u/QuitInevitable915

I have had treatment resistant depression for 2 years. I have tried Sertraline, duloxetine, mirtazapine, trintellix, TMS, Ketamine, Psilocybin, and I currently take Nortriptyline (TCA), lithium, and low dose quetapine. Like my previous attempts, it isn’t doing much, although, the best thing I have tried so far. I still feel depressed all time, and my psychiatrist have suggested to go with ECT or a MAOI (Marplan).

Would you go for the MAOI first despite the need for tapering and washout and did you have a similar series of trials before you got to a MAOI with depression? And of course, was it then helpful for you?

Hello!

I’m 28 and I suffer from TRD. I have had 4 depressive episodes over the past many years, and the current episode has lasted 2 years. I have tried SSRIs, SNRIs, TMS, Ketamine, and Psilocybin without meaningful response.

8 weeks ago I started taking a TCA with lithium, and for the first time in this episode I feel some relief. If I had to quantify it, I would say that I feel 40-50% better, which is a major change from the suicidal lows, but still with some residual symptoms such as mild/moderate sadness, some anhedonia, and low motivation.

I’m going to meet with my psychiatrist in two weeks to make the final decision on whether I should get ECT or not. I’m torn because I know my history of relapse, and not achieving remission will put me at risk of relapsing again, but I’m also reluctant to do it given the potential cognitive/memory side effects.

Would you do ECT or not in this situation?

I have been lurking for some time, and while I have anhedonia as a secondary symptom to my depression (main is sadness and emotional pain), I read about the German randomized control trial called “Foresee |||” with 46 patients, which builds on the previous open-label trial “Foresee ||”.

In the previous study they enrolled 16 patients with TRD and 100% achieved response (more than 50% symptom reduction) and 8 of them got remission (symptom free).

The target used in the brain for this trial is closely connected to anhedonia, and has shown a lot of promise for this subtype of depressive symptoms.

The results are expected to be published in end of 2026 or beginning of 2027, and if they are good (which the most likely will be based on the previous results), they will apply for a CE approvement, making it available as a treatment option for the broader public. This may of course take some time, but I encourage you to stay updated on the trial and the progress of the treatment. Hopefully it will help many of us!

Hello everyone,

Have any of you received ECT while being on a MAOI?

I’m currently on nortriptyline and lithium, and while I get some symptom reduction from my depression, it isn’t much. I will switch to Marplan (my first MAOI), and if that does not work, I will move to ECT. Therefore, I wondered if any of you have received ECT while being on a MAOI, and what the experience was like for you?

Hello guys,

A little bit of context: I’m struggling with treatment resistant depression and my core symptoms are sadness, emotional pain, and moderate anhedonia. This is my third depressive episode and it has been ongoing for 21 months. In the past 7 years, I have had about 1,5 years of remission while the remaining 5,5 years have been in depression.

During my first and second episode I could manage with SSRI, therapy, and a keto diet. Now, none of that has worked. I have tried SNRIs, Mirtazapine, Trintellix, Ketamine (IM), TMS, Psilocybin (micro and macro doses), and none of it has worked.

I’m currently on a TCA (nortriptyline), which probably has given me about 15-20% relief. I have spoken to my psychiatrist and he has recommended to try augmenting with lithium for the next three weeks, and if that doesn’t bring me to 40-50% relief, which I doubt it will, we will go for ECT.

Have any of you been through a similar journey, and did ECT end up helping? And if you were in my shoes, how would you prepare for ECT?