Posted by phidippus on August 28, 2012, at 23:33:24
In reply to Stimulants make me feel alive, but I need a sustainable solution, posted by jcc80 on August 22, 2012, at 22:49:41
> anhedonia
Is the trickiest m*th*rf*ck*r to treat. Your answer will lie in drugs that are used off-label to treat depression.
> I have tried:
> -almost all ssri/snrisProblem is, SSRIs and SNRIs can incur anhedonia. I've tried 'em all too and the only one that didn't lay me flat was Viibryd
> -wellbutrin
If your hypothesis is that you need more dopamine, well Wellbutrin throws a wrench in it. Wellbutrin is an NDRI so it inhibits the reuptake of dopamine allowing more of it in your system
> -requip
This cute little drug did enhance my mood after a couple weeks of use. It is a dopamine agonist, meaning it increases dopamine in the CNS.
> -abilify (currently at 2mg)
Helps balance dopamine in the CNS. Its also a potent 5ht1a partial agonist, which means it has a litttle kick when it comes too treatiing depression and anxiety.
> -desipramine (currently at 100mg)
Basically like an SNRI.
> -ritalin (currently at 40mg)
increases the levels of dopamine and norepinephrine in the brain through reuptake inhibition of the respective monoamine transporters
From Wikipedia:
Contraindications
Methylphenidate should not be prescribed concomitantly with tricyclic antidepressants, such as desipramine, or monoamine oxidase inhibitors, such as phenelzine or tranylcypromine, as methylphenidate may dangerously increase plasma concentrations, leading to potential toxic reactions (mainly, cardiovascular effects). Methylphenidate should not be prescribed to patients who suffer from severe arrhythmia, hypertension or liver damage. It should not be prescribed to patients who demonstrate drug-seeking behaviour, pronounced agitation or nervousness.[19] Care should be taken while prescribing methylphenidate to children with a family history of Paroxysmal Supraventricular Tachycardia (PSVT).
Be careful!
>I am indecisive, unmotivated, and don't take >much interest in anything, including my wife and >kids.
This pains me to hear your illness is robbing you of what is essentially your life. I wish I could do more than give drug addvice.
> The stimulant seems to point me in the right >direction, but obviously I can't maintain that >24/7.
There is no reason you couldn't take Concerta on a daily basis (Concerta is the ER version of Ritalin.)
>What CAN I look into next? This seems to scream >"more dopamine!" at me, if I can grossly >oversimplify this.
What I think is more likely you've come onto a combination of drugs that work well together to treat your symptoms-I don't think Ritalin on its own is making you feel better.
One drug I can think of adding to your cocktail is Memantine. It helps with depression, anxiety and is a potent D2 agonist.
Unfortunately, persistent anhedonia often takes multiple drugs to treat succesfully.
Get back to me.
Eric
poster:phidippus
thread:1023981
URL: http://www.dr-bob.org/babble/20120818/msgs/1024379.html