Other medical treatments

Tricyclic antidepressants (TCAs) and Monoamine Oxidase Inhibitors (MAOIs)

The older antidepressants (TCAs, and MAOIs) are effective against depression, and are still sometimes prescribed. However, people mainly had these drugs before the 1990s. People reported more side effects with these drugs compared to the newer anti-depressants (see 'Newer Anti-depressant medication'). With tricyclics, people talked about problems such as constipation, drowsiness, dry mouth, blurred vision, tremor, and weight gain. MAOIs could make people feel sluggish and drowsy, gain weight, and there was a risk of fainting when standing up due to low blood pressure. And because of the risk of a sudden increase in blood pressure called "hypertensive crisis", people on MAOIs had to follow a strict tyramine-free diet, excluding such diverse foods as broad bean pods, cheese and marmite.

For more information on antidepressants see MIND’s booklet – Making sense of antidepressants.

Lithium

A number of people took lithium, a drug which was first used to control manic depression, or bipolar disorder. People with bipolar disorder (which often runs in families) have a chemical disturbance in the brain which causes alternate periods of very high and very low mood, over periods of weeks or months. Sometimes these mood swings go in only one direction - either high or low - and this is called "unipolar disorder". Lithium can help some people who experience serious downward swings into depression, whether or not these lows are followed by highs.

Many thought that lithium helped them to steady their moods, and avoid extreme highs and lows. However, people on lithium had to have their blood monitored regularly to avoid toxic levels building up in their blood. There were also side effects with lithium that people did not like. Common side effects included increased urination, increased thirst, metallic taste in the mouth, mild nausea, weight change, and trembling hands.

One man felt that lithium took away some of the enjoyment of life, as well as his creativity and 'about 10 IQ points.' He wanted to be in control of his treatment, and so he negotiated with his doctor to come off lithium. Unfortunately, some found that reducing their lithium led to depression again. Some people who needed lithium were tempted to come off it when they felt well, not realising how it was preventing mania and depression. A few were angry that their doctors were not aware of less common problems with lithium such as hair loss (due to low thyroid function). Although friends of hers did well on lithium, one woman was adamant that lithium made her more paranoid, and also suicidal and violent. After much effort, she persuaded her doctor to change to another medication, and she then improved substantially.

Was well informed about lithium side effects, and was willing to take lithium to avoid depression again even though she is against long-term medication.

Says he did not like taking lithium because it stopped him doing things he enjoyed, and so he decided to slowly come off lithium with his doctors knowledge. (Read by an Actor).

He tends to become depressed when he tries to come off lithium, although his last depression wasn't so bad, so he feels more in control of his depression.

He lost his faith in psychiatrists when his hair fell out. His psychiatrist initially said it was to do with stress, but later said it was due to too much lithium.

Though her friends did well on lithium, she became suicidal and very paranoid before she stopped the lithium. (Read by an actor).

For more information on lithium see MIND’s booklet – Making sense of lithium and other mood stabilisers.

Electroconvulsive Therapy (ECT)

People who had electroconvulsive therapy (ECT) were so severely depressed they were often in hospital at the time. Being severely depressed, it was difficult for people to decide whether or not ECT was the right treatment for them. One man said 'I didn't know what ECT meant' when he had began a series of 20 sessions of ECT.

One woman insisted that ECT had resulted in her extraordinary recovery. Others had more mixed experiences, feeling only slight improvements, or unsure if there was any benefit. Because many were also taking medication for depression, some found it difficult to know if ECT had helped them. The main problems were memory loss (temporary and more permanent), severe headaches, tearfulness, and feeling confused and frightened. Several people reported being more forgetful after ECT, e.g. they forgot names of things. A few people had a particular dislike of ECT, and some were especially traumatised by the experience. Some people associated the look and smell of the ECT theatre with their negative and frightening experiences. One woman avoided further ECT treatment by pretending she was better. Another woman tried to find the humour in a frightening experience.

While she was unable to give consent to ECT (Electroconvulsive Therapy) in hospital, her recovery from depression was dramatic.

He 'swallowed his tongue' during ECT (Electroconvulsive Therapy) and had to try to alert the anaesthetists, and lost memory of a holiday and work practices.

Did not like ECT (Electroconvulsive Therapy), felt frightened and confused, and when she tried to exchange contact details with another patient who had ECT, neither of them could remember their own details.

It was also felt that the side effects of ECT could be much more substantial than people were initially led to believe. Some people reported the loss of large chunks of past memories, and were angry with doctors for denying that long-term memory could be lost.

After ECT (Electroconvulsive Therapy), she has no memory of specific time periods, and her doctors deny that the ECT caused her problems. She is angry her doctors seem so ill-informed about ECT. (Read by an actor).

For more information on electoconvulsive therapy see MIND’s booklet – Making sense of electroconvulsive therapy.

For more information on advance directives and the Mental Capacity Act see Mind’s factsheet - Briefing 4: Healthcare and welfare/personal care decisions under the Mental Capacity Act 2005.
 

Anti-anxiety and sleeping tablets

Anxiety and panic were very common among the people we talked to. Two common treatments for anxiety were benzodiazepines (e.g. diazepam, lorazepam, chlordiazepoxide), and beta-blockers (e.g. Inderal (propanolol)). Some benzodiazepines (e.g. temazepam) were also used to help people sleep. These drugs helped many people to cope with anxiety and sleep better. A few people had become addicted to benzodiazepines and had trouble withdrawing.

For more information see MIND’s booklet - Making sense of sleeping pills and minor tranquillisers.

Last reviewed October 2010.

Last updated October 2010.