Re: prozac/abilify

I'm sorry to hear that you haven't been getting any relief from your anhedonia with the medications that you've been trying. I experience some anhedonia as part of my anergic depression, and I can certainly relate to the frustration associated with failing trials with one medication after another. I would not give up on trying to treat your anhedonia with pharmacological treatments, though. You mentioned selegiline in your other post, and I think that it might be worth trying. When I took selegiline, I experienced a pronounced reduction in all of my depressive symptoms for about three days followed by a loss of effectiveness and the emergence of cognitive impairment and agitation thereafter. However, my temporary response to selegiline does not seem to be very typical, so I wouldn't base your decision on whether or not to try selegiline completely on my response to the medication.

Since you're looking at something to increase dopaminergic neurotransmission, you might want to consider trying Provigil (modafinil) or Nuvigil (armodafinil) if you haven't already. Provigil is a dopamine reuptake inhibitor (Volkow et al., 2009), and Nuvigil may be as well, considering that it's derived from Provigil. Also worth considering, in my opinion, are the supplements l-tyrosine and dl-phenylalanine, as well as possibly St. John's Wort and SAM-e. All are thought to increase dopaminergic neurotransmission in some way.

Finally, I would like to say that I wouldn't look at Abilify as being a medication that increases dopaminergic neurotransmission. Abilify is a partial agonist at D2 receptor sites, which means that it does activate the receptors but with less strength than a full agonist. One use of Abilify is in the treatment of schizophrenia, a condition in which dopaminergic neurotransmission is thought to be overactive. It's my understanding that even though Abilify activates the D2 receptors to an extent, it also competes with the dopamine molecules for binding at the receptor sites. The activation that Abilify produces at D2 receptor sites is thought to be weak with the medication being a partial agonist, and because the D2 receptors are occupied by Abilify when the medication is taken, the dopamine molecules themselves theoretically shouldn't be able to reach the receptors and fully activate them. This may be why Abilify is said to reduce the activity of dopamine when it's too high and increase the activity of the neurotransmitter when it's too low. So, I know that Abilify is a dopamine agonist of sorts, but a partial agonist is different from a full agonist, and at least the understanding is that partial agonists don't simply increase the activity of the neurotransmitters that they're associated with like full agonists do.

At any rate, I'd like to wish you luck with your ongoing battles against anhedonia. I hope you find an effective treatment, whether that ends up being something that works on the dopaminergic system or not.

Volkow, N.D., Fowler, J.S., Logan, J., Alexoff, D., Zhu, W., Telang, F., et al. (2009). Effects of modafinil on dopamine and dopamine transporters in the male human brain: Clinical implications. JAMA: The Journal of the American Medical Association, 301, 1148-1154. Abstract: http://www.ncbi.nlm.nih.gov/pubmed/19293415

Suffers from anergic depression and aminoguanidine-induced psychosis and cognitive impairment, diagnosed with schizoaffective disorder.

Taking 5 mg Abilify, 2.25 mg Hydergine, and six supplements.

Re: prozac/abilify

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