![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2 to 26 of 101. Go back in thread:
Posted by missinglynxx on February 2, 2003, at 18:34:03
In reply to ADHEDONIA QUESTIONS ?? please read , posted by LAURA777 on February 2, 2003, at 16:53:01
> hi i am just curious if people who suffer from this have any commonalities ,, here are some questions for you all .. This is for people who suffer from adhedonia naturally and not a result from taking AD drug or meds
> what age did you notice it started ???
>
> did SSRI make it worse ???
> Much Worse!
> if ssri was augmented with a stimulant like dexadrine or welbutrin , were you a wide awake flat person ???
> Dont have the type of depression, mental illness that requires stimulants
> do you suffer from hypersomnia when non medicated or just medicated with ssri ??
> must worse on SSRIS,, better on Tricyclics
> do opiates help you fell normal ??
> HELL NO
> do opiates stimulate you but yet you are calm ??
> HELL NO
> do any of you get sleepy on opiates ???
> sleepy and depressed and talkative
> sorry for all the questions but i would like to see if any of us have commonalities .. i need some info and things to back me up because i am so tired of living in this greyness .. i am 38 years old and this has paralized me long enough .. so if you can please respond .. thanks in abundance lauraI enjoy your writing style and personality. NO doubt you are gorgeous and interesting in real life. BE WELL SOON
Michael in PDX
Posted by LAURA777 on February 2, 2003, at 20:19:41
In reply to Re: ADHEDONIA QUESTIONS ?? please read , posted by missinglynxx on February 2, 2003, at 18:34:03
> > hi i am just curious if people who suffer from this have any commonalities ,, here are some questions for you all .. This is for people who suffer from adhedonia naturally and not a result from taking AD drug or meds
> > what age did you notice it started ???
> >
> > did SSRI make it worse ???
> > Much Worse!
> > if ssri was augmented with a stimulant like dexadrine or welbutrin , were you a wide awake flat person ???
> > Dont have the type of depression, mental illness that requires stimulants
> > do you suffer from hypersomnia when non medicated or just medicated with ssri ??
> > must worse on SSRIS,, better on Tricyclics
> > do opiates help you fell normal ??
> > HELL NO
> > do opiates stimulate you but yet you are calm ??
> > HELL NO
> > do any of you get sleepy on opiates ???
> > sleepy and depressed and talkative
> > sorry for all the questions but i would like to see if any of us have commonalities .. i need some info and things to back me up because i am so tired of living in this greyness .. i am 38 years old and this has paralized me long enough .. so if you can please respond .. thanks in abundance laura
>
> I enjoy your writing style and personality. NO doubt you are gorgeous and interesting in real life. BE WELL SOON
> Michael in PDX
Michael are you making fun of me ??
i do hope that you are not .... if you suffer from adhedonia , what medications are working for you ???? ssris for me are just terrible and the augmentation with the wellbutrin just made me a wide awake bored joyless person .. i'd rather sleep !!! thanks , laura
Posted by not exactly on February 3, 2003, at 1:50:07
In reply to ADHEDONIA QUESTIONS ?? please read , posted by LAURA777 on February 2, 2003, at 16:53:01
> what age did you notice it started ???
0 (i.e. from birth, or at least ever since I can remember)
> did SSRI make it worse ???
Yup. Made *everything* worse!
> if ssri was augmented with a stimulant like dexadrine or welbutrin , were you a wide awake flat person ???
Didn't try.
> do you suