![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 64. This is the beginning of the thread.
Posted by JohnL on August 14, 1999, at 17:17:25
My previous post asking about Selegiline probably gave me away. Here's the situation. I need some ideas. I have been on Prozac for six weeks (20mg). Jumpstarted it with SAMe. St Johns 900mg a day. Remeron (7.5-15mg) as needed for sleep. Prozac is the foundation treatment, the other stuff seems to help, but not enough to write a book about. I have a 1-10 depression scale. 1 is suicidal. 10 is "It's a nice day, I think I'll take the dog for a walk." Or, a 10 might be "I feel like playing my guitar". I've been at 2 to 4 range for two years. But right now I'm about a 6 or 7. Definitely improved. More sociabe at times, more confident, less procrastination. The primary symptom remains: anhedonia. Inability to anticipate or enjoy pleasure. No joy. No spark.
Anhedonia seems to stump every doc I've talked to. I've tried the SSRIs, Serzone, Wellbutrin, TCAs, Remeron. Haven't tried MAOIs. It is my guess that the dopamine system is at fault here, and that something like selegiline, amisulpride, amineptine might do the trick. Anhedonia is a primary negative symptom of schizophrenia as well, which is treated well with amisulpride. Don't know, maybe a Ritalin or something is possible. I just don't think any more serotonin approaches are going to help much, or they would have already.(Paxil, Zoloft, Celexa, now Prozac)
I've played guitar professionally for 30+ years. Some enthusiastic peers said I was the best in the state. But since depression hit me, my poor guitars remain untouched in their cases. Haven't played in 1 1/2 years. What a waste. I can't play because it breaks my heart to not enjoy it. Or anything else for that matter. I want so much to sit down and pump out some serious music again. Anhedonia, what a beast. So my good friends, help me out here. Ideas to ponder? Thanks. JohnL.
Posted by Glenn on August 14, 1999, at 18:04:30
In reply to Your vote to treat ANHEDONIA, posted by JohnL on August 14, 1999, at 17:17:25
>John,
I can sympathize with your cause as I have been battling the "beast" for quite some time now. I did try selegiline for a short time (6months) and recieved a little relief but not as much as I had on effexor. I'm with you on that I also believe that anhedonia is tied in with DA. More specifically the D2 and D3 receptors.
I've read some initial reports saying the new DA agonist mirapex used for parkinsons disease has shown some potential antidepressant actions. Also L-phenylalanine taken concurrently with selegiline might be another option. I just ordered some reboxetine from overseas I hope to give it a trial soon. As for now I am currently taking 225mg of effexor xr. I've read that effexor inhibits the reuptake of DA and NE only in the higher doses so I am adjusting my dose as I tolerate the side effects. I know this is'nt much but I hope it gets the mind turning!
Posted by Elizabeth on August 14, 1999, at 21:46:22
In reply to Your vote to treat ANHEDONIA, posted by JohnL on August 14, 1999, at 17:17:25
> I've played guitar professionally for 30+ years. Some enthusiastic peers said I was the best in the state. But since depression hit me, my poor guitars remain untouched in their cases. Haven't played in 1 1/2 years. What a waste. I can't play because it breaks my heart to not enjoy it. Or anything else for that matter. I want so much to sit down and pump out some serious music again.
This jumped out at me. I had much the same thing going on. This may sound odd, but adding lithium to my otherwise-effective antidepressant was what did the trick.
Posted by Stephan on August 14, 1999, at 23:50:37
In reply to Your vote to treat ANHEDONIA, posted by JohnL on August 14, 1999, at 17:17:25
Haven't touched my guitar for many months, either. People who think beating depression is primarily a matter of starting to doing things again that you used to love are seriously deluded. This only makes my depression worse. Anhedonia is a curse like no other.
On a brighter note, I don't think anhedonia is necessarily a dopamine-related problem. Have you tried an SSRI/Tricyclic combo? Thyroid hormone augmentation? Buspirone augmentation? There's tons of other stuff out there. (Finding a competent doctor willing to try all or even some of the available options, however, may prove to be the far greater challenge).
