment and 80% recover that ANY doctor would advise ECT.

When years of even the most powerful medications fail to produce a response, then I can understand thinking about ECT. NEVER BEFORE THAT!

I don't even think ECT should EVER be allowed unless the patient has failed on a minimum of 12 different combinations of antidepressant therapy over many years.

There is a lot that this doctor is not telling you about ECT. Don't believe me just PM cookie. She can tell you all about ECT and her husband is not getting any better with it and his memory has been damaged also.

It is also important to keep in mind that many doctors and Psychiatrist get HUGE money for every patient they start on ECT.

This is a conflict of interest IMO and makes me trust it even less.

[LeftCoastChick]

As far as I've been told there are 5 types of depression, one of them being refractory depresion which means hard to treat. It takes time to find the right med too.  ECT isn't as bad as it used to be, it's far more effective and painless, as well the side effects are far less. I've contemplated it myself. I'm on a mood stabilizer, and I'm still not feeling 100%, but i was warned that depression may never fully lift. ECT will give your brain a quick boost and there are many positive studies regarding it.It's like boosting a stalled car engine.  I would do it in a second if I knew it would jolt my brain into some normalcy for a while. It's hard to get it here though.

[therese83]

It takes time to recover and most people still go up and down a bit, but less and less as the time progresses.  3 months is still very soon in the treatment.

What medicaiton did the Doc give you? Is he/she an experienced psychiatrist?  This is an important point.

There are other ways to improve, like my Docor gave me a low dose anti psychotic which helped greatly to get me 'right' along with the anti depressant.  I do not think that ECT is first line treatment?