![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 46 to 70 of 79. Go back in thread:
Posted by jerrympls on May 20, 2005, at 18:06:53
In reply to Re: ECT failure?, posted by Mr.Scott on May 20, 2005, at 17:14:58
> Has anyone considered the timeline of their depresion and where their benzodiazepine usage was at that time?
>
> I have certainly heard (and may be experiencing some of this) that benzos, particularly clonazepam may induce depression.
>
> However...I have to concur with whoever said benzo+Stim+SSRI is the best combo I've had to date.
>
> For me ECT worked great. I had 6-8 treatments, (right unilateral) and was doing very well. After 5 months the effect dissipated. I am now considering maintenance ECT. My doc suggests starting once a week for 3 weeks and then continuing to spread it out until once every 2 months for maintenace. The only impairment I had was from the anesthesia. No memory problems at all. Some day's I even went to work after a treatment (which was highly ill advised by my doc). I guess everyone is different in how they respond to all this stuff.
>
> I'm interested in the opiate thing. After all morphine was the treatment of choice for depression at one time.
>
> ScottScott- I have heard many successful stories like yours involving maintenance ECT treatment. I'm so glad that you don't have the memory problems. I would go for the maintenance treatments especially if the ECT helped you for 5 months before it pooped out.
My doc has me on benzo+stim+ssri+opiate (hydrocodone) now and it's been the best combo so far for me. I wish I didn't have to reply on a stimulant to get me up and going - it's scary to know that if I don't take my stimulant that I'll just sit on the couch all day or sleep and escape from the world. But, until we find something better I'll keep taking it to keep me going.
Opiate therapy is used more than people know. Mainly at bigger teaching hospitals/universities where they experiment with a lot of off-lable stuff and help drug companies conduct clinical trials. The University of Minnesota is one such place. Even though I see a resident, his attending ok'ed the opiate trials - and I'm not the only one. I found out that a handful of the staff psychiatrists on faculty who are involved with depression research/treatment have tried opiate treatments with other patients - some successful and others not. So far I've been a success. It's been Since December 2004 when I began the opiate and to date I have NO tolerance issues nor do I feel the need to increase the dosage or take more than what the doc prescribed.
It wasn't easy getting to the point where I am with doctors willing to try opiates - and it's not a cure-all - but it helps a lot.
Jerry
Posted by Bob on May 20, 2005, at 18:12:28
In reply to Re: ECT failure? » Mr.Scott, posted by jerrympls on May 20, 2005, at 18:06:53
>
> My doc has me on benzo+stim+ssri+opiate (hydrocodone) now and it's been the best combo so far for me. I wish I didn't have to reply on a stimulant to get me up and going - it's scary to know that if I don't take my stimulant that I'll just sit on the couch all day or sleep and escape from the world. But, until we find something better I'll keep taking it to keep me going.
>
> Opiate therapy is used more than people know. Mainly at bigger teaching hospitals/universities where they experiment with a lot of off-lable stuff and help drug companies conduct clinical trials. The University of Minnesota is one such place. Even though I see a resident, his attending ok'ed the opiate trials - and I'm not the only one. I found out that a handful of the staff psychiatrists on faculty who are involved with depression research/treatment have tried opiate treatments with other patients - some successful and others not. So far I've been a success. It's been Since December 2004 when I began the opiate and to date I have NO tolerance issues nor do I feel the need to increase the dosage or take more than what the doc prescribed.
>
> It wasn't easy getting to the point where I am with doctors willing to try opiates - and it's not a cure-all - but it helps a lot.
>
> JerryJerry:
What exactly does opiate treatment do? Does it address anxiety, or give people energy and motivation, or what? I would figure that opiates would knock me out and have me sleeping all day.
Bob
Posted by Bob on May 20, 2005, at 18:16:07
In reply to Re: ECT failure?, posted by Mr.Scott on May 20, 2005, at 17:14:58
>
> For me ECT worked great. I had 6-8 treatments, (right unilateral) and was doing very well. After 5 months the effect dissipated. I am now considering maintenance ECT. My doc suggests starting once a week for 3 weeks and then continuing to spread it out until once every 2 months for maintenace. The only impairment I had was from the anesthesia. No memory problems at all. Some day's I even went to work after a treatment (which was highly ill advised by my doc). I guess everyone is different in how they respond to all this stuff.
>
> ScottScott:
I would definitely recommend that you restart the ECT if it worked that well for you. Needless to say, my experience with ECT has not been nearly as good. I'm going in for my 17th treatment next week, and I'm not sure it's doing anything but making me worse any longer. I'm going to ask my doctors once again how much longer I should be trying it, but I'm afraid I'll be stopping soon. Problem is, I just don't know what I'll do next. I hate the meds so much I can't even put it into words.