Posted by Paul on August 15, 1999, at 1:19:20
In reply to While my guitar gently rusts, posted by Stephan on August 14, 1999, at 23:50:37
> Haven't touched my guitar for many months, either. People who think beating depression is primarily a matter of starting to doing things again that you used to love are seriously deluded. This only makes my depression worse. Anhedonia is a curse like no other.
>
> On a brighter note, I don't think anhedonia is necessarily a dopamine-related problem. Have you tried an SSRI/Tricyclic combo? Thyroid hormone augmentation? Buspirone augmentation? There's tons of other stuff out there. (Finding a competent doctor willing to try all or even some of the available options, however, may prove to be the far greater challenge).
I can't disagree with any of these posts. I'm struggling with similar probs. I think a stimulant, Ritalin, dexadrine spansules, cylert, would be my first choice, if you can get your doc to prescribe it, I can't. It seems that there's a seesaw like effect with serotonin and dopamine. When you raise one, the other seems to be lowered. But many have found relief with the addition of a stimulant, dopamine agonist, lithium, pindolol, something called "Revia" which I'm looking for more info. on. Also, a loaner high spectrum SAD light could help, I think I'm gonna try it. Here in Atlanta, at Emory U., they're having great results with Transcranial Magnetic Stimulatition, seems to be as effective as ECT, without the amnesia, etc. Just remember, you've got a lot of options, and more are emerging daily. Hope some of this helps.
Posted by Elizabeth on August 15, 1999, at 1:42:11
In reply to Re: fellow anhedonia sufferer tips , posted by Paul on August 15, 1999, at 1:19:20
> I think a stimulant, Ritalin, dexadrine spansules, cylert, would be my first choice, if you can get your doc to prescribe it, I can't.
If it's any consolattion, I tried these; they didn't seem to help. I had the same not-interested-in-music problem that everybody else is describing (only I don't play the guitar ). I also wasn't eating, going outside except when I had to, socializing, etc. Within a week on lithium I started having urges to do all this stuff again. Lithium has about a dozen pharmacological mechanisms, many of which involve things that I don't yet understand very well.
> But many have found relief with the addition of a stimulant, dopamine agonist, lithium, pindolol, something called "Revia" which I'm looking for more info. on.
Revia blocks opioid receptors. I'd stay away from it if you have anhedonia; a guy I know who has been doing clinical research on opioids in depression says it tends to be dysphoric.
There is buprenorphine, but I think if you can't get your doc to prescribe Ritalin or Dexedrine, you probably won't be able to get him/her to write for buprenorphine, either. Still, it's a great drug for anhedonia. I've heard of people using long-acting morphine (MS Contin, Kadian) as well. I tried MS Contin for a bit (it comes in pill form, unlike buprenorphine) and it worked, but not as well as a supposedly-equivalent dose of buprenorphine did (on depressive symptoms in general, not just anhedonia).
> Also, a loaner high spectrum SAD light could help, I think I'm gonna try it.
Let us know how it goes!
Posted by JohnL on August 15, 1999, at 8:33:50
In reply to While my guitar gently rusts, posted by Stephan on August 14, 1999, at 23:50:37
Thanks all for great ideas. Keep em coming if you can. My psychiatrist will write a precip for anything. No prob. He's been around a long time, worked with lots of heavy hitters, and I think he knows that often times finding the right treatment is about the same as throwing darts, throwing the dice, picking straws. He is well aware that what ends up working may or may not have any logical reason as to why. Body chemistries are just so different. No way to predict. He helps me weigh the pros and cons of choices. But he, like me, is willing to try anything that makes some sense. He did mention Ritalin once. So, getting a prescrip is no prob. Deciding what to do is. Meanwhile, the guitar does gently rust (good one Stephan!) Very grateful for your ideas and support. Thanks. JohnL.
Posted by andrewb on August 15, 1999, at 12:43:37
In reply to Re: While my guitar gently rusts, posted by JohnL on August 15, 1999, at 8:33:50
> Thanks all for great ideas. Keep em coming if you can. My psychiatrist will write a precip for anything. No prob. He's been around a long time, worked with lots of heavy hitters, and I think he knows that often times finding the right treatment is about the same as throwing darts, throwing the dice, picking straws. He is well aware that what ends up working may or may not have any logical reason as to why. Body chemistries are just so different. No way to predict. He helps me weigh the pros and cons of choices. But he, like me, is willing to try anything that makes some sense. He did mention Ritalin once. So, getting a prescrip is no prob. Deciding what to do is. Meanwhile, the guitar does gently rust (good one Stephan!) Very grateful for your ideas and support. Thanks. JohnL.
