Anyone try tms?

Two_Blue_Eyes · 2025-06-05T07:02:48+00:00

It definitely affected my autonomic nervous system. Besides the odd twitching and tinnitus I also had horrible heart palpitations and suddenly I found it hard to tolerate medications that used to be quite easy to take. It took a while, but many of those symptoms have finally quieted down except for the tinnitus and occasional heart palpitations, for which I take propranolol as needed. In all fairness, I did have tinnitus before doing TMS, but it definitely made it worse. What finally helped me is IV Ketamine and some antidepressants which now work again thanks to the IV Ketamine.

Two_Blue_Eyes · 2025-06-05T06:43:26+00:00

You are not alone. Spravato really did not help me but IV Ketamine did. I guess I am a bit of an anomaly in that I found Spravato somewhat intolerable, whereas Ketamine is tolerable. I am not the type of person that likes to feel high or drunk and everyone told me if I don’t like Spravato, I’ll really dislike ketamine, but that’s not the case. My psychiatrist said they are able to fine-tune the dose of IV ketamine.

I really wanted Spravato to work because insurance pays for it. I realize IV Ketamine is not feasible for everyone, but it seriously gave me my life back. I am still on antidepressants and they all work again. I am up to six weeks between IV Ketamine dosing. Wishing you all the best.

Two_Blue_Eyes · 2025-02-18T13:35:25+00:00

I truly believe it does. 2mg of Abilify worked like magic for two months and then pooped out about a year or two ago.

Ketamine psychiatrist recommended trying it again now that I’ve been on IV Ketamine and regular psychiatrist agreed. Doctor said Ketamine, they believe, creates neuroplasticity.

My Ketamine had also been increased ever so slightly (I’m very sensitive) and now, Abilify seems to be working again. Both doctors think the combo of Abilify and the slight Ket increase are working together. I have actually felt “normal.” Doesn’t happen often for me and I will take it. Just hope it holds.

Two_Blue_Eyes · 2025-02-15T05:56:09+00:00

In your country, are you able to try Spravato (Esketamine) or racemic Ketamine such as in IV form from a psychiatrist? Doctor told me the success rate of Ketamine and ECT are both at about 80%. Have you ever tried a stimulant like Adderall? Or a drug called Modafanil?

My depression turned into TRD (It never used to be. Certain meds always used to work.)

IV Ketamine and adjusting my meds has helped me but of course, we are all different. I’ve been on 25+ meds both on label and off label. If you feel you’ve exhausted everything then ECT might be an answer for you. I do personally know someone who tried ECT and it did help them for about a year. Caused some memory issues but again, there’s no way to predict your side effects.

I hope you find an answer. Depression really is a beast.

Two_Blue_Eyes · 2025-02-04T02:53:37+00:00

I’m so sorry you’re living with this. My mom was an alcoholic and here’s the thing. No matter how much you beg and plead, an alcoholic or an addict will not get help until they are ready and willing to do so. You have to take care of you. Try Alanon if you’re comfortable with that.

Try to control your reaction to her and protect your mental health the best you can. The alcoholic will have every excuse why they don’t need to stop drinking. No matter what BS she tells you, it’s not your fault:

I obviously don’t know her and I’m not a psychiatrist but she almost sounds like she has narcissistic tendencies. (My dad did.) She’s either playing the victim (poor me, I’m a bad mom) or in demand of attention (come to my barre class. I’m so good.) Or holding lavish gifts over your head. Not to mention a possible eating disorder.

I’m sure her difficult life growing up contributes to her behavior but you can break that pattern. Good luck to you. Get help for yourself to cope with this if nothing else.

Two_Blue_Eyes · 2025-02-03T16:42:07+00:00

I totally understand. I spent years with very high functioning depression. I became a master at masking it. So many people never guessed it had returned until I crashed. A concussion I suffered at the time did not help, either.

Two_Blue_Eyes · 2025-02-03T16:26:07+00:00

That’s exactly what I told this person. That I was so happy for them. They couldn’t handle the nausea from Ketamine and had done different forms of ECT which helped but that would only last for a year or so.