Bob
Posted by ed_uk on May 20, 2005, at 18:23:29
In reply to Re: ECT failure? » Mr.Scott, posted by jerrympls on May 20, 2005, at 18:06:53
Hi Jerry,
Did you stop Lunesta?
Kind regards,
Ed.PS. Did you sleep any better on oxycodone than on hydrocodone?
Posted by Mr.Scott on May 20, 2005, at 18:28:04
In reply to Re: ECT failure? » Mr.Scott, posted by Bob on May 20, 2005, at 18:16:07
Hi,
Are you doing unilateral or bilateral? Any other meds on board?
Scott
Posted by 4WD on May 21, 2005, at 0:17:10
In reply to Re: ECT failure? » Mr.Scott, posted by Bob on May 20, 2005, at 18:16:07
>
>
>
>
>
> Scott:
>
> I would definitely recommend that you restart the ECT if it worked that well for you. Needless to say, my experience with ECT has not been nearly as good. I'm going in for my 17th treatment next week, and I'm not sure it's doing anything but making me worse any longer. I'm going to ask my doctors once again how much longer I should be trying it, but I'm afraid I'll be stopping soon. Problem is, I just don't know what I'll do next. I hate the meds so much I can't even put it into words.
>
> BobBob,
Have you considered the VNS implant? Some people have gotten really good results. And then there's the DBS (deep brain stimulation) treatment that's being tested now. Have you seen an endocrinologist?
I guess my point is, don't give up. There are new drugs every month it seems and new treatments.
Hang in there.
Marsha
Posted by Bob on May 21, 2005, at 10:25:45
In reply to Re: ECT failure? » Bob, posted by Mr.Scott on May 20, 2005, at 18:28:04
> Hi,
>
> Are you doing unilateral or bilateral? Any other meds on board?
>
> Scott
I think something like the first 3 of my 16 treatments so far were unilateral. After that they have been bilateral. After the first couple treatments, 450mg of Li was added, as well as something like .25mg of Clonazepam a couple times per day. Then the Clonazepam was taken away. It was taken away due to concerns with muscle discomfort and a rash, but I had a "breakdown of sorts after my 15th treatment in the beginning of May. Nobody really knows why, but I feel like it may have been the withdrawl of the minute amounts of Clonazepam. The doctors don't think it was a reaction to the ECT itself, although I have my doubts about that. I'm taking Ativan now, and I had another treatment last Wednesday. I am quite leery of what is going down here, as on most days I feel anxious and depressed in the mornings (and sometimes for most of the day), and then feel a little better in the late evening and night. Then, it starts all over again the next day. I also spend many days feeling drowsy and tired, when I'm not feeling anxious and depressed, which causes me to hesitate adding more Ativan and Li to the mix.Crazy, huh?
Posted by Bob on May 21, 2005, at 10:33:05
In reply to Re: ECT failure? » Bob, posted by 4WD on May 21, 2005, at 0:17:10
> >
>
> >
> >
> >
> >
> > Scott:
> >
> > I would definitely recommend that you restart the ECT if it worked that well for you. Needless to say, my experience with ECT has not been nearly as good. I'm going in for my 17th treatment next week, and I'm not sure it's doing anything but making me worse any longer. I'm going to ask my doctors once again how much longer I should be trying it, but I'm afraid I'll be stopping soon. Problem is, I just don't know what I'll do next. I hate the meds so much I can't even put it into words.
> >
> > Bob
>
> Bob,
>
> Have you considered the VNS implant? Some people have gotten really good results. And then there's the DBS (deep brain stimulation) treatment that's being tested now. Have you seen an endocrinologist?
>
> I guess my point is, don't give up. There are new drugs every month it seems and new treatments.
>
> Hang in there.
>
> Marsha
>
>Thanks for the encouragement, Marsha. I was actually involved in a VNS study here at the University of Maryland, until it fell apart financially, and the chance to actually get the device disappeared. That lasted a couple years, actually, where I would go down there every couple weeks and answer questions and fill out forms. I guess if that thing gets officially approved, I might be able to get it put in, but the percentage of people who respond to the device doesn't seem very encouraging - I think it's under 20%. I also wouldn't want to go through surgery to get a device implanted and then have it cause and episode of panic and suicidality. Not that it necessarily would, but I haven't had real good luck so far.