John,
After more than a month of usage, I continue to have good results and euthymic effect from amisulpride. As you know amisulpride is specific to the D2-D3 receptors, mainly those in the limbic system. I think that pramipexole (Mirapex), though it hasn't been studied as thoroughly for depression as amisulpride, would have a similar effect with the added benefit of being available in the US. Since pramipexole acts more preferentially on the striatum D2-D3 than amisulpride it may have more of an anxiolytic effect and it has certainly been noted for that. Another good thing about these med.s is that they act quickly. You have no reason to take amisulpride longer than a week to decide whether or not it is helping you.
It certainly seems possible that other medicines could combat anhedonia even if the key lies in the D2-D3 pathways. I've read that SSRIs and classic antidepressants increase the responsiveness of D2-D3 receptors over time, possibly by increasing receptor density.
I've tried amineptine and it can be effective. However it seems to stimulate unnecessary parts of the dopaminergic system causing unwanted side effects like agitation or muscle tension and visual distortion. I only tried selegiline at a low dose (5-10mgs.), with and without phenylalanine. I did not experience good effect. Phenylalanine by itself I found to be unpleasantly stimulating.
I use buprenorphine (the sublingual form that isn't available in the US) very occasionally for pain. From what I've read there are some cases where it has been effectively used to treat depression. But be warned that it seems there is some potential for habituation and even abuse. I believe its mode of action is via occupation of opiate receptors.
By the way I hear it mentioned here and there in posts that Wellbutrin (bupropion) acts through dopaminergic mechanisms. I'm confused on this. How does bupropion’s dopaminergic effect compare in significance to the med.s effect on norepinephrine. I've also read that while it inhibits the reuptake of dopamine, bupropion also diminishes the release of dopamine. Does that make its net effect on the dopaminergic system a wash? Should bupropion’s energizing effects be attributed to norepinephrine or dopamine action?
John glad to hear you are feeling better. Best of luck finding relief for your anhedonia. From reading your posts it seems that your approach to recovery serves you well.
Posted by DL on August 15, 1999, at 14:41:18
In reply to Re: fellow anhedonia sufferer tips , posted by Elizabeth on August 15, 1999, at 1:42:11
>>I also wasn't eating, going outside except when I had to, socializing, etc. Within a week on lithium I started having urges to do all this stuff again.
I'm curious to hear from any posters about using lithium as above? I had heard that lithium has so many side effects and must be watched carefully. I don't hear as many people mention it with all the newer drugs out now. Is it used in much smaller doses than when used alone for Bi Polar? Interested to hear responses as I also feel like posters have described above. Also seems to me lithium tends to cause weight gain? I take Remeron and it does let me sleep finally, and also lowers anx level. I cannot take the SSRI's, Effexor or Wellbutrin. They all instantly (and on low dose) make me feel plugged into an electric outlet and I can't sleep or function or even sit still. With Remeron I don't need another incentive to my body to gain weight. I can't seem to decrease the 25 lbs I added on Remeron no matter what. Any ideas to deal with anhedonia? I am in therapy. But only rarely to I have minutes of what it feels like, perhaps, to be normal--to be excited,-as above to enjoy music-or really mostly anything. Life is mostly a routine.
Posted by Cynthia on August 15, 1999, at 17:53:15
In reply to Lithium augmentation, posted by DL on August 15, 1999, at 14:41:18
Hi John,
I admire your determination to get better. I don't have any doubts that you won't get there. I use lithium (I'm bipolar) but it does more for my depression than any AD has ever done. I use lights; could be worth trying if you imagine your depression could be seasonal - I can feel my mood altering on a cloudy day in summer. I think I remember you mentioning in one of your posts you live close to Canada (great health care/lousy weather - I'm Canadian). And Dexedrine has been as good as lithium for my depression. I'm not certain exactly what it has done, I don't believe my body has completely adjusted to its introduction in my pill taking routine, but it gave the depressive part of my cyclothymic cycle a great kick. For the past 3 weeks, the depressive part of this cycle is gone, first time ever! I can't speak for the future, but for now, I've pretty well given up on ADs. Keep us up to date John. I certainly haven't arrived, but I, too, am definately getting there. What a process, huh?
