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Dr. Bob is Robert Hsiung, MD,
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Posted by Trevpr on September 24, 2012, at 20:09:11
In reply to Re: ANHEDONIA - Questions and Answers, posted by jono_in_adelaide on September 24, 2012, at 19:44:31
Thanks for the help everyone! I hope Parnate will be my next trial.
Now as far as libido/interest in women goes, how likely is it that it will come back? I mean, I'm in my prime here, and I really would love to start dating again, so it's sort of important to me, but it's been gone for 11 months without any change. Does Parnate necessarily raise sex drive? From anecdotal user reviews, it appears to be equally likely to cause problems as to fix them sexually.
Posted by schleprock on September 25, 2012, at 0:05:06
In reply to Re: ANHEDONIA - Questions and Answers, posted by jono_in_adelaide on September 24, 2012, at 19:44:31
I'm currently in some sort of remission from anhedonia and other meloncholic like symptoms (they may be technically more rooted in anxiety than depression, though.) I've suffered them off and on over the past several months. Clonazepam helped in varying degrees, though I ended up gradually increasing my dosage from .5mg to 1.5 mg. I'm still on clonazepam (and nortriptyline) and have been on Lyrica (titrated from 50 mg - 150 mg) for about a month. So far this is about the longest I've went without the meloncholic\anhedonic symptoms returning. The anhedonic symptoms I'd had were very severe (as in an uncomfortable and excruciating wait for the day to pass so I could go to sleep and pray I felt better the next day; much more dostressing than just some sort of boredom.)
I've had no real relief in mood or libido (which has steadily decreased over the past year,) but at least I'm somewhat comfortable again. Before the Lyrica I tried Risperidone, which brought about two weeks of relief before it wore off and started to make me feel worse.
I've never gotten a clear answer, but there's a chance that (neurotransmitter produced) anxiety may share many symptoms associated with melancholic depression, so an anti-anxiety med strategy might be something to look into.
Posted by Trevpr on September 25, 2012, at 1:22:00
In reply to Re: ANHEDONIA - Questions and Answers, posted by schleprock on September 25, 2012, at 0:05:06
I personally have no anxiety or panic, but I did experience this to an extreme degree the first 3 months of the depression, so I'm not worried about that, I'm just worried about feeling like a zombie still. I'm calling my psychiatrist tomorrow and ill update with what she said
Posted by jono_in_adelaide on September 25, 2012, at 3:57:59
In reply to Re: ANHEDONIA - Questions and Answers, posted by schleprock on September 25, 2012, at 0:05:06
Just came to me in a dazeling flash - have you had your testosterone levels checked?
Posted by bleauberry on September 25, 2012, at 4:57:46
In reply to ANHEDONIA - Questions and Answers, posted by Trevpr on September 23, 2012, at 17:47:02
QUESTIONS
1.) Has anyone here had remission from anhedonic symptoms? If so, how? What was it like? How long did it take before remission?Mine is about 80% gone and getting better with time. As you have already seen in your research, it's a complicated mechanism, and as such, takes time. My progress has not been noticeable on a daily or weekly basis, but rather on a monthly and yearly basis. 3 years from total anhedonia to only 20% anhedonia, for me.
2.) Anyone have any experience with the beforementioned treatments? Any of them help anhedonic symptoms?
Basically the NE and DA circuits are the ones primarily involved. But we can't predict the mechanism or drug that will do what we want, so we have to try stuff that focuses on NE and DA. For me, I have discovered NE is a much bigger player in anhedonia than is dopamine. Of all the meds you listed, there are actually only meds in my experience worth looking at....savella, parnate, amisulpride. Don't worry about the scientific reasoning stuff....savella shares similarities with ritalin for example....I'm just saying these things had a definite impact on my anhedonia when absolutely nothing else did squat.
3.) Has anyone gotten their sex drive back after having it absent for months? Did it come back fully?