As far the the DBS is concerned, I think it would be very difficult to get this, as it is only offered in studies, as far as I know, and getting in those studies is can be quite difficult. I guess we'll see.
BTW, what new medecines are you talking about that are coming out?
Posted by jerrympls on May 21, 2005, at 12:57:15
In reply to Re: ECT failure? » jerrympls, posted by ed_uk on May 20, 2005, at 18:23:29
> Hi Jerry,
>
> Did you stop Lunesta?
>
> Kind regards,
> Ed.
>
> PS. Did you sleep any better on oxycodone than on hydrocodone?Hi Ed-
Lunesta doesn't seem to be helping much and the doc won't prescribe me two opiates.
Posted by ed_uk on May 21, 2005, at 13:06:10
In reply to Re: ECT failure? » ed_uk, posted by jerrympls on May 21, 2005, at 12:57:15
Hi Jerry,
I'm sorry to hear that :-(
Ed.
Posted by 4WD on May 21, 2005, at 14:21:57
In reply to Re: ECT failure? » 4WD, posted by Bob on May 21, 2005, at 10:33:05
> > >
> >
> > >
> > >
> > >
> > >
> > > Scott:
> > >
> > > I would definitely recommend that you restart the ECT if it worked that well for you. Needless to say, my experience with ECT has not been nearly as good. I'm going in for my 17th treatment next week, and I'm not sure it's doing anything but making me worse any longer. I'm going to ask my doctors once again how much longer I should be trying it, but I'm afraid I'll be stopping soon. Problem is, I just don't know what I'll do next. I hate the meds so much I can't even put it into words.
> > >
> > > Bob
> >
> > Bob,
> >
> > Have you considered the VNS implant? Some people have gotten really good results. And then there's the DBS (deep brain stimulation) treatment that's being tested now. Have you seen an endocrinologist?
> >
> > I guess my point is, don't give up. There are new drugs every month it seems and new treatments.
> >
> > Hang in there.
> >
> > Marsha
> >
> >
>
> Thanks for the encouragement, Marsha. I was actually involved in a VNS study here at the University of Maryland, until it fell apart financially, and the chance to actually get the device disappeared. That lasted a couple years, actually, where I would go down there every couple weeks and answer questions and fill out forms. I guess if that thing gets officially approved, I might be able to get it put in, but the percentage of people who respond to the device doesn't seem very encouraging - I think it's under 20%. I also wouldn't want to go through surgery to get a device implanted and then have it cause and episode of panic and suicidality. Not that it necessarily would, but I haven't had real good luck so far.
>
> As far the the DBS is concerned, I think it would be very difficult to get this, as it is only offered in studies, as far as I know, and getting in those studies is can be quite difficult. I guess we'll see.
>
> BTW, what new medecines are you talking about that are coming out?
>
Well, while it didn't work for me, Cymbalta is new. And the selegiline patch is apparently pretty close to being available. And there are several drugs that are not available in this country (yet) that might be of benefit. Like Stablon. There's another I can't remember the name of but it's a serotonin reuptake accelerator. It's possible your doctor could prescribe something like that for you and you could try it legally. (Dr. Bob I am specifically trying not to suggest ordering meds not legal here. But if his doctor prescribes it and he gets it from abroad, isn't that legal?)There are so many people here who have tried so many drugs and combinations of drugs and after almost giving up hope finally FINALLY found something that worked. I know it's hard to keep hope up when you are severely depressed. And I feel especially frustrated when people (friends, family ) offer well meaning suggestions that I know in my heart haven't worked for me (go for a brisk walk, improve your nutrition, think positive thoughts). But we do want to be here for you. I guess we all wish we could fix it for each other even if we can't fix it for ourselves.
Marsha
Posted by Phillipa on May 21, 2005, at 16:56:22
In reply to Re: ECT failure? » Bob, posted by 4WD on May 21, 2005, at 14:21:57
After being a nurse and helping other people, it's very theraputic to think I might help someone here even if it's just to add support. I wouldn't even consider recommending a med combo. I leave that to the med experts. Right Ed, and SLS, Chemist, to name a few. Fondly, Phillipa
Posted by jerrympls on May 21, 2005, at 17:02:13
In reply to Re: ECT failure? » 4WD, posted by Phillipa on May 21, 2005, at 16:56:22
> After being a nurse and helping other people, it's very theraputic to think I might help someone here even if it's just to add support. I wouldn't even consider recommending a med combo. I leave that to the med experts. Right Ed, and SLS, Chemist, to name a few. Fondly, Phillipa
hey! I want to be a med expert! (heheeh)
Actually I studied biological psychology in college. Perhaps I should post more. ;-)
Jerry
Posted by jerrympls on May 21, 2005, at 17:08:57
In reply to Re: ECT failure? » jerrympls, posted by Bob on May 20, 2005, at 18:12:28
>
> Jerry:
>
> What exactly does opiate treatment do? Does it address anxiety, or give people energy and motivation, or what? I would figure that opiates would knock me out and have me sleeping all day.