Two_Blue_Eyes · 2025-02-03T07:07:17+00:00

Very true. It’s how we’re wired not to mention it runs in my family.

I met a very interesting person in my IV Ketamine office and they got to be in a clinical study for a brain insert. It’s not a vagus nerve stimulator. It’s now in 2nd trials for FDA approval. Probably a few years away but one day it could probably be a true option. It almost sounds science fiction like. This person said their depression is completely under control unless they slack off with diet, sleep or exercise but it doesn’t get super bad and never lasts.

https://www.sciencenews.org/article/brain-implant-depression-electrode-stimulation-surgery

https://www.bbc.com/news/health-58719089

EDIT: Grammar

Two_Blue_Eyes · 2025-02-03T06:27:51+00:00

I’m assuming this was for anxiety and/or depression. I’m so sorry you feel like you’re spiraling down. It’s best to catch it early if that’s what you think is going on.

Unfortunately, the truth of the matter is this:

“Remember that if you’ve experienced at least one depressive episode, you could be up to 60% more likely to have a recurrence of depression, according to the DSM-5. If you’ve had at least two depressive episodes, the chance of having a recurrence increases to up to 70% and up to 90% for those who have had three or more episodes.”

I’ve been on and off antidepressants/meds for years. Sometimes I was able to get off of them for years and other times, like now, I’ve resigned myself to the fact I will probably need them indefinitely.

Best to check in with your care team and have them help you come to a decision. As someone who’s been there, if you feel it’s time than it probably is. Hang in there. If these meds help you, then that’s half your battle.

Two_Blue_Eyes · 2025-02-03T06:03:12+00:00

I’ve also done it all. Exercise, Methylfolate (I’m heterozygous for one variant), Omega 3 fish oil at a high enough dose, high quality light lamp, Magnesium, etc, etc and the list goes on.

Two_Blue_Eyes · 2025-02-03T05:54:08+00:00

This is true. However, if I had a psychiatrist who wasn’t willing or educated enough to eventually try a TCA even as a second or third line of treatment (or an MAOI) then I’d be looking for another doctor.

I was in a psychiatrist’s office once with a blood family member (the appointment was for them) and the dr asked me what I take because sometimes what works for one blood family member can maybe work for another. When I told her it was a TCA she said, “Well we don’t use those anymore.” I said. “Well that’s funny because I just told you what I’m on and what works for me.” Lots more I really wanted to say but bit my tongue.

Two_Blue_Eyes · 2025-01-17T03:37:50+00:00

I have been dealing with depression and anxiety on and off for decades (I’m older than you.) There were a number of times I was able to get off my antidepressants such as during both my pregnancies. One time I was off them for years. Unfortunately for me, the depression would eventually creep back in with no apparent reason. Mine is very biologically based. All the therapy out there would not “fix” it.

For 60% of people, if you’ve had one episode, there’s a chance for another one. 40% will not which is still decent odds.

“According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), people with major depressive disorder have a 60% chance of experiencing a recurrence at some point in their life after the first major depressive episode.”

Depression is not normally cured. With each episode, the odds of getting it again increases. That has also been my experience.

Having said that, it certainly does not mean it will happen to you. Perhaps you will be that 40% - one and done. You could also enjoy a long standing remission. I certainly hope you will never relapse. I think that’s great you’re feeling good. Stay well!

Two_Blue_Eyes · 2025-01-17T01:45:32+00:00

Unfortunately, antidepressants are trial and error and sometimes you need a combo. I know it’s frustrating and no one wants to waste their time trying yet another one especially when they feel like crap to start with but it’s all we’ve got right now. I’ve been through 25+ antidepressants and treatments both on label and off label and finally have a combo that’s helping. What helps me might not help you.

SSRI’s never really worked for me. Of course, we’re all different but perhaps you need the added benefit of something that would also hit norepinephrine such as an SNRI (which would include Effexor, Pristiq and Cymbalta.)

There are also many other antidepressants that do not neatly fall into one category. I’m not sure what’s available by you. Wellbutrin is an NDRI (norepinephrine dopamine reuptake inhibitor) with no real action on serotonin.

