Posted by fachad on February 3, 2003, at 21:27:56
In reply to ADHEDONIA QUESTIONS ?? please read , posted by LAURA777 on February 2, 2003, at 16:53:01
Laura,
That's a long post...I'll put in a few things that seem significant...
First, much clinical experience and research supports that anhedonia is best treated with MAOIs. Nardil (phendlzine) and Parnate (tranylcypromine) being the gold standard meds for effective treatment of anhedonia. You may have an easier time finding a doc to write for opiates, however. Pdocs generally hate MAOIs.
As to SSRI's - yes, I definitely think they make anhedonia and anergia much worse. I think the longer they are taken the worse it gets.
After 3 years of Zoloft, I was literally too tired to breathe. It seemed like sooooo much effort to inhale, and then I would feel a tinge of sadness that came from knowing that I would have to expend more effort to exhale.
For me, the only cure came by discontinuing the SSRIs, and adding stimulants. Ritalin, Adderall, or Dextrostat are the ones to try. I do not understand it, but it really seems like pdocs are generally pretty comfortable with prescribing stimulants - much more so than about benzodiazapines, opiates, or MAOIs.
As for the TCAs, I think they may be worth a try. They are safe if used at proper doses, although they do have nuisance side effects. The worst for me was constipation, but if you're thinking about opiates, you are ready to endure that one.
I have had extensive experience with opiates due to a herniated disk in my back. I got hundreds of Vicodin over a few months. For the first few days, it felt really good to be on Vicodin. However, after only a few days the good feeling faded. After a few weeks, I felt very down.
Vicodin definitely caused me to be depressed when taken over time. This was actually worse for me than SSRIs, which caused me to be anhedonic and anergic when taken over time. But with Vicodin, I was genuinely melancholy.
Some here have reported success with opiates. The real problem is finding a pdoc who will write for them. You will of course be suspected of being an opiate abusing drug seeker concocting a story to get dope. Here's a link to a polemic I posted a few months ago on that dilemma:
http://www.dr-bob.org/babble/20020416/msgs/103521.html
That was in response to a post from Elizabeth, who was having trouble finding a pdoc in a new town to write for Xanax and opiates.
> hi i am just curious if people who suffer from this have any commonalities ,, here are some questions for you all .. This is for people who suffer from adhedonia naturally and not a result from taking AD drug or meds
> what age did you notice it started ???
>
> did SSRI make it worse ???
>
> if ssri was augmented with a stimulant like dexadrine or welbutrin , were you a wide awake flat person ???
>
> do you suffer from hypersomnia when non medicated or just medicated with ssri ??
>
> do opiates help you fell normal ??
>
> do opiates stimulate you but yet you are calm ??
>
> do any of you get sleepy on opiates ???
>
> sorry for all the questions but i would like to see if any of us have commonalities .. i need some info and things to back me up because i am so tired of living in this greyness .. i am 38 years old and this has paralized me long enough .. so if you can please respond .. thanks in abundance laura
poster:fachad
thread:138954
URL: http://www.dr-bob.org/babble/20030130/msgs/139218.html