Cynthia
DL,
lithium - caused tremendous nausea which I successfully treat with ginger root daily. Other than this, it's has no side affects, no weight gain, worked great within a few days of taking it, no problems with my blood. Good luck!
Cynthia
Posted by Elizabeth on August 15, 1999, at 18:47:09
In reply to Lithium augmentation, posted by DL on August 15, 1999, at 14:41:18
> I'm curious to hear from any posters about using lithium as above? I had heard that lithium has so many side effects and must be watched carefully.
It has a lot of side effects for some people. I don't find it too bad. Augmentation doses are very low, though; not like what is used in bipolar. For me, the side effects have been: diarrhea (went away after a few days); acne (I was just recovering from adolescence! I'm now using topical clindamycin and it seems like it might be starting to help); and having to urinate all the time (haven't figured out a way to deal with this one, except staying near a bathroom at all times!). It may or may not be causing attention problems - this is the most worrisome to me, since I'm a student!
Some other potential side effects are nausea (already mentioned; ginger is a great tx for this) and tremor (exacerbated by caffeine). Also, it should not be used during pregnancy, as there's definitely a good chance of birth defects. (Yes, I know this doesn't apply to everyone here!)
You do have to get blood tests every so often, including serum levels, TSH, electrolytes, I forget what else. Renal, thyroid, and parathyroid functioning are the main things that need to be watched. I think this should be a limiting factor only if you are afraid of needles.
> I don't hear as many people mention it with all the newer drugs out now.
I think there is less evidence supporting it as an augmenter for the newer drugs, just because it hasn't been tested as much. I'm taking it with Parnate. (What can I say? I'm an old-fashioned kind of girl.)
> Is it used in much smaller doses than when used alone for Bi Polar?
Yeah...serum levels for augmentation are supposed to be around 0.5-0.8 mmol/L, whereas for bipolar disorder (maintenance), they're supposed to be more like 0.8-1.2 (and up to 1.4 or 1.5 for acute mania). I take 600mg, which puts me at a serum level of 0.7 or so; you might need more, depending on your body size.
> Also seems to me lithium tends to cause weight gain?
I've heard this, but it hasn't been true in my case. I gained weight because I started eating again, but not more than I would have expected.
> I take Remeron and it does let me sleep finally, and also lowers anx level.
Some people find Li+ to help with insomnia and anxiety. I don't, personally. Then again, *nothing* helps with my insomnia. (My psychopharmacologist said he would set me up with a sleep doc he knows; I think it's time to take him up on this offer.)
> I cannot take the SSRI's, Effexor or Wellbutrin. They all instantly (and on low dose) make me feel plugged into an electric outlet and I can't sleep or function or even sit still.
SSRIs just don't work for me, Wellbutrin made me feel awful, and Effexor...well, it seemed to be working pretty well, but then something bad happened.
> Any ideas to deal with anhedonia? I am in therapy. But only rarely to I have minutes of what it feels like, perhaps, to be normal--to be excited,-as above to enjoy music-or really mostly anything. Life is mostly a routine.
I don't think therapy will help with this. I feel like talk therapy only became helpful to me once I started the lithium, actually.
Posted by cynthia on August 16, 1999, at 20:51:11
In reply to John and DL, posted by Cynthia on August 15, 1999, at 17:53:15
>yes, I completelyl forgot about the acne, which I didn't have before lithium. It's a pain in the ass, especially because I am 31 years old and rarely had a pimple before lithium. Now, I go to the dermatologist to have my pimples(cysts) injected. I go about once a week, and this just barely keeps it under control.