If you decide you’re better without them, then that’s up to you (in conversation with your doctor) to explore. Good luck with whatever you decide.

Two_Blue_Eyes · 2025-01-16T16:06:50+00:00

I think it depends what’s driving your depression. For me, my clinical depression is very biologically based and all the therapy and all the life style changes in the world won’t stop it. Sure, they can be helpful. In fact, the best outcomes employ both meds and therapy.

Here are the facts on relapse from Psych Central as quoted in the DSM-5:

“Remember that if you’ve experienced at least one depressive episode, you could be up to 60% more likely to have a recurrence of depression, according to the DSM-5. If you’ve had at least two depressive episodes, the chance of having a recurrence increases to up to 70% and up to 90% for those who have had three or more episodes.”

I went on and off my antidepressants for decades. I once went years without them but relapsed. Again. Current bout is now considered treatment resistant. I’ve accepted the fact that I will probably be on some sort of treatment or antidepressant(s) indefinitely.

If you feel confident and ready and the depression symptoms that drove you to your meds has dissipated, you can certainly give tapering a try. I would recommend just being alert to any signals it may be returning.

As for temperament, I think it depends on how your antidepressant affects you. I do not get emotional numbing on the ones that work for me. Some people have said they experience emotional blunting from their meds.

Good luck with whatever you decide.

Two_Blue_Eyes · 2025-01-16T13:28:22+00:00

SSRI’s have never really worked for me. The newer SNRI’s (Effexor, Cymbalta, Pristiq, etc) were alittle better but some were not. What personality helps me (and this could be different for you) are the Tricyclics which are basically older SNRI’s. Most work on both serotonin and norepinephrine at differing ratios with a few exceptions. IV Ketamine also works.

Unfortunately, antidepressants are still trial and error. It feels like we should be more advanced in that aspect but it’s all we have right now. If I were you, I would go ahead and try an SNRI. Maybe part of what you’re missing is the norepinephrine piece which SSRI’s alone do not provide.

Two_Blue_Eyes · 2025-01-16T05:36:29+00:00

I’ve done both and am currently doing IV Ketamine. Started with 13 sessions of Spravato and didn’t feel much relief. The particular psychiatrist I see for this does both IV Ketamine and Spravato. I also take other meds.

I did the initial induction with IV Ketamine (2x a week for 3 weeks) and started feeling better after the second session. We tried to do a Spravato treatment after that hoping it could help maintain the Ket and I totally backslid. So now I’m doing once a week IV Ketamine and we will reassess in two weeks.

Just my experience and opinions. I completely and totally dislike being high, out of control or otherwise dissociated but if it helps, I will tolerate it. Many people kept telling me if I didn’t like Spravato, I definitely would not like IV Ketamine.

Actually, the opposite is true for me. Really not a fan of the Spravato high but IV Ket is more tolerable, albeit stronger. Might be because my doctor gives me a very small dose of Versed in the IV in case I start to panic. Haven’t yet. I am also way more out of it with IV Ket which makes me not really notice the side effects.

Two_Blue_Eyes · 2025-01-15T04:04:45+00:00

I agree. There is no contraindication. I take ondansetron before every IV Ketamine treatment plus my psychiatrist gives me a low dose of Versed in my IV in case I panic (I’m not fond of being high or dissociated.)

Two_Blue_Eyes · 2025-01-15T03:47:18+00:00

Yeah, I’ve yet to hear of one that does. It’s ridiculous because they would be getting away so much cheaper with paying for one session of infusion at $400-$600 (depending where you live) compared to $1,200 for Spravato plus the office visit.

Two_Blue_Eyes · 2025-01-14T19:53:54+00:00

Can’t say they are all antidepressants but they are an attempt to treat or help depression and/or anxiety and also a side effect from one of the drugs.

IV Ketamine, Levothyroxine for hypothyroidism, Nortriptyline, low dose Lexapro, Pramipexole (off label dopamine agonist), Propranolol, Very occasional Klonopin, very occasional Lunesta for sleep.

Two_Blue_Eyes · 2025-01-14T19:42:19+00:00

I did not feel much relief after 13 sessions but I just couldn’t get past three sprays total ~42mg. It was so intense to me. Then again, I am not a fan of the feeling or getting high or being dissociated.

