Posted by SLS on November 21, 2008, at 7:37:16
In reply to anhedonia along with severe insomnia, posted by X_ander on November 16, 2008, at 22:44:12
Do you suffer from derealization or depersonalization? These things are a likely result when one suffers from both anhedonia and anxiety? I imagine chronic sleep deprivation could have the same effect, especially if it is associated with anxiety.
Your choice of combining Wellbutrin + Zoloft is a good one. Of course, there are many more. These two drugs do not cancel each other out. In fact, they might work synergistically, as the nickname "Well-Oft" suggests.
I would leave stimulants to be used as augmentors only at this time. I don't think neuroscience has yet yielded much success by thinking in terms of "levels" of neurotransmitters. That is not to say that you are not on the right track. It just means that trying to choose drugs based upon such a simple paradigm does not alway work. If this kind of thinking keeps you away from trying specific drugs, you might miss the target entirely. Sometimes, you need to play dumb, and perform trials that seem paradoxical to the ideas you have committed yourself to.
Abilify (aripiprazole) would make a good first choice of neuroleptic to add to antidepressants. It is often referred to as a dopamine system stabilizer (DSS) because it changes its behavior base upon how much dopamine is available in the synapse. If there is not enough, Abilify acts as an agonist (stimulator) of receptors rather than an antagonist (blocker) of them. It is a bit of a chameleon. I have seen people profit from using sulpiride or amisulpride, but these drugs are more classical than atypical. They can wreak havoc with hormones and have a greater risk of producing movement EPS. With Abilify, akathisia is a risk. However, it is usually mild-moderate and passes within a week or two.
- Scott
poster:SLS
thread:863507
URL: http://www.dr-bob.org/babble/20081114/msgs/864381.html