Yes. For me, the sexual comeback period was maybe about 3 to 6 months. I am well versed and experienced with a bunch of herbs and plant medicines. The one I would suggest to you as a longterm friend for sex, endurance, energy, and hormonal/mood support, is Cordyceps. It can be combined with anything except perhaps an maoi.
4.) Anyone have any advice on treating anhedonia?
Do not rely on meds alone. The brain needs to be shown and taught what you want it to do. Which means purposefully going out to do fun things, even though they won't feel fun. Brain training. Church, hobby, social interaction....all good healthy stuff that helps to diminish anhedonia even without drugs or herbs, and makes drugs/herbs work better. Since sex is an issue, then of the 3 meds I mentioned I would probably put savella at the top of the list as being the least offensive to sex.All three worked for me and did so fast.
Side effects caused me to only take them short term. The most dramatic improvement was with savella. I found that especially meaningful, because prior to that I had just failed ECT and prior to that a backpack full of meds and herbs.
Posted by Trevpr on September 25, 2012, at 9:03:35
In reply to Re: ANHEDONIA - Questions and Answers, posted by jono_in_adelaide on September 25, 2012, at 3:57:59
Yes, all hormones are ok
Posted by Trevpr on September 25, 2012, at 11:19:02
In reply to Re: ANHEDONIA - Questions and Answers, posted by bleauberry on September 25, 2012, at 4:57:46
I'm thinking about compiling an anhedonia guide with all the info I'm getting. Thank you all for your helpful comments
Posted by jono_in_adelaide on September 25, 2012, at 18:37:45
In reply to Re: ANHEDONIA - Questions and Answers, posted by Trevpr on September 25, 2012, at 11:19:02
The other thing I need to add is that you cant always achive 100% remission with drug therapy, sometimes you need to be satisfied with 70% improvement or whatever - you arnt at that point yet, but keep it in mind that pills might not bring total remission of every symptom.
I'd also strongly suggest you start seeing a compotent psychologist along with exploring every avenue of drug therapy.
Posted by Trevpr on September 26, 2012, at 0:45:42
In reply to Re: ANHEDONIA - Questions and Answers, posted by jono_in_adelaide on September 25, 2012, at 18:37:45
That's exactly what I'm afraid of... I really miss the old me!!!
Sometimes I contemplate just coming off all drugs all together because none have worked.
Does anyone know anything about chronic depression? The only info I could find was about dysthymia which only usually states things like "It lasts at least two years" and "it is less severe than major depression (bullsh*t in my opinion)." Does chronic depression necessarily last a lifetime? Does it never go away fully?
I hope that something works... I just went up to 20mg daily of Vivactil and 5mg abilify daily.
Posted by AlexCanada on September 26, 2012, at 3:16:38
In reply to Re: ANHEDONIA - Questions and Answers, posted by bleauberry on September 25, 2012, at 4:57:46
Hi. I'm very curious about Savella (my doc may have to somehow import it since I can't get it in Canada) and would love to try it but can you tell me more about how Amisulpride effected you?
How would you describe your depression? Mine is strong melancholic with full blown melancholic symptoms. Especially very poor cognition and lack of interest/enjoyment.
Dopamine based meds have tended to work best for me in my 10 year history but is Amisulpride likely to cause cognitive impairment in someone whom already is very impaired or more likely to alleviate it?
I had some other questions but I can't recall right now.
> QUESTIONS
> 1.) Has anyone here had remission from anhedonic symptoms? If so, how? What was it like? How long did it take before remission?
>
> Mine is about 80% gone and getting better with time. As you have already seen in your research, it's a complicated mechanism, and as such, takes time. My progress has not been noticeable on a daily or weekly basis, but rather on a monthly and yearly basis. 3 years from total anhedonia to only 20% anhedonia, for me.
>
> 2.) Anyone have any experience with the beforementioned treatments? Any of them help anhedonic symptoms?
