At the end of the line - ECT or take a gamble with ketamine

[HeatherinTO]

Hi everyone,

I have struggled with treatment resistant depression for most of my life. In 2021, I tried IV and oral ketamine with some but limited success. In late 2021, I got admitted into a clinical trial for psilocybin. 

After my third dose of psilocybin, I started experiencing derealization, intense anxiety and some vision changes. However, I thought psychedelics were key to my healing so I did mushrooms with a guide after the trial. When my distress increased even further, I used prescribed ketamine one week later.

Since then, I've experienced intense HPPD, anxiety, cognitive issues and depression. I'm on keppra (500 mg) and lorazepam as needed, but I can't tolerate any SSRIs or even gabapentin. I was on SSRIs for 25 years before I came off them to participate in the clinical trial.

At this point, several doctors tell me that my only option is ECT. I'm not a candidate for TMS because of a past concussion and a couple of seizures I had when I overdosed on SSRIs at 17.

My psychotherapist/psychiatrist said that we could potentially try ketamine again... Since she feels that ECT could aggravate my cognitive issues.

Does anyone have any thoughts?

I'm also thinking I'm going to apply for MAID (assisted suicide) in March when it becomes available in Canada for people with mental illness.

[HeatherinTO]

I did try lamictal and didn't notice a difference. Perhaps it's worth trying again.  

[AmitV]

On 8/27/2023 at 8:21 AM, HeatherinTO said:

Hi everyone,

I have struggled with treatment resistant depression for most of my life. In 2021, I tried IV and oral ketamine with some but limited success. In late 2021, I got admitted into a clinical trial for psilocybin. 

After my third dose of psilocybin, I started experiencing derealization, intense anxiety and some vision changes. However, I thought psychedelics were key to my healing so I did mushrooms with a guide after the trial. When my distress increased even further, I used prescribed ketamine one week later.

Since then, I've experienced intense HPPD, anxiety, cognitive issues and depression. I'm on keppra (500 mg) and lorazepam as needed, but I can't tolerate any SSRIs or even gabapentin. I was on SSRIs for 25 years before I came off them to participate in the clinical trial.

At this point, several doctors tell me that my only option is ECT. I'm not a candidate for TMS because of a past concussion and a couple of seizures I had when I overdosed on SSRIs at 17.

My psychotherapist/psychiatrist said that we could potentially try ketamine again... Since she feels that ECT could aggravate my cognitive issues.

Does anyone have any thoughts?

I'm also thinking I'm going to apply for MAID (assisted suicide) in March when it becomes available in Canada for people with mental illness.

Hello, what are the things that helped you so far? I'm also in Canada,

[AF44]

19 hours ago, AmitV said:

Hello, what are the things that helped you so far? I'm also in Canada,

Hello, 

I’m so sorry to hear about all of this, it makes me so sad. So you are saying you did not get HPPD until you did the psilocybin trial? That’s terrible! I don’t understand how hallucinogenics are supposed to relieve depression. Then it’s a tragedy when someone tries that therapy and ends up a million times worse. 
I am curious about mental health assisted suicide. At what point are you allowed to make a decision? Here in the U.S. (and probably a lot of other places) if you try to commit suicide they lock you up basically. They won’t LET you, much less assist with it. I’m just super curious about how the whole thing works. 
I really hope your symptoms ease up and that maybe you can find a different medication that might work for you. 

[AmitV]

42 minutes ago, AF44 said:

Hello, 

I’m so sorry to hear about all of this, it makes me so sad. So you are saying you did not get HPPD until you did the psilocybin trial? That’s terrible! I don’t understand how hallucinogenics are supposed to relieve depression. Then it’s a tragedy when someone tries that therapy and ends up a million times worse. 
I am curious about mental health assisted suicide. At what point are you allowed to make a decision? Here in the U.S. (and probably a lot of other places) if you try to commit suicide they lock you up basically. They won’t LET you, much less assist with it. I’m just super curious about how the whole thing works. 
I really hope your symptoms ease up and that maybe you can find a different medication that might work for you. 

I got approved in Canada for MAID under neurological disorders provision. I gave them the VSS diagnostic criteria, which has a neurological ICD code.