Antidepressant Alternative for Pregnant Women: Shock Therapy

[Sgent]

http://blogs.wsj.com/health/2009/08/21/antidepressant-alternative-for-pregnant-women-shock-therapy/

Pregnant women should consider psychotherapy as an alternative to antidepressants, but those with more severe or recurrent bouts of depression should remain on their meds during pregnancy, according to a new report from two big physicians’ groups.

But there’s an alternative treatment for the sickest depressed women, the guidelines say: electroconvulsive therapy, often called shock therapy.

ECT, which involves an electric current that induces a seizure in the brain, has been “long regarded as a safe and effective treatment for severe depression in pregnancy,” the guidelines say. It may be particularly help for for women who aren’t helped by medication, or when a disorder is life-threatening. It doesn’t appear to be harmful to either the mother-to-be or the unborn children when they are carefully monitored, according to the guidelines.

ECT should be considered more often to treat pregnant woman, Kimberly Yonkers, first author on the report and a professor at Yale University told the Health Blog. “ECT happens to be one of the most effective treatments we have in our treatment armamentarium,” she said. “ECT is safe, it’s fast and it’s not contraindicated in pregnancy.”

But ECT suffers from the problem of public perception, says Yonkers. “That is the real drawback.” Recipients also experience what is supposed to be short-term memory impairment, but which some patients say is much longer lasting than expected.

[ejpoeta]

1. oh hell no!!! i am currently pregnant and have not taken my antidepressant

for several months now (i am eight months pregnant). I admit i am floundering but if I could continue going to my counselor it would not be so bad. I sure as hell wouldn't want to get electroshock anything! LOL!

[thereismore]

3. It's only for the desperately ill. Depression does affect the fetus too. It's a tough problem. nt

[Javaman]

2. Gimmie Gimmie shock treatment. nt

[MineralMan]

4. OK, Linda...I'm going to recommend an alternative therapy

for your depression while you're pregnant. Nurse Ratched, here, will take you to the treatment room.

[pitohui]

5. probably a stupid question but...

i don't understand why women who need to maintain their mental health with regular doses of a medication that alters their brain chemistry should be getting pregnant in the first place, ok, sure accidents happen, but why are they bringing these pregnancies to term?

oh and by the way, pregnancy increases your risk of depression to begin with -- post partum depression anyone? sheesh, even healthy women have to take care when getting PG, severely clinically depressed patients who have to be maintained on medication...i'm like WTF that they're even thinking of doing this?

there is likely an inherited compoment in mental illness that responds to these medications, what joy do they get out of passing it on? or maybe they just don't care about anybody else except themselves?

let's have a helpless baby to give my pitiful life meaning!!!

do you know anyone who was actually cured of severe depression, bipolar disorder etc. by either pills or ECT? nope, me neither, they get better/worse/better/worse but their entire life is pretty much struggle...why do they wish that on a child? at least their own parents can say they didn't know any better, since it used to be taught that mental illness was caused by a bad upbringing...

but now...with what we know about the brain...it's ridiculous in my humble view that people w. these disease are reproducing

sorry, ok, rant over

but this problem simply wouldn't arise if people didn't suffer from the disease of entitlement... the fantasy that all women should be able to do all things

[MineralMan]

6. Well, there's another country heard from...

I wonder why you feel like you have the right to recommend that women with depression not have children. I really do. It's not your decision, is it? What other decisions would you like to make for women with depression?

Your use of the phrase, "disease of entitlement," really isn't something I normally hear on this progressive forum.

I'm really, really disappointed in what you wrote. I know a number of women who have depressive disorders who have had children and are wonderful moms. They went off their anti-depressant medication to carry the child, then went back on it after the birth. They were doing well before and are doing well now.

Feh!

[GreenPartyVoter]

10. I would guess this poster may have experience with the pain of mental illness, either

as a person who has it or who lived with someone else who has it, and it has been so terrible for them that it led them to this way of thinking. :(

[MineralMan]

11. I suppose that's possible.

I try not to make any speculative guesses about posters. I try very hard to look at just what they write, and react solely to that. Most of the time, I don't even remember who's writing, which gets me in trouble from time to time, but, given the anonymity of this medium, it is what is written that's the issue, rather than who I think that person might be.