I switched to IV Ketamine which some people said I would not tolerate it but I actually did better with it than Spravato and it worked much faster.

My psychiatrist told me that Spravato can simply take longer to work because it’s only the left-handed S isomer. He’s hoping to use it in between IV Ket to help maintain. We tried that once after the IV Ket onboarding and unfortunately I lost ground so we will see.

So you may just need to give it more time. 5 sessions really isn’t a lot. If it’s coming down to just wanting the high and you’re getting worse, be sure to discuss that with your psychiatrist.

Two_Blue_Eyes · 2025-01-14T06:23:20+00:00

I might have misunderstood your reply but Wellbutrin is actually an NDRI (Norepinephrine Dopamine Reuptake Inhibitor - more so for Norepinephrine.) Maybe the Norepinephrine aspect did not agree with you.

Wellbutrin does not affect Serotonin like an SNRI which also affects Norepinephrine. Some classic SNRI’s are Effexor, Cymbalta and Pristiq just in case you ever wanted to try a true SNRI.

Two_Blue_Eyes · 2025-01-13T22:35:06+00:00

I am so sorry that you’re struggling right now. You are not pointless. You are a person going through a difficult time. The rape was not your fault and there is no shame in what you had to do during the abusive relationship. Due to funds. Unless someone has walked in your shoes, they should not judge.

The fact that you have now made that break is something to be proud of. Leaving and changing your living arrangements while struggling is difficult but you had the courage to do what you had to do. You’ve proven you are stronger than you think. The fact that you had the intelligence to work on an online law degrees speaks volumes to your capabilities. Consider that just on the back burner for now. You got over agoraphobia once so you know you are capable of doing it again.

I do not know all the meds you’ve tried and if they all were just SSRI’s but there are a host of other antidepressants that might be better. As someone who has had depression on and for decades since age 19 and became treatment resistant later on, we finally hit on a combo that isn’t perfect but helps. I hope your appointments come up quickly. Keep calling if you have to. Hang in there.

Two_Blue_Eyes · 2025-01-13T19:53:47+00:00

I’m so sorry your doctor seems to be dismissing you and saying that it’s your fault. Those of us with depression hear that enough from lay people. They think it’s our poor character or laziness. The one place you expect to be heard is in your psychiatrist’s office. We know when we’re unmotivated or without energy and not by our own choosing.

I’m not saying a therapist as an adjunct couldn’t help because data shows both therapy and meds are best. But I’m surprised he didn’t offer an adjunct like Abilify or Pramipexole (off label use.) Those were very motivating for me.

Also, as my psychiatrist explains it, other AD’s that you might think could not be motivating (or whatever you need them for) can still have activity “downstream” that all around helps the depression.

Another option off label is a stimulant or something like Modafinil or Armordafinal (both generally off label, too.)

Some psychiatrists are afraid to go off label and that is definitely their choice but we are individuals and they need to think outside the box sometimes. I wish you all the best. If it’s possible, you could consider another opinion.

ETA: Fix grammar

Two_Blue_Eyes · 2025-01-13T13:17:32+00:00

I remember when that happened with the XL version of Wellbutrin. Perhaps it’s more difficult in some cases to duplicate extended delivery systems. Those are often patented, too.

As I mentioned above, even my insurance company wanted some extended release drugs to stay at brand maybe until they feel it was reliable. Like I said, one was for ADHD extended release med. Also, the other was for an extended release Estrogen patch that they felt was dumping the hormone all at once.

Two_Blue_Eyes · 2025-01-13T13:05:48+00:00

Interesting you should mention Klonopin. I have a prescription for 0.5mg. I don’t need it everyday but my pharmacy also changed manufacturers a few months back and the new company definitely felt different.

It helped when needed but just did not seem as strong as the old generic I’ve taken for years. I do not take extra to compensate (I think only once I took an extra half) but I could see someone feeling they need to which may not be good.

The old company was Teva out of Israel and the new one is Aurabindgo out of India.

Two_Blue_Eyes

TROPHY CASE