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Re: Long-standing Anhedonia

Posted by King Vultan on November 13, 2004, at 11:21:13

In reply to Long-standing Anhedonia, posted by sundown on November 13, 2004, at 1:19:17

> I seem to have chronic mild depression which anti-depressants do little to change. But I believe now that a more basic anhedonic tendency is the real problem. I have been anhedonic as long as I can remember.
>
> Does anyone have any treatment suggestions. I am currently taking 20mg of Lexapro and it did give me more energy. But I still am unable to enjoy myself and feel good.


I've also suffered from anhedonia for years, with it perhaps being the major contributing cause to my depression. Typically, the more dopaminergic drugs seem to be indicated for what you are describing. While most of the antidepressants I've tried brightened by mood, only a few of them seemed to really be effective for my fundamental anhedonia. The two that I found to be the best in this area were Wellbutrin and Parnate, and Parnate is the med I am currently on and will likely be staying with for the forseeable future. As suggested, a tricyclic might also be worth trying. Nortriptyline has shown some efficacy in smoking cessation (as has Wellbutrin, which is the same thing as Zyban), indicating it may have some positive effects on dopamine transmission, and hence in relieving anhedonia. Nortriptyline also has fairly low side effects for a tricyclic. I think the Provigil that has been mentioned is also a good suggestion, as this also appears to be somewhat dopaminergic; although, precisely how it works does not seem to be particularly well understood.

Todd


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poster:King Vultan thread:415319
URL: http://www.dr-bob.org/babble/20041113/msgs/415418.html