Most of the people we spoke to had been on a number of different medications throughout their lives. You can read more about the effectiveness of different types of medication and their side effects here: ‘Medication for mental health conditions: effectiveness and side effects‘. This summary is about the process of changing from one medication to another and about moving from medication to ECT.
Changing medication could sometimes be a difficult process and it often took time to find a drug that worked. It can take some weeks for the side effects of a medication, for a particular individual, to be known. While patients may not like certain side effects, doctors try to balance the side effects of a medication with its effectiveness (how well it works to reduce the symptoms). Some doctors try to include patient views in decisions about medication. Some people we spoke to said they themselves had had to weigh up the side effects of medication with the benefits that they might bring.
Catherine Y found that she had to keep changing anti-depressants because of the side effects or because they stopped working after a while. It was difficult but they did help her overall.
Some found that changing medication improved their wellbeing. For others, changing medication could have a negative impact because the new drug didn’t work, or because it took too long to work. Some experienced side effects from stopping taking a drug.
Tania found antidepressants were acting as a stimulant and contributing to her inability to sleep. When she tried to come off them, it triggered her mental illness.
When Sunil had his medication changed from carbamazepine to disodium valproate and then to olanzapine and lamotrigine over a few years to combat side effects, he linked the changes to a relapse of his illness. Tristan’s wife had her antidepressant medication changed just before she gave birth and he thinks that left her vulnerable for the time it took the new medication to take effect. She suffered severe postnatal depression and eventually was given another drug that ‘suited her much better’ and ‘got her better properly in the long term’.
Yvonne had been ok for ten years, but the doctors changed her medication and it kinda knocked [her] back and she was admitted to hospital. Shes now asked for her medication not to be changed.
Carys said her daughter was taking many pills a day when a new psychiatrist said to bin them and start again. It made a dramatic change and she started being active.
Medication and ECT
Medications were usually given before ECT was offered, and ECT was only suggested when medications had not worked. People had different opinions about moving from medications to having ECT. Some people felt ECT had worked well for them and wanted ECT to be offered to them sooner. Others thought medications were a better solution in the long term.
Catherine Z had found ECT very effective for her and when her son was diagnosed with mental illness and medications weren’t working, she wanted him to have ECT from very early on. She felt it was ‘slightly barbaric’ giving her son high doses of drugs that were having no effect, when ECT could have been given much earlier. However, when David Y’s wife was offered ECT she had only been given very low doses of medication (Depixol), because she was pregnant. They gave ECT saying it was a ‘last resort’, but he felt more therapies and treatments should have been tried first. Tristan felt that medications were, in the long term, a more ‘humane’ and effective treatment for his wife, although in the short-term, ECT had improved his wife’s severe depression.
David Z didn’t get any great relief from antidepressants and found that ECT gave him a lift, which the tablets didn’t. He finds he is able to manage his moods better by himself than with tablets.
When Tania used ECT to help take her off medication it was absolutely incredible. Despite withdrawal symptoms from coming off the drug, she found she didn’t relapse.
Occasionally when people were taking medications at the time of the ECT, there were concerns some medication could get in the way of its effectiveness. Sheila mentioned that her husband had 5 ECT treatments before they discovered that he was not having proper seizures because of medication he was on to stop the threat of a stroke. The one time that ECT didn’t work for Tania she thinks it was because they were giving her a minor tranquillizer, a benzodiazepine (clonazepam), at the time.