>
> Basically the NE and DA circuits are the ones primarily involved. But we can't predict the mechanism or drug that will do what we want, so we have to try stuff that focuses on NE and DA. For me, I have discovered NE is a much bigger player in anhedonia than is dopamine. Of all the meds you listed, there are actually only meds in my experience worth looking at....savella, parnate, amisulpride. Don't worry about the scientific reasoning stuff....savella shares similarities with ritalin for example....I'm just saying these things had a definite impact on my anhedonia when absolutely nothing else did squat.
>
> 3.) Has anyone gotten their sex drive back after having it absent for months? Did it come back fully?
>
> Yes. For me, the sexual comeback period was maybe about 3 to 6 months. I am well versed and experienced with a bunch of herbs and plant medicines. The one I would suggest to you as a longterm friend for sex, endurance, energy, and hormonal/mood support, is Cordyceps. It can be combined with anything except perhaps an maoi.
>
> 4.) Anyone have any advice on treating anhedonia?
> Do not rely on meds alone. The brain needs to be shown and taught what you want it to do. Which means purposefully going out to do fun things, even though they won't feel fun. Brain training. Church, hobby, social interaction....all good healthy stuff that helps to diminish anhedonia even without drugs or herbs, and makes drugs/herbs work better. Since sex is an issue, then of the 3 meds I mentioned I would probably put savella at the top of the list as being the least offensive to sex.
>
> All three worked for me and did so fast.
> Side effects caused me to only take them short term. The most dramatic improvement was with savella. I found that especially meaningful, because prior to that I had just failed ECT and prior to that a backpack full of meds and herbs.
>
Posted by phidippus on September 26, 2012, at 14:06:10
In reply to ANHEDONIA - Questions and Answers, posted by Trevpr on September 23, 2012, at 17:47:02
Not all antidepressants blunt mood. Mirtazapine has an affinity for dopamine receptors,especially D4(Ki 25)-something that contributes to its efficacy as an antidepressant. I never felt blunt on it.
What dopamine agonists have you tried?
What about Marijuana?
Eric
Posted by Trevpr on September 26, 2012, at 20:14:33
In reply to Re: ANHEDONIA - Questions and Answers » Trevpr, posted by phidippus on September 26, 2012, at 14:06:10
Marijuana made my heart rate go up with no effect on mood or emotion. I tried mirapex but it just made me tired
Posted by phidippus on September 27, 2012, at 15:45:47
In reply to Re: ANHEDONIA - Questions and Answers, posted by Trevpr on September 26, 2012, at 20:14:33
Persistent anhedonia strikes me as a disorder unto its own, sharing similarities with Depersonalization Disorder, a feature of which includes,"feeling detached from one's own thoughts or emotions".
I don't think drugs are going to offer you a solution.
Eric
Posted by Trevpr on September 27, 2012, at 18:52:08
In reply to Re: ANHEDONIA - Questions and Answers » Trevpr, posted by phidippus on September 27, 2012, at 15:45:47
Dang, well I hope then it will eventually go away on its own...
Posted by phidippus on September 28, 2012, at 16:17:17
In reply to Re: ANHEDONIA - Questions and Answers, posted by Trevpr on September 27, 2012, at 18:52:08
How long have you had this condition?
Eric
Posted by Trevpr on September 28, 2012, at 17:02:54
In reply to Re: ANHEDONIA - Questions and Answers » Trevpr, posted by phidippus on September 28, 2012, at 16:17:17
its been about 11 months now
Posted by phidippus on September 29, 2012, at 16:25:59
In reply to Re: ANHEDONIA - Questions and Answers, posted by Trevpr on September 28, 2012, at 17:02:54
What happened 11 months ago that started this?
