Posted by bleauberry on May 30, 2012, at 16:56:38
In reply to dysthymia and MDD, posted by b2chica on May 30, 2012, at 14:15:18
Dysthymia is almost like a stand alone thing by itself, different from depression, even though it is also a part of depression. I think sometimes it is called double depression when you have both, but I think you have really be splitting hairs to do that. It really doesn't matter what you call it. All that matters is.....you basically have no fire for life and it feels biological in cause....if that's true then ok what are some things that could improve that?
Well, usually not the ssris. They will almost predictably make it worse through further numbing. Not always, sometimes one of them will be miraculous once in a while. But usually you can count on them to sort of squash or compress the entire emotional spectrum.
That is unless something is taken with them as a counter balance for a full spectrum effect, such as combining with a TCA or a stimulant maybe.
After I failed ECT I ordered milnacipran from overseas. It wasn't in the usa then but is now, called savella. Probably the biggest effect it had on me and fairly rapid was the anti-dysthymia thing. I got some fire back. Pretty amazing considering other meds didn't do that and neither did ECT. But we're all different.
I think in general if we're talking dysthymia as the primary issue, or anhedonia, a lot the same, anything similar in that realm, the herbs or meds you want to be experimenting with are ones that have mechanisms on norepinephrine and/or dopamine with a little bit of serotonin to go along with it maybe. The problem is we don't know exactly what mechanism will work for you...antagonism, agonism, reuptake inhibition, maoi, etc. so various things have to be tried to find out.
And if there are any over stimulated or fearful type feelings that are involved then serotonin and/or gaba meds would probably help to balance that out.
Sometimes an antipsychotic can cover a lot of bases all at once when combined with ssri. Prozac plus zyprexa for example which worked good for me for several years along with the mild stimulant adrafanil. Abilify is another possible AP. I personally only favor those two but the others are prescribed a lot.
poster:bleauberry
thread:1018923
URL: http://www.dr-bob.org/babble/20120522/msgs/1018932.html