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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by SLS on May 14, 2004, at 9:19:19
Simple system for staging antidepressant resistance
Stage Definition
I - Failure of at least one adequate trial of one major antidepressant classII - Stage I resistance plus failure of an adequate trial of an antidepressant in a distinctly different class from that used in Stage I
III - Stage II resistance plus failure of an adequate trial of a tricyclic antidepressant
IV - Stage III resistance plus failure of an adequate trial of a monoamine oxidase inhibitor
V - Stage IV resistance plus failure of a course of bilateral electroconvulsive therapy
Source: Thase ME, Rush AJ. When at first you don’t succeed: sequential strategies for antidepressant nonresponders. J Clin Psychiatry 1997;58(suppl 13):24.
Posted by SLS on May 14, 2004, at 9:23:55
In reply to TRD Treatment Resistance Definitions, posted by SLS on May 14, 2004, at 9:19:19
Posted by snapper on May 14, 2004, at 16:19:20
In reply to Stage V - Woohoo! (nm), posted by SLS on May 14, 2004, at 9:23:55
Scott, I know that you have probably posted this before somewhere, but ...
1. did you have any benefit w/ect before and if so how long?
2.was it bi-lateral
3.are you now preparing to have Bi-Lat again or is this the first .....
4. also what are your primary Dx's and primary symptoms.
let us know.... I am struggling very bad right now also, and I just was hoping we could maybe swap notes and give ea. other some support. I am supposed to get ect (again) first part of June.
snapper
Posted by SLS on May 14, 2004, at 17:31:15
In reply to Re: Stage V - Woohoo!, posted by snapper on May 14, 2004, at 16:19:20
Hey, Snapper.
Sorry to hear that you are in such a bad place right now.
> 1. did you have any benefit w/ect before and if so how long?
> 2.was it bi-lateral
I had a series of 15 treatments. The first 8 were unilateral-left, the rest were bilateral. I actually experienced a significant improvement after the fifth treatment, but it lasted for less than half a day. Nothing after that. This was done in 1991.
> 3.are you now preparing to have Bi-Lat again or is this the first .....
I don't know. I haven't ruled it out, but I am not placing it high up on my list of things to try next. I corresponded with Max Fink, MD regarding my treatment history. I described to him the course of ECT I had and the results. His comment to me was that the usage of ECT had evolved since then, and that it might be worth a try with the updated protocols.
> 4. also what are your primary Dx's and primary symptoms.
Chronic severe depression, most likely a variant of bipolar disorder. Anergia, anhedonia, psychomotor-retardation, hypersomnia, hyperphagia, decreased libido, impairments of cognition and memory, and social anxiety.
Which type of ECT are you planning to have? (high-dose, low-dose, unilateral-left, unilateral-right, bi-frontal, bilateral, etc.)
How did you respond to your first course of treatments? What type were they?
If you'd like, you can e-mail me at sl.schofield @ att dot net
I wish you all the best.
- Scott
Posted by snapper on May 14, 2004, at 18:11:54
In reply to Re: Stage V - Woohoo! » snapper, posted by SLS on May 14, 2004, at 17:31:15
> Hey, Snapper.
>
> Sorry to hear that you are in such a bad place right now.
> Thanks and sorry about your situation as well!
> > 1. did you have any benefit w/ect before and if so how long?
>
> > 2.was it bi-lateral
>
> I had a series of 15 treatments. The first 8 were unilateral-left, the rest were bilateral. I actually experienced a significant improvement after the fifth treatment, but it lasted for less than half a day. Nothing after that. This was done in 1991.
>
> > 3.are you now preparing to have Bi-Lat again or is this the first .....
>
> I don't know. I haven't ruled it out, but I am not placing it high up on my list of things to try next. I corresponded with Max Fink, MD regarding my treatment history. I described to him the course of ECT I had and the results. His comment to me was that the usage of ECT had evolved since then, and that it might be worth a try with the updated protocols.
> Yes, the treatment itself is very pleasant! Some of the best short term sleep I ever had (under anethesia :)
> > 4. also what are your primary Dx's and primary symptoms.
>
> Chronic severe depression, most likely a variant of bipolar disorder. Anergia, anhedonia, psychomotor-retardation, hypersomnia, hyperphagia, decreased libido, impairments of cognition and memory, and social anxiety.
> Sounds a lot like my symptomology...
> Which type of ECT are you planning to have? (high-dose, low-dose, unilateral-left, unilateral-right, bi-frontal, bilateral, etc.)
> I don't know what the doc will decide, last time ...almost 3 yrs ago I think i had unilateral left and responded well enough to what ever they gave me...(10 to 12 treatments)to be able to take a trip to Arizona-thinking I was cured I stupidly Started to drink again and could feel my self sinking slowly but surely and by the time I got home (5 weeks later)...I had an an additional 14 or 15 treatments- they then said that any more would most likely not be beneficial...
> How did you respond to your first course of treatments? What type were they?
>
> If you'd like, you can e-mail me at sl.schofield @ att dot net
>
> I wish you all the best.
> Same to you and yes I will e-mail you
>
> - ScottSnapper
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