>
> Bob
>
>For me, opiate therapy helps tremendously with:
- Social fears/anxiety
- General Anxiety
- Motivation (apathy, lethargy)
- Anhedonia
- Energy
- Mood improvement ( better general sense of well-being)I know many people with treatment-resistant depression who resort to self-medicating with opiates because they are the only meds that help them feel "normal" or close to it.
It depends on how you respond to opiates. Some opiates put me to sleep and some - like hydrocodone (opiate in Vicodin) acts more like a stimulant. My doc tried me on Oxycontin first and that really made me foggy and sleepy.
I take 5mg 4x daily. I do not feel a "high" or extreme euphoria. I just feel closer to "normal." I have not had any problems with abuse or tolerance.
I always like to add that opiate treatment is not a cure-all. But, it's what works for me right now until something better comes along.
Jerry
Posted by ed_uk on May 21, 2005, at 17:13:21
In reply to Re: ECT failure? » Bob, posted by jerrympls on May 21, 2005, at 17:08:57
Hi Jerry,
Why won't your pdoc let you take hydro three times a day and oxy at night? It seems logical since there is no drug interaction.
Kind regards,
Ed.
Posted by ed_uk on May 21, 2005, at 17:22:34
In reply to Re: ECT failure? » Bob, posted by jerrympls on May 21, 2005, at 17:08:57
PS. Sorry to repeat myself, I hope you're not annoyed with me. Did you sleep well on oxycodone? If so, oxycodone would be a simpler option than Xyrem. I know you don't want to 'push' your doc too far but it might be worth it just this once.
Kind regards,
Ed.
Posted by jerrympls on May 21, 2005, at 17:35:52
In reply to Re: ECT failure? » jerrympls, posted by ed_uk on May 21, 2005, at 17:13:21
> Hi Jerry,
>
> Why won't your pdoc let you take hydro three times a day and oxy at night? It seems logical since there is no drug interaction.
>
> Kind regards,
> Ed.Nope. Plain and simple.
Posted by jerrympls on May 21, 2005, at 17:38:20
In reply to Re: ECT failure? » jerrympls, posted by ed_uk on May 21, 2005, at 17:22:34
> PS. Sorry to repeat myself, I hope you're not annoyed with me. Did you sleep well on oxycodone? If so, oxycodone would be a simpler option than Xyrem. I know you don't want to 'push' your doc too far but it might be worth it just this once.
>
> Kind regards,
> Ed.
>
>Well, I am seeing a sleep doc to sort out my insomnia. I think being on an opiate off-lable it stretching it already and adding ANOTHER opiate would be WAY WAY over the line. Yes, it would probably help - but I'm afraid to push the issue. It took me forever just to get on the one opiate.
However, I do see your point.
Posted by ed_uk on May 21, 2005, at 17:51:30
In reply to Re: ECT failure? » ed_uk, posted by jerrympls on May 21, 2005, at 17:38:20
I'm sorry Jerry I didn't mean to offend you :-(
Posted by jerrympls on May 21, 2005, at 18:15:13
In reply to Re: ECT failure? » jerrympls, posted by ed_uk on May 21, 2005, at 17:51:30
> I'm sorry Jerry I didn't mean to offend you :-(
>
>Ed- OH NO NO NO! Sorry if my reply came out that way. I was just trying to say that my doc wouldn't go for adding another opiate "plain & simple." Sorry about that!!!
Jerry :-)
Posted by Phillipa on May 21, 2005, at 20:34:48
In reply to Re: ECT failure? » ed_uk, posted by jerrympls on May 21, 2005, at 18:15:13
Jerry, I'm sorry I left you out of the med experts. But there are so many. Some more Maxime, Racer, Stressor, Med_empowered, Minniehaha. Matt84.I just can't remember them all. Sometimes it seems like I'm the only one who isn't an expert. Fondly, Phillipa
Posted by 4WD on May 21, 2005, at 21:52:50
In reply to Re: ECT failure? » Phillipa, posted by jerrympls on May 21, 2005, at 17:02:13
> > After being a nurse and helping other people, it's very theraputic to think I might help someone here even if it's just to add support. I wouldn't even consider recommending a med combo. I leave that to the med experts. Right Ed, and SLS, Chemist, to name a few. Fondly, Phillipa
>
> hey! I want to be a med expert! (heheeh)
>
> Actually I studied biological psychology in college. Perhaps I should post more. ;-)
>
> Jerry
>Ah ha! Then tell me, can I change the size of my hippocampus by thinking about it i.e. visualization?
