![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 39. This is the beginning of the thread.
Posted by falconman on April 5, 2007, at 17:14:07
What are peoples opinions on the best meds for releiving anhedonia. Stimulants? selegeline? tianeptine? PEA?
Thanks
Posted by falconman on April 5, 2007, at 17:50:51
In reply to Best meds for anhedonia, posted by falconman on April 5, 2007, at 17:14:07
I want to feel something whether its good or bad. I want to be able to cry, to look forward to things, to feel warmth off people, to be able to connect with others, to feel love towards the people that intellectualy I know I love. I want some sex drive, a sense of humour, some sense of spontaneity, a sense of well being. I want to know my likes and dis-likes, have a sense of self, of what my personality is like and basically not keep exsisting like an empty shell without a soul.
Posted by Quintal on April 5, 2007, at 19:25:44
In reply to Best meds for anhedonia, posted by falconman on April 5, 2007, at 17:14:07
Opiates.
Q
Posted by Phillipa on April 5, 2007, at 20:25:58
In reply to Re: Best meds for anhedonia, posted by falconman on April 5, 2007, at 17:50:51
Me too. Love Phillipa
Posted by flmm on April 5, 2007, at 21:06:11
In reply to Re: Best meds for anhedonia » falconman, posted by Phillipa on April 5, 2007, at 20:25:58
opiates are the best med for chronic apathy, depression, lethargy, and an unmotivated pathetic existence.
Posted by Declan on April 5, 2007, at 21:38:33
In reply to Re: Best meds for anhedonia, posted by flmm on April 5, 2007, at 21:06:11
>an unmotivated pathetic existence<
Really? That's good. Must get some.
Posted by flmm on April 5, 2007, at 21:47:45
In reply to Re: Best meds for anhedonia » flmm, posted by Declan on April 5, 2007, at 21:38:33
That's the life addicts live, isn't it?
Posted by flmm on April 5, 2007, at 21:49:39
In reply to Re: Best meds for anhedonia, posted by flmm on April 5, 2007, at 21:47:45
I new I could count on the PB opiate pushers for a post!
Posted by Declan on April 6, 2007, at 1:20:48
In reply to Re: Best meds for anhedonia, posted by flmm on April 5, 2007, at 21:49:39
> I new I could count on the PB opiate pushers for a post!
How could I resist you?
Posted by Declan on April 6, 2007, at 1:33:38
In reply to Re: Best meds for anhedonia » flmm, posted by Declan on April 6, 2007, at 1:20:48
Anyone who can get me to confess to crimes I have not committed has my attention.
I was originally not going to recommend opiates.
I thought tianeptine or deprenyl might be better.
(Sounds like a pretty poor alibi to me)I've always been fond of confession.
Posted by psychobot5000 on April 6, 2007, at 2:20:29
In reply to Re: Best meds for anhedonia, posted by Declan on April 6, 2007, at 1:33:38
Not technically a 'med' but fish oil (EPA) might help. MAO inhibitors might be another good bet.
Posted by falconman on April 6, 2007, at 5:51:47
In reply to Re: Best meds for anhedonia, posted by flmm on April 5, 2007, at 21:06:11
Name some opiates. I'm weary but interested.
Thanks for your responses
Posted by Quintal on April 6, 2007, at 7:12:06
In reply to Re: Best meds for anhedonia, posted by falconman on April 6, 2007, at 5:51:47
For me OTC painkiller tablets containing small amounts (20-40mg) of codeine (not enough to get 'high' incidentally) have worked better for my depression/anhedonia/anxiety than any other pharmaceutical. I tend to build up tolerance after a few months of continuous use, then taper off to regain the effects. The tapering off is not at all unbearable because it's such a small dose, and I've just this week found that Mirapex (pramipexole) halts rebound anhedonia and helps physical/emotional pain. It feels very similar to the 'nodding' sensation of opiates i.e. no high or euphoria, just calm, peaceful contentment.
Buprenorphine is the opiate most often prescribed for treatment resistant depression, but other here have been prescribed hydrocodone, methadone etc.
Amisulpride at doses below 50mg is also helpful for dysthymia/anhedonia. They key linking all these drugs is that they are pro-dopamine.
Q
Posted by emme on April 6, 2007, at 7:17:25
In reply to Best meds for anhedonia, posted by falconman on April 5, 2007, at 17:14:07
> What are peoples opinions on the best meds for releiving anhedonia. Stimulants? selegeline? tianeptine? PEA?
> ThanksAbilify. Focalin.
Posted by flmm on April 6, 2007, at 10:35:37
In reply to Re: Best meds for anhedonia » falconman, posted by emme on April 6, 2007, at 7:17:25
Opiates are pain killers, plain and simple! If you are in pain they make you feel better. Are you in pain Declan?