[NashVegas]

8. Reproduction Is a Biological Imperative

It really is that simple.

[GreenPartyVoter]

9. You do know that not all kids of parents with mental illnesses have them too, right?

But as a woman with bipolar (diagnosed after having kids) and as a mother of two beautiful children, I appreciate you wishing that they didn't exist while laying out your eugenics plan. I really do. Life is a crapshoot. You never know what illnesses or physical or mental challenges will show up in a child, but that doesn't mean people should stop having children.

Here are some pictures of my kids if you are interested. But I doubt you are since you have so much vitriol towards them, and me: http://www.democraticunderground.com/discuss/duboard.php?az=show_topic&forum=105&topic_id=8900920

If you have a mental illness or grew up with someone who did and were very badly affected by the situation, I am very sorry. I truly am. But that doesn't necessarily mean it is/was like that for everyone dealing with those kinds of illnesses.

[REP]

14. The person to whom you are replying seems to encounter only those who are psychotic,

have personality disorders or gave have other diagnoses made by that person. Snap Judgement is a fun game, but when the results are always "dangerously insane," I'd wonder if I were projecting.

[hedgehog]

17. Life would be very boring without all of us crazy people about!

I used to think it was a cliche, but I'm more and more convinced society needs us strange ones to come up with ideas. Without us bipolor people and the autistics, we'd never had invented fire, IMO.

BTW - was that one picture taken at Fort Oswego?

[GreenPartyVoter]

18. Actually at Fort KNox here in Maine. Funny how all forts seem to look alike. I have been

asked if it is X Fort in Y state several times now. LOL

And yes, the genius is near to madness idea is true for me. My greatest & best bursts of creativity came when I was manic. Of course, being bipolar 2 means the mania never lasts long, so I never finished any of those projects or books. :P Who knows? Maybe someday I will.

[REP]

13. Not everyone is you; not all depression is the same

Some women may not know that their depression will worsen with pregnancy; others do and take that on. Many people are successfully treated for many depressive disorders and lead normal lives. I'm sorry this has not been your experience. :hug:

[Warpy]

7. I saw a lot of shock treatments back in the 60s

when they were still finding out what they were good for, and they were often miraculous in people with severe depression. They did nothing for other patient populations.

They're a lot less brutal these days, the treatment having been modified and combined with anesthesia and muscle relaxants. They're no longer "One Flew over the Cuckoo's Nest" treatments.

Shock treatments are still a last ditch measure for people who are profoundly depressed and are either resistant to medications or who can't take them at all.

The alternative is suicide for many of these people.

[elehhhhna]

12. Worked wonders for my Grandfather...and a friend had it

maybe 10 years ago -- says she'd do it again in a minute, got her out of the crazy zone & functional in a few days.

[REP]

15. One of my friends loves ECT

I was horrified when she was telling me about it, but she said it's not like in the movies and it helps her tremendously. It's one anecdote, but it made me willing to be more open-minded about modern ECT.

[Lance_Boyle]

16. ECT does work wonders in treatment-resistant major depression.

I've not heard of it even being trialed for other conditions in this century, but for major depression it is a fantastic treatment option when the alternative is NOTHING.

Probably a far bit more responsible for pregnant women than most drug options would be, as the pharmaceutical racket rejects any attempt to test drugs in that population (liability exposure, don'tcha know?).

On the other hand, I think pitohui raises an important point upthread - if you have an ongoing struggle with major depression, pregnancy is certainly not the most responsible choice you could make. Responsible people don't choose "debilitating neurochemical imbalance for two, Alex."

[Warpy]

19. I can't sit in judgment of women who undertake any kind

of risky pregnancy. Procreation is one of those basic drives and throw in accident and morbid religious scruples and you have more than ample reason to go through with it.

At least with ECT approved, both of them have a greater chance to live through it.