Marsha
>
Posted by 4WD on May 21, 2005, at 22:00:51
In reply to Re: ECT failure? » Bob, posted by jerrympls on May 21, 2005, at 17:08:57
>
> >
> > Jerry:
> >
> > What exactly does opiate treatment do? Does it address anxiety, or give people energy and motivation, or what? I would figure that opiates would knock me out and have me sleeping all day.
> >
> > Bob
> >
> >
>
> For me, opiate therapy helps tremendously with:
>
> - Social fears/anxiety
> - General Anxiety
> - Motivation (apathy, lethargy)
> - Anhedonia
> - Energy
> - Mood improvement ( better general sense of well-being)
>
> I know many people with treatment-resistant depression who resort to self-medicating with opiates because they are the only meds that help them feel "normal" or close to it.
>
> It depends on how you respond to opiates. Some opiates put me to sleep and some - like hydrocodone (opiate in Vicodin) acts more like a stimulant. My doc tried me on Oxycontin first and that really made me foggy and sleepy.
>
> I take 5mg 4x daily. I do not feel a "high" or extreme euphoria. I just feel closer to "normal." I have not had any problems with abuse or tolerance.
>
> I always like to add that opiate treatment is not a cure-all. But, it's what works for me right now until something better comes along.
>
> Jerry
I was one of those self medicaters. Hydrocodone made me enjoy life. I wanted to go plant a garden. I liked to work the crossword puzzle. I liked to clean the house. I even enjoyed working on my taxes!Unfortunately, I couldn't control my use. I didn't take 5mg. I took 30mg. And when it started to wear off, I wanted some more. In the past year or so, I got my use down to once or twice a month, but I still took the large amounts. I didn't just want to feel okay. I wanted to feel super! And it worked. But then more and more often, a day of use would be followed by a week of severe severe depression. So I had to quit.
I wondered if you have an issue with the acetominophen in the Vicodin. I always set limits for myself about how much I would take because I was afraid of the liver consequences. I think, though, if you don't use alcohol it's not nearly as much of an issue.
I'm glad you found something that works for you.
I'm also envious that you can take it and I can't. Oh well.Marsha
Posted by Phillipa on May 21, 2005, at 22:36:09
In reply to Re: ECT failure?, posted by 4WD on May 21, 2005, at 22:00:51
How does tylenol #3 work? As an opiate? I took it after my surgery and it didn't make me high. Fondly, Phillipa
Posted by jerrympls on May 22, 2005, at 1:19:10
In reply to Re: ECT failure? » jerrympls, posted by 4WD on May 21, 2005, at 21:52:50
> > > After being a nurse and helping other people, it's very theraputic to think I might help someone here even if it's just to add support. I wouldn't even consider recommending a med combo. I leave that to the med experts. Right Ed, and SLS, Chemist, to name a few. Fondly, Phillipa
> >
> > hey! I want to be a med expert! (heheeh)
> >
> > Actually I studied biological psychology in college. Perhaps I should post more. ;-)
> >
> > Jerry
> >
>
> Ah ha! Then tell me, can I change the size of my hippocampus by thinking about it i.e. visualization?
>
> Marsha
> >
>
>Short answer: Yes. Recent studies have shown that "an old dog CAN learn new tricks..." - not that I am calling you a dog :-) . I recently read a Journal study that found proof that adults DO continue to make new connections in the brain - growing neurons/axons - new communication pathways = increase size. Visualization is a powerful powerful tool. I learned it in my music studies. I learned that I could "practice" my music performances in my head and that doing so would translate to my kinesthetic "memory" = meaning, visualizing myself playing a music passage over and over - visualizing my body in balance, the music notes, etc. was practically the same as if I were doing it physically. I didn't learn this technique overnight, but I did learn it. This also translates easily to meditation and other forms of deep relaxation. The journal article went on to explain that by using techniques like these, the brain is exercised to stay fit and grow/expand and ward off dementia. Even by doing things like crosswords, playing cards, etc would help and does help.
I wish I could find the source so you knew I wasn't making this up - but trust me. I've used visualization techniques to get me through depression. It's exercise for the brain - and it can be and is it comparable to a physical workout that keeps muscles strong, lean and fit.
So, yes.
Jerry :-)
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.