Cynthia
Posted by RG on August 18, 1999, at 9:28:04
In reply to Your vote to treat ANHEDONIA, posted by JohnL on August 14, 1999, at 17:17:25
> My previous post asking about Selegiline probably gave me away. Here's the situation. I need some ideas. I have been on Prozac for six weeks (20mg). Jumpstarted it with SAMe. St Johns 900mg a day. Remeron (7.5-15mg) as needed for sleep. Prozac is the foundation treatment, the other stuff seems to help, but not enough to write a book about. I have a 1-10 depression scale. 1 is suicidal. 10 is "It's a nice day, I think I'll take the dog for a walk." Or, a 10 might be "I feel like playing my guitar". I've been at 2 to 4 range for two years. But right now I'm about a 6 or 7. Definitely improved. More sociabe at times, more confident, less procrastination. The primary symptom remains: anhedonia. Inability to anticipate or enjoy pleasure. No joy. No spark.
>
> Anhedonia seems to stump every doc I've talked to. I've tried the SSRIs, Serzone, Wellbutrin, TCAs, Remeron. Haven't tried MAOIs. It is my guess that the dopamine system is at fault here, and that something like selegiline, amisulpride, amineptine might do the trick. Anhedonia is a primary negative symptom of schizophrenia as well, which is treated well with amisulpride. Don't know, maybe a Ritalin or something is possible. I just don't think any more serotonin approaches are going to help much, or they would have already.(Paxil, Zoloft, Celexa, now Prozac)
>
> I've played guitar professionally for 30+ years. Some enthusiastic peers said I was the best in the state. But since depression hit me, my poor guitars remain untouched in their cases. Haven't played in 1 1/2 years. What a waste. I can't play because it breaks my heart to not enjoy it. Or anything else for that matter. I want so much to sit down and pump out some serious music again. Anhedonia, what a beast. So my good friends, help me out here. Ideas to ponder? Thanks. JohnL.Wow is all I can say. I have tried those SSri's, too, but with your same results. I am going to my doc today cuz I am sick of living like this. I have little to look forward to. Would you believe I live in Aspen, CO and am miserable? I am on zoloft (100mg) now for 5 weeks after trying celexa for 7 weeks (did little). Maybe the SSRI treat the depression, but I have no joy or happiness. I go out infrequently. My job (which I know I like) performance is minimal now and I don't do anything. Nothing interests me and this isn't right. I have been sober for almost 3 years and now I don't even have alcohol and drugs to get some relief so....I look forward to any more input here on the subject.
RG
Posted by JohnL on August 19, 1999, at 3:26:13
In reply to For John or anyone RE: Anhedonia (DR. Bob??), posted by RG on August 18, 1999, at 9:28:04
RG, so sorry you're dealing with anhedonia too. I wish there was a recipe to treat it. Suggestions though? If Zoloft is OK, except for the anhedonia, try working with it. Choices are many. Add a TCA like Nortriptyline, Desiprimine, Vivactil. Buspar is so supposed to have real good synergy with Zoloft. Lithium augmentation is a standard approach. If one was to assume a dopamine connection, rather than serotonin, then there is Wellbutrin, Amisulpride. The choices really are staggering. I think it's important to have a good doc to help you understand the pros and cons of choices and set some priorities in them. Wishing you well. JohnL.
Posted by Rg on August 19, 1999, at 18:31:51
In reply to My vote for anhedonia relief, posted by andrewb on August 15, 1999, at 12:43:37
> > Thanks all for great ideas. Keep em coming if you can. My psychiatrist will write a precip for anything. No prob. He's been around a long time, worked with lots of heavy hitters, and I think he knows that often times finding the right treatment is about the same as throwing darts, throwing the dice, picking straws. He is well aware that what ends up working may or may not have any logical reason as to why. Body chemistries are just so different. No way to predict. He helps me weigh the pros and cons of choices. But he, like me, is willing to try anything that makes some sense. He did mention Ritalin once. So, getting a prescrip is no prob. Deciding what to do is. Meanwhile, the guitar does gently rust (good one Stephan!) Very grateful for your ideas and support. Thanks. JohnL.
>
> John,
> After more than a month of usage, I continue to have good results and euthymic effect from amisulpride. As you know amisulpride is specific to the D2-D3 receptors, mainly those in the limbic system. I think that pramipexole (Mirapex), though it hasn't been studied as thoroughly for depression as amisulpride, would have a similar effect with the added benefit of being available in the US. Since pramipexole acts more preferentially on the striatum D2-D3 than amisulpride it may have more of an anxiolytic effect and it has certainly been noted for that. Another good thing about these med.s is that they act quickly. You have no reason to take amisulpride longer than a week to decide whether or not it is helping you.
