Anonymous asked this question on 5/16/2000:
I am a w/53yrold female suffering from chronic severe, treatment resistent depression for many years, this last episode is now in the 2nd year, I am on my third psychitrist. My current doctor is at Johns Hopkins and is well known in the field of mental illenss. If have tried every anti-dpressent known to man, I even had 7 ECTS last year, and they did not help! I don't understand what is wrong. I see ads that depression can be helped, but nothing has helped me. I want to feel better so badly, it's making me more depressed. I never go out of the house, or get dressed and most days don't get out of bed except when my husband takes me to the doctors or the hospital. Luckily I have an understanding husband and no children to care for, so sleeping all day is only hurting me. Does anyone have any advise or suggestions for me? thank you so much
Desertphile gave this response on 5/17/2000:
Greetings. Please note that I am NOT a doctor.
And also please note that I grieve for you. To live with depression that resists all previous attempts at treatment must be, of course, very painful and anxienty producing. I know my compassion for your concers and issues does not help at all, but please know that you have it. That you are still hoping for a successful treatment is, I think, a good sign. (If you no longer held any hope, you would not have asked people here for input and advice.)
It is also with some dismay that you report that 7 treatments of ECT did not help. That is unusual, but not unheard of. ECT is used as a last resort to buy a depressed person a reprieve from depression so that medication and psychotherapy can "work." That ECT did not help must have been a great dissapointment.
Seems to me that medication is still your best hope, though it also sounds like it will be very difficult and time-consuming to find the correct "cocktail" mixture at the correct dosages. I am assuming that you have tried several anti-depressant medications at the same time? That is, both 40mg Paxil and 20mg of Celexa? And perhaps a small amount of an anti-anxiety medication? From what you wrote, it seems obvious that this has already been tried.
Damn. This is certainly a tough issue.
There are newer anti-depressants in the European markets that are the most selective of the serotonic reuptake inhibitors. These medications have not yet been passed as safe by the United States Food and Drug Administration. However, you could ask your physician / psychiatrist if she or he thinks trying the non-approved by the FDA drugs from over seas. Celexa, if you have not alread tried it (it is relatively "new," having been out for about two years), might be a good suggestion. The average recomended dosage is 20mg, though I would suggest, IF I WERE A DOCTOR WHICH I AM NOT, that you start with 40mg. Studies show that anything over 60mg is no longer effective, i.e., the peak dosage is around 60mg. 30 to 40 mg I would consider a "treatment" phase dosage, with 20mg as a maintainence dosage.
I realize that my input has not helped you any, and for this I apologize. I only wanted to mention to you that there are new drugs you probably have not tried because they are not available in the USA (I am here assuming you are a USA citizen and / or living in the USA). Your psychiatrist might know of these new drusg.