ECT and seizure disorder

I have an appointment in a few days and I have a rather large decision I need to make before then.

My pdoc suggested ECT since I have have been depressed nearly every day for a bit over 2 decades. He is also very uncertain about it. He thinks the chance of success is below 50% and is concerned that it could make my seizure disorder worse.

I don't have a serious seizure disorder, I haven't had a grand mal since 1995 but I do get things that no neurologist can say with certainty are seizures or just seizure auras. What these are is I go completely blind, get a feeling of extreme terror, and I get visions of things I have dreamed of. I don't think they last more than 30 seconds at most. I don't fall while I have them, but usually fall after it is over if I was standing or even sitting. They knock me out mentally for the rest of the day, at best. Once I get one, I take a benzo and it usually stops. If I don't, I will get another within 2-3 hours, and they keep coming in closer time intervals until they happen non-stop and then I get a grand mal.

Some neurologists called that an aura, other call it simple partial seizures. I don't know if it what it is really matters to my current problem. What matters to me is that I fear them far more than I fear a grand mal even though it causes heart rhythm issues for a few days that got me placed into an ICU.

Grand mals, major depression, psychosis, none of those compare to the auras or whatever they are.

Luckily, my pdoc always lets me research things first. I am also in the position of having to be careful about declining things, unless I can come up with a real medical reason why something is contraindicated when I decline I risk losing my veterans disability rating because they could say I am not trying to get better. It is even worse right now because I am under review for an increase. I have been kicking the ECT can down the road for a year now and I really need to make a decision this week. I am hoping his doubt makes the decision for me but I need to be ready to answer if he asks me to make the call.

There doesn't seem to be a whole lot of research that I could find that is definitive one way or another. But my pdoc is iffy on it and when I had my rating exam by a neuro-psychologist she told me that it could be risky and agreed that the chances of success are low. I would like to get better and am tempted to say yes but since they cause seizures, I am afraid I will have heart issues, or worse those auras will be triggered.

Are my fears about my seizure disorder getting worse misplaced? I know there are other side effects like memory loss but my MDD causes a lot of that already and seems like a minor issue when stacked up against my seizure disorder.

not from experience but knowing some with these problems having ECT did not make their seizure disorders worse. in some it actually corrected the seizure disorder.

no one that I know that had ECT ended up with heart problems. in fect those with heart problems the ECT corrected it, just like they use a defibulator (otherwise known as pace makers and other words for this) on people with some heart problems to correct the rhythm.

No, they're not, because there are so many variables. ECT was once used to treat intractable epilepsy. Does this article help? Response Predictors in ECT: A discussion about Seizure Threshold | British Journal of Medical Practitioners

Thanks for that. I didn't know that too low of a current to induce seizures could cause worse side effects.

It seems like everything else in psychiatry, it is a "your mileage may vary" kind of thing and I won't know what is likely to happen until I do it.

(((hugs))) Good luck and blessings

I don't know if this is good or bad news. My pdoc is going to hold off on ECT until I get some hormone tests completed and if low wait to see if replacement therapy is needed. Just what I need more drugs which add more anxiety over side-effects and interactions.

He ran a thyroid and testosterone test months ago, my thyroid levels were great but the other was low and wants a more detailed test before moving forward. The really sad part is that I had to bring the lab work up, and he thought my GP ordered the tests when he was the one who did it. The joys of being in a system where I see him once every 3 months and he probably sees well over 200 other vets in between my appointments. At least my follow up is in a month so I won't have to spend 3 months obsessing over it. At least all of my care(except dental) is free. That is the one thing that kept me upright all these years.

I suppose replacement therapy might be better than ECT, but now it feels like I am nearing the end of the road. From the way he was talking today, all I have left for any hope is hormone therapy or ECT.