> It certainly seems possible that other medicines could combat anhedonia even if the key lies in the D2-D3 pathways. I've read that SSRIs and classic antidepressants increase the responsiveness of D2-D3 receptors over time, possibly by increasing receptor density.
> I've tried amineptine and it can be effective. However it seems to stimulate unnecessary parts of the dopaminergic system causing unwanted side effects like agitation or muscle tension and visual distortion. I only tried selegiline at a low dose (5-10mgs.), with and without phenylalanine. I did not experience good effect. Phenylalanine by itself I found to be unpleasantly stimulating.
> I use buprenorphine (the sublingual form that isn't available in the US) very occasionally for pain. From what I've read there are some cases where it has been effectively used to treat depression. But be warned that it seems there is some potential for habituation and even abuse. I believe its mode of action is via occupation of opiate receptors.
> By the way I hear it mentioned here and there in posts that Wellbutrin (bupropion) acts through dopaminergic mechanisms. I'm confused on this. How does bupropion’s dopaminergic effect compare in significance to the med.s effect on norepinephrine. I've also read that while it inhibits the reuptake of dopamine, bupropion also diminishes the release of dopamine. Does that make its net effect on the dopaminergic system a wash? Should bupropion’s energizing effects be attributed to norepinephrine or dopamine action?
> John glad to hear you are feeling better. Best of luck finding relief for your anhedonia. From reading your posts it seems that your approach to recovery serves you well.So, would you agree that Wellbutrin may not help, but actually limit the dopamine release??
Posted by JohnL on August 20, 1999, at 14:07:37
In reply to Re: My vote for anhedonia relief, posted by Rg on August 19, 1999, at 18:31:51
RG, Wellbutrin's mechanism seems to be a mystery. It works wonders for some. My psychiatrist says his results with it have been "spotty". I did try it once, but it caused such severe tinnitus I had to stop after just 2 weeks. I do have amisulpride on order and expect delivery in another week or two. We'll see what happens. Thanks. JohnL.
Posted by Anhed on January 4, 2009, at 19:11:59
In reply to Your vote to treat ANHEDONIA, posted by JohnL on August 14, 1999, at 17:17:25
> My previous post asking about Selegiline probably gave me away. Here's the situation. I need some ideas. I have been on Prozac for six weeks (20mg). Jumpstarted it with SAMe. St Johns 900mg a day. Remeron (7.5-15mg) as needed for sleep. Prozac is the foundation treatment, the other stuff seems to help, but not enough to write a book about. I have a 1-10 depression scale. 1 is suicidal. 10 is "It's a nice day, I think I'll take the dog for a walk." Or, a 10 might be "I feel like playing my guitar". I've been at 2 to 4 range for two years. But right now I'm about a 6 or 7. Definitely improved. More sociabe at times, more confident, less procrastination. The primary symptom remains: anhedonia. Inability to anticipate or enjoy pleasure. No joy. No spark.
>
> Anhedonia seems to stump every doc I've talked to. I've tried the SSRIs, Serzone, Wellbutrin, TCAs, Remeron. Haven't tried MAOIs. It is my guess that the dopamine system is at fault here, and that something like selegiline, amisulpride, amineptine might do the trick. Anhedonia is a primary negative symptom of schizophrenia as well, which is treated well with amisulpride. Don't know, maybe a Ritalin or something is possible. I just don't think any more serotonin approaches are going to help much, or they would have already.(Paxil, Zoloft, Celexa, now Prozac)
>
> I've played guitar professionally for 30+ years. Some enthusiastic peers said I was the best in the state. But since depression hit me, my poor guitars remain untouched in their cases. Haven't played in 1 1/2 years. What a waste. I can't play because it breaks my heart to not enjoy it. Or anything else for that matter. I want so much to sit down and pump out some serious music again. Anhedonia, what a beast. So my good friends, help me out here. Ideas to ponder? Thanks. JohnL.Dear John,
I know this reply is some 10 years after your post.
Anyway, if your're still around, for what it's worth, my oldest son Alex, 24, also a musician, suffers from what you describe.
