Posted by JahL on July 13, 2005, at 16:59:44
In reply to Re: Opioids as a treatment of last resort - Metyrapone » JahL, posted by ed_uk on July 13, 2005, at 15:00:48
> May I ask.......what was your experience with ECT? I think you said you 'forgot who you were' for a while....or something to that effect.
Hi Ed. Thanks for your interest.
To be honest, the deterioration caused by the ECT is responsible for my present suicidal status. I've had suicidal ideation since childhood and so I'm used to it, but post-ECT, it's near overwhelming.
I think there are two factors responsible for the worsening. Firstly, I had an extra long course (14+ treatments), which seems to have knocked my brain out of kilter. I had initially shown some improvement - the reason behind our perseverance - but it was transient and eventually we had to stop chasing that temporary high. I was in pieces.
Secondly, the course disrupted my Lamotrigene regimen because obviously I couldn't take it on the days I received ECT treatment. By the end of the course, my 400mg dose no longer worked properly. I have gone up to 600mg, but have never been able to recapture the same degree of efficacy. Lamotrigene is my lifeline - as it appears to be for many with Bipolar depression (my baby brother included) - and I need it to work just to function.
On this point I have noticed an interesting phenomenon, if you're interested. It seems that Lamotrigene can exhibit 'dose stickiness', whereby if you increase your dose you become stuck on this latter dose since the former no longer works. I originally responded to just 25mg but a succession of pdocs bumped up the dose so that I am now stranded on 600mg.
A good friend on this board (some years ago) went through an almost identical experience to me; after 10 treatments of ECT she was on *800mg* of Lamotrigene (up from 200mg) and like me, was in pieces. I have not heard from her since. A great shame, and a real worry.
The 'forgot who I was' quote basically refers to the intense sense of disorientation I experienced post ECT. I was so bad I lost all contact with the outside world and all sense of purpose. I have improved a little since then - but it would appear that ECT has permanently lowered my baseline depression.
My memory has been badly affected, mostly short-term (names, tasks, conversations etc). Just a week after I finished my course, an authoritative report appeared in The English Journal of Psychiatry (?) which demonstrated that ECT associated memory loss is a far bigger problem than was originally thought.
Perhaps the moral of the story is that ECT is pretty effective for, say, psychotic depression, but much less so for Bipolar depression.
Ed, it strikes introspective ol' me that this is all one way traffic. Obviously you're a *major* attribute to this site, but I'm assuming something other than your ability to help drew you to here in the first instance? Can you tell me what brought you to PB? No probs if you'd rather not elaborate; I'm just curious.
> > I wondered if you had some kind of medical background.....
> I'm a pharmacy student.
Ahhh...we're in safe hands then. :-)
Best,
Jamie.
Sorry, once again longer than intended. Can you tell I have a lot of spare time on my hands? And that I suffer from pathological boredom?
poster:JahL
thread:500631
URL: http://www.dr-bob.org/babble/wdrawl/20050712/msgs/527212.html