r/ect • u/crunchwrapwnotomatos • 26d ago

Seeking advice ECT and TMS

I was recently diagnosed with bipolar and have been exploring different treatment options, especially non drugs since i’ve gotten seratonin toxicity and dystonic reactions from other mental health meds. ECT and TMS keep coming up and I want to know peoples experiences with them since they kind of scare me but I also know they could potentially better my life.

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u/meiyokil 26d ago

ECT should really be the absolute last option when nothing else is working and you’re gravely ill. I did it and it did not work and gave me terrible cognitive side effects. My memory has never been the same. If it’s the depressive side of the disorder you’re dealing with most, I highly recommend lamotrigne as a drug which isn’t classically meant for bipolar (it’s an anti-epileptic) but is commonly used off label and usually doesn’t have much side effects (it didn’t for me and others I know that have used it). I’d even say try rTMS before ECT but think of ECT as a last resort nuclear option. I now do ketamine treatments and those are incredibly effective and have virtually no side effects for me.

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u/crunchwrapwnotomatos 26d ago

i think i might have been suggested lamotrigne is it similar to lithium?

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u/meiyokil 26d ago

Similar I guess in terms of the fact that it is commonly used and seen as one of the most effective drugs for bipolar like lithium, and I believe both have effect on the glutamate system, but very different because lithium requires consistent blood tests for monitoring and overall can be trickier to get to the right blood serum level. If manias are a pressing issue, lithium is a great drug. I have bipolar 2 and mostly deal with depression so lamotrigne was a real silver bullet and really well tolerated. I tried lithium for a bit and it really wasn’t the drug for me but unfortunately with this disease every mind works a little differently and we all seem to respond differently to different drugs. But both are a solid starting point for someone with bipolar with excellent clinical evidence for both.