Alex discovered a recent patent dated 02/23/2006 on the internet by a certain Dr Nathanson entitled "Treatment of Anhedonia". The link is:
http://www.freepatentsonline.com/y2006/0217394.html
Hope this helps. At least you're in the US where psychiatrists, such as Nathanson, are less conservative. Most psychiatrists just don't get it - namely that the very anti-depressants they prescribe are also responsible for causing what Nathanson calls "iatrogenic anhedeonia." Ritalin (methylphenidate)is certianly in there as the main drug to treat it.
Alex is still struggling. If you would like to correspond with him,let me know and I'll send you his email address.
To see someone who used to love music so much is to suffer with them.
You're not alone.
Kind Regards,
Paul
Australia
Posted by Sigismund on January 9, 2009, at 23:21:57
In reply to Re: Your vote to treat ANHEDONIA, posted by Anhed on January 4, 2009, at 19:11:59
>Most psychiatrists just don't get it - namely that the very anti-depressants they prescribe are also responsible for causing what Nathanson calls "iatrogenic anhedeonia."
In Australia many psychs (though less often their patients) see the iatrogenic anhedonia as therapeutic.
Posted by SLS on January 10, 2009, at 4:16:00
In reply to Re: Your vote to treat ANHEDONIA, posted by Sigismund on January 9, 2009, at 23:21:57
What about using Abilify with amphetamine? I haven't seen this combination used before, so I am afraid you would be a bit of guinea pig.
- Scott
Posted by X_ander on January 11, 2009, at 1:52:43
In reply to Re: Your vote to treat ANHEDONIA, posted by Sigismund on January 9, 2009, at 23:21:57
> >Most psychiatrists just don't get it - namely that the very anti-depressants they prescribe are also responsible for causing what Nathanson calls "iatrogenic anhedeonia."
>
> In Australia many psychs (though less often their patients) see the iatrogenic anhedonia as therapeutic.
Wow...I actually thought it was only myself who had that impression of psychs in australia...do you find it's just a general attitude to things or have they actually said something along those lines...?
Posted by Sigismund on January 11, 2009, at 14:38:04
In reply to Re: Your vote to treat ANHEDONIA, posted by X_ander on January 11, 2009, at 1:52:43
>have they actually said something along those lines...?
Well, yes.
They are aware that SSRIs promote apathy and they see that as the flip side of the therapeutic effect.
One said so to me.Anhedonia from a psychiatric point of view is no big deal..........that's the impression I get.
Posted by Cseagraves on January 14, 2009, at 11:25:28
In reply to Re: Your vote to treat ANHEDONIA, posted by Anhed on January 4, 2009, at 19:11:59
Hi John,
Sorry, but I haven't had any experience regarding anhedonia. Just wanted to welcome you here and I'm sure you will be able to get great advice from others on the board.
I wish you and your son the very best.
Courtney
Posted by Cheryl-Lynn on January 17, 2009, at 15:53:21
In reply to Re: Your vote to treat ANHEDONIA, posted by Cseagraves on January 14, 2009, at 11:25:28
I too have felt no joy for years now and have seemingly tried every combo of drugs to the point where my Dr is getting frustrated. What I haven't tried is lithium.
I'd love to hear more advice on the topic of anhedonia and how to "feel" again.
My heart goes out to all who are feeling this way - it's almost as bad as the depression.
Posted by X_ander on January 19, 2009, at 20:09:15
In reply to Re: Your vote to treat ANHEDONIA, posted by Cheryl-Lynn on January 17, 2009, at 15:53:21
Go to this weblink, read it and give it to your psychiatrist:
http://www.freepatentsonline.com/y2006/0217394.html
> I too have felt no joy for years now and have seemingly tried every combo of drugs to the point where my Dr is getting frustrated. What I haven't tried is lithium.
> I'd love to hear more advice on the topic of anhedonia and how to "feel" again.
> My heart goes out to all who are feeling this way - it's almost as bad as the depression.
Posted by Connor on January 20, 2009, at 19:46:39
In reply to Re: Your vote to treat ANHEDONIA, posted by Anhed on January 4, 2009, at 19:11:59
One of the adhd drugs such as adderall, dopamine seems to be a key component I think
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.