Posted by falconman on April 6, 2007, at 12:40:03
In reply to Re: Best meds for anhedonia » falconman, posted by Quintal on April 6, 2007, at 7:12:06
To get 20-40mg codeine from OTC painkillers you would have to take loads of parecetamol/asprin too. This can't be good for you. An average co-codamol tablet contains codeine phosphate 8mg and paracetamol 500 mg.
would > For me OTC painkiller tablets containing small amounts (20-40mg) of codeine (not enough to get 'high' incidentally) have worked better for my depression/anhedonia/anxiety than any other pharmaceutical. I tend to build up tolerance after a few months of continuous use, then taper off to regain the effects. The tapering off is not at all unbearable because it's such a small dose, and I've just this week found that Mirapex (pramipexole) halts rebound anhedonia and helps physical/emotional pain. It feels very similar to the 'nodding' sensation of opiates i.e. no high or euphoria, just calm, peaceful contentment.
>
> Buprenorphine is the opiate most often prescribed for treatment resistant depression, but other here have been prescribed hydrocodone, methadone etc.
>
> Amisulpride at doses below 50mg is also helpful for dysthymia/anhedonia. They key linking all these drugs is that they are pro-dopamine.
>
> Q
Posted by falconman on April 6, 2007, at 13:25:06
In reply to Re: Best meds for anhedonia » falconman, posted by Quintal on April 6, 2007, at 7:12:06
Am I right in saying that ssri's and ssnri's decrease the effects of codeine?
Thanks
Posted by Quintal on April 6, 2007, at 14:57:50
In reply to Re: Best meds for anhedonia » Quintal, posted by falconman on April 6, 2007, at 12:40:03
No, you don't have to take more than the therapeutic dose of either paracetamol or ibuprofen to get 20-40mg of codeine, but it depends on the brand you use. I use Paramol which contains 7.46 mg dihydrocodeine. Dihydrocodeine is about 1.5x as potent as codeine, so you get roughly 22mg equivalent of codeine from the recommended two tablets if my math is correct. I sometimes add Nurofen Plus which contains 12.8mg codeine per tablet, so in total I can get the equivalent of roughly 47mg codeine from that cocktail if I take the two tablets of each brand.
It is safe to take paracetamol and ibuprofen together - I was started on this cocktail for pain control after being discharged from hospital. I'm sure there are risks to it, but probably no more so than with any other drug cocktail recommended here for anhedonia.
Yes, SSRIs are CYP2D6 inhibitors which can reduce or eliminate the effect of codeine because CYP2D6 converts codeine into morphine - the metabolite apparently responsible for most of the therapeutic effect.
Q
Posted by falconman on April 6, 2007, at 15:26:33
In reply to Re: Best meds for anhedonia » falconman, posted by Quintal on April 6, 2007, at 14:57:50
Posted by Declan on April 6, 2007, at 15:48:33
In reply to Re: Best meds for anhedonia, posted by flmm on April 6, 2007, at 10:35:37
>Opiates are pain killers, plain and simple! If you are in pain they make you feel better. Are you in pain Declan?<
Not so much now that I have read your post, but yes....surely everyone over a certain age is in pain?
I have a degenerative spinal condition (sounds good, that one) and arthritis (worse than you might think).
But physical pain is no harder to bear than the other sort.
Most people over 50 (I only pick that because I just squeeze over) are simply used to pain, don't you think?
Posted by flmm on April 6, 2007, at 16:05:34
In reply to Re: Best meds for anhedonia » flmm, posted by Declan on April 6, 2007, at 15:48:33
Well then Declan, you should take something for your "physical" pain! Mental pain is something entirely different than physical pain, no matter how you try to justify it. I blew out my back 5 years ago due to herniated disk, failed surgery etc. Been on those drugs, glad to be off. There is a difference between pain and the pain that requires opiates to treat! It's not just pain!
Posted by flmm on April 6, 2007, at 16:09:42
In reply to Re: Best meds for anhedonia, posted by flmm on April 6, 2007, at 16:05:34
By the way, telling people who are in need of help that opiates treat depression, is reckless and not true!
Posted by Declan on April 6, 2007, at 16:43:23
In reply to Re: Best meds for anhedonia, posted by flmm on April 6, 2007, at 16:09:42
It isn't that I want to tell people that so much as that I find the attitude of some people and governments to opiate addiction difficult to handle.
If you've had a herniated disc you know all about pain.
If you have bad nerve pain, even opiates won't help much.
Some pain can be endured. As I've got older my capacity to endure pain has risen (neccessarily).
Must go and do my back exercises.
Pilates has helped more than anything.
Posted by Quintal on April 6, 2007, at 17:03:18
In reply to Re: Best meds for anhedonia, posted by flmm on April 6, 2007, at 16:09:42
Based on my experiences I could say the opposite, that telling people who are in need of help that SSRIs treat depression, is reckless and not true!
As I said, low dose opiates have been the only thing that have really helped my depression/anhedonia/anxiety and left me feeling like a human being, not some sort of Clockwork Orange.
Q
Posted by flmm on April 6, 2007, at 18:38:50
In reply to Re: Best meds for anhedonia, posted by Quintal on April 6, 2007, at 17:03:18
Addiction is a constant rehersal of justifying drug abuse. Opiates are not antidepressants!
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.