Eric
Posted by Trevpr on September 29, 2012, at 17:24:28
In reply to Re: ANHEDONIA - Questions and Answers » Trevpr, posted by phidippus on September 29, 2012, at 16:25:59
Triggered by chronic academic stress, a significant breakup, and life changes
Posted by phidippus on September 29, 2012, at 17:39:49
In reply to Re: ANHEDONIA - Questions and Answers, posted by Trevpr on September 29, 2012, at 17:24:28
Do you work with a therapist?
Eric
Posted by Trevpr on September 29, 2012, at 19:09:44
In reply to Re: ANHEDONIA - Questions and Answers » Trevpr, posted by phidippus on September 29, 2012, at 17:39:49
Yes, I am seeing a therapist. To me, so far, she emphasizes CBT which doesnt seem too useful since I already think overrationally (many think I'm like spock) and dont feel "down" - it seems to focus mostly on negative thinking and thought distortions.
Posted by phidippus on September 29, 2012, at 19:20:05
In reply to Re: ANHEDONIA - Questions and Answers, posted by Trevpr on September 29, 2012, at 19:09:44
You might benefit from ACT more than CBT. Can you give me a list of all the meds you've tried?
Eric
Posted by Trevpr on September 29, 2012, at 21:40:41
In reply to Re: ANHEDONIA - Questions and Answers » Trevpr, posted by phidippus on September 29, 2012, at 19:20:05
I've never heard of ACT, what is it?
The Meds I've tried are:
Effexor - Felt like a placebo, may have made me feel more "spacey," but I didn't give it much time to work because they quickly switched me to Wellbutrin in the psych ward.
Wellbutrin - Felt like a placebo
Desipramine - Felt like a placebo, had to come off of it due to liver toxicity
Abilify - May have helped slightly with other symptoms at the beginning of the depression such as concentration, now feels like a placebo and does not make a difference whether or not I'm taking it. Never touched the anhedonia
Ritalin - The only med to have helped at all with the anhedonia and maybe a small tiny bit of libido. It formed a tolerance and so I couldn't raise the dose to make it effective again without my heart rate going up insanely high.
Adderall - Just raised my heart rate
Mirapex - Made me tired, exhausted, and a bit irritable, other than that, no effect on mood or emotional responsivity
Trazodone - As needed for sleep, worked for that at least, didn't touch anything else
Posted by phidippus on September 30, 2012, at 15:27:43
In reply to Re: ANHEDONIA - Questions and Answers, posted by Trevpr on September 29, 2012, at 21:40:41
ACT teaches one to "just notice," accept, and embrace their private events, especially previously unwanted ones. ACT helps the individual get in contact with a transcendent sense of self known as "self-as-context"the you that is always there observing and experiencing and yet distinct from one's thoughts, feelings, sensations, and memories. ACT aims to help the individual clarify their personal values and to take action on them, bringing more vitality and meaning to their life in the process, increasing their psychological flexibility.
Ritalin is the only medication that has helped with the anhedonia. How did you feel while you were on it?
Eric
Posted by Trevpr on September 30, 2012, at 15:32:23
In reply to Re: ANHEDONIA - Questions and Answers » Trevpr, posted by phidippus on September 30, 2012, at 15:27:43
I felt a little bit of that refreshing joy/happiness/contentment/emotional responsivity that I'm missing, but didnt feel nearly %100. I also felt more chatty and my heart rate was alot higher. my libido was slightly better. when the ritalin wore off I felt irritable waiting for my next dose.
Posted by phidippus on September 30, 2012, at 16:12:21
In reply to Re: ANHEDONIA - Questions and Answers, posted by Trevpr on September 30, 2012, at 15:32:23
I'm wondering if an MAOI like Parnate might be your solution...Ritalin acts like a mini-MAOI.
Of course there are a lot of antidepressants you haven't tried. I know you may believe they cause emotional blunting, but that's not necessarily true of all antidepresssants.
I understand your strife. I too struggle with anhedonia. But I found attacking it from multiple angles reduced its hold on me. There are still times when I feel nothing, but it doesn't affect me.
Eric
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