Chemical Kaleidoscope - May 2003

Two months have gone by since I last wrote my thoughts down in this digital diary and I have to say that there has not really been anything of interest to write about!
However I have noticed that my level of depression has sunk somewhat so I mentioned this to my doctor and he prescribed an extra 50mg of Clomipramine, taking my daily dose to 200mg. Although I have seen no marked improvement there may still be time for the extra pill to work.

Apparently there are four classes of antidepressants, these being;
1. Selective serotonin reuptake inhibitors (SSRI's). E.g. Prozac, Luvox, Paxil and Celexa
2. Tricyclics. E.g. Elavil, Anafranil, Norpramin, Tofranil and Pamelor.
3. Monoamine oxidase inhibitors (MAOI's) E.g. Nardil and Pardate.
4. Atypical antidepressants such as Asendin, Wellbutrin, Serzone and Efexor.

I know I have tested around 4 or 5 different antidepressants, including Prozac and Effexor but in today's pharmaceutical world, I may have taken others in the list above but they have been under another brand name. The fact is I don't take much notice of what is going down my throat but I do know if they have any effect on my depression or, indeed, have any side effects. I have trust in the medical people who prescribe these drugs.

The funny thing about taking these drugs, whichever ones they may be, is that nobody has told me what to expect from them! Are they supposed to make me happy? Are they supposed to make me into a zombie? Or are they taken to make the downers less potent? I suppose it is up to me to ask these questions of the medical experts but I get so stressed out when I leave the house to make a visit to the GP's or the hospital I find that any conversation I do have has to be dragged out of me.

The other major point concerning antidepressants is the fact that the effects they have on each individual who takes them is something of a mystery until the patient has been taking them for 6 weeks or more. Now this, to me, is a little bizarre. Primarily the main effect of taking these drugs should be the alleviation of patients depression. Secondarily should be the minimisation of side effects. Unfortunately one cannot see into the future so the whole process of drug prescription is one of hit or miss and this can have a dramatic effect oon the drug taker.

Personally I have undergone several changes in medication due to the ineffectiveness of the prescribed drugs to give me relief. Each drug has had its own side effects whilst I have been taking them and also some withdrawal symptomes as I have come off them. The worst of the lot was Efexor (click here for details) and I hope that I never have to go through that kind of experience again!

So basically all depressed people who are prescribed drugs by the medical profession are, in effect, laboratory rats who may have to endure many weeks, or even months, of discomfort before they find relief from their symptoms. Once again, personally speaking, the benefits of taking antidepressants are vastly outweighed by the side effects. I have been given very little relief via the drugs I am/have been taking and am/have suffered some quite nasty side effects e.g. uncontrollable perspiration, dry mouth, and sexual dysfunction to name but three!

Of course there is one treatment for depression that I haven't mentioned yet and that is ECT or Electroconvulsive Therapy. This involves the patient being sedated and then having an electric current (of approximately 200 joules which, according to Andrew Solomon in his book The Noonday Demon, is enough power to light a domestic 100-watt light bulb) passed through the brain via electrodes applied to the head.
Although there has been a high percentage of successful treatment by ECT it is a course of action that fills me full of dread, mainly because I cannot agree with someone meddling with the brain's most basic workings (electrical impulses or logic gates).

ECT has a number of advantages over treatment using drugs. It is quick, patients report feeling substantially better after just a few days. It has a high success rate and it has very few side effects although the main side effect, long term memory loss, can be quite dramatic in a very low number of patients. ECT doesn't react with other drugs and is considered safer for treating the elderly or pregnant women.

Personally I have seen the results of ECT and it frightened me. When I was in hospital a fellow patient, who was experiencing acute, suicidal depression, walked into the treatment room and came out in a wheelchair after 15 minutes. The physical change was scary. The person was like a zombie. Perhaps it was the effects of the general anaesthetic that caused this - come to think of it that was the probable cause but to me, as a stranger in a strange place, it put the willies up me!

So let's keep trying the pills doc, please.