ECT for Bipolar Disorder

[southernbelle87]

I’m new here so please be kind. I was diagnosed with Bipolar 1 about two months ago and I’m starting to think Lamotrigine is not enough. Has anyone ever tried electro-convulsive therapy? During a stint in a psych ward I saw this treatment help others but I’m honestly afraid of it.

[Hidden]

Hi and welcome to this community! I hope we can support you wherever possible. I've heard of ECT but that's about it.

[FeelingVerySad]

I take Lamotrigine for (what was at one point) severe anxiety/depression, as prescribed by my psychiatrist, and have been taking it since since mid April 2021. I started with 25mg and worked my way up to 100mg over 3 months. (Now I have been consistently at 125mg for almost a year.) But between being at the level where I took 50mg and where I took 100mg (a two week span in May 2021) it very apparently stopped working completely and it was hell again (as it was before I started taking it). I can't believe there was the start of an end point at some point eventually, 2 months later.

But that's what I'm wondering: if it's possible that you think you need something more though it would seem from your question that your psychiatrist thinks Lamotrigine alone is what will help you. If you're new to Lamotrigine, and have been taking it for less than 2 months, you may have only seen it in its period of inconsistency, of working for 3 days and then stopping for 10 days etc, and you may have not yet seen its full possible effects.

I hope you can find a working medication and therapy treatment to end your hell.

[southernbelle87 in reply to FeelingVerySad]

Thank you so much for this. I thought I was losing it. I still don’t feel like myself but I will speak to my doctor about maybe upping my dose. I am on 100 mg of Lamotrigine right now and it’s definitely not working like it was when I started it.

[PurpleDreamerBeagle]

I agree with the above post, you may need additional medication. Not everyone is the same obviously, but I also have bipolar disorder and I'm on 4 different medications for it. Hope you feel better soon!

[kim111]

ECT is not scary once you get into the routine. I have completed nine months of treatments starting in February. My pre-therapy diagnosis was treatment resistant depression because of many, many medications trials that were unsuccessful.

Once completing about two months of various physical and mental checkups my treatments began. I needed a caregiver to drive me home and observe my postoperative period for the day.

The first step involved signing in and getting an IV. Then we walked into the operating room and prepared for the procedure. The anesthesiologist asked all of his questions and the psychiatrist checked my progress to plan for the next ECT. Initially I was three days per week and now am every other week. A few deep breaths of oxygen, I went out and my seizure was produced from electrified paddles

About 20 minutes later one of the nurses was checking my vitals, hydrating me and questioning me for departure. She walked with me to the waiting room and released me to my caregiver. Rest and recovery filled the remainder of the day.

ECT was successful in reducing my depression along with medication. I would recommend it if your psychiatrist finds you treatment resistant.

[kim111 in reply to kim111]

I forgot to mention Lamotrigine was one of the trials that didn’t work for me.

[southernbelle87 in reply to kim111]

I don't think it is working for me any more either.

[kim111 in reply to southernbelle87]

Another alternative to medication that was successful for me was TMS. It was less invasive, no anesthesia, and I drove myself home. This year I was signed up for both TMS and ECT but the ECT was the first one available. Currently I am on Wellbutrin and Rexulti. Hopefully you have a psychiatrist that is open to alternatives after medication trials.

[southernbelle87 in reply to kim111]

Right now I have a part time job and no insurance so I’m not even seeing a psych because I can’t afford it.

[kim111 in reply to southernbelle87]

Some cities have alternative clinics. This is from my closest city, “Psychiatry Residency Spokane (PRS) has a reputation for continuous improvement and clinical excellence, with an emphasis on treating the underserved, poor and vulnerable.” You may have to do a search but it may be out there to serve you.

[Demuse in reply to southernbelle87]

You can possibly go to a clinic that charges on a "sliding scale". IF your income is low enough, you may pay nothing at all. Hope this helps!

[Mott55]

I had ECT about 12 to 15 times about 14 years ago and still take bupropion and Pristiq for depression but I do not feel too depressed any more. I think it helped me. Good Luck.

[southernbelle87]

Thank for your advice and support. 😁

[Ruthy24]

Hi! I have bipolar disorder and was/am very depressed. I was in a psych hospital and the doctors talked me into having ECT. Also my psychologist was in favor of it. I didn't want to do it because a friend had it years ago and said it messed up her memory. But I consented and had about 8 treatments. They say you need 8-12. Well it didn't help and it has effected my memory - not drastically but I am having a harder time remembering things than I used to. However, there were some women in the hosp. who said the treatments really helped them. I think going back to the same environment I was in before the hosp. didn't help.

[Demuse]

HI, I was in a psychiatric hospital in the late 90s and a woman there I know had to have ECT. I do not recommend it. It can cause you to forget memories and whether short term or long term, I feel it is a high risk procedure. I take lamictal twice a day and it seems to help a lot. nothing seems to help all the way. but it's a good drug. At least look into ECT very carefully before you ever have it done. Know the risks and benefits and what you feel is important to you in life.

[Oreo0430]

My wife has been battling BP and severe depression for the last 5-6 years. In addition to Lamotrigine, she has been on a half dozen or so other anti-depressants. Unfortunately for her, she is now classified as ‘Treatment Resistant’ so we started looking at other options such as TMS, Ketamine (both IV and Spravato) and ECT. Once you find a psychiatrist you trust (and hopefully like), I would suggest exhaust the antidepressants options first as you may find one that helps. If they don’t then I would look into IV Ketamine as it may address your depression with little fear of triggering a manic episode. TMS falls into this category so it is not usually an option for BP. I consider ECT the last option given it is essentially shock therapy and hard on you. Every case is unique so try to be objective in your treatment. The field is psychiatry is very challenging since we know so little about the brain and how it really works. A lot is ‘hit & miss’ as you will discover. Do your homework and don’t feel afraid to ask questions. Good luck…

[Hidden]

ECT is often very effective. It is usually reserved for severe cases.

To find out if you are a candidate you can talk to your healthcare team. Questions you can ask:

Have you ever had a patient receive ETC for their bipolar? If yes, what was the result?

Where is the nearest ETC?

Will my insurance cover ETC?

Why would I be a good candidate for ETC? Why not?

What are the complications of ETC that I should be aware of?

Just like everything in healthcare, it is a science, there is no perfect answer and there is trial and error involved.

You do have to be an advocate for your own health, so speak up and ask the right questions.

You are also always entitled to a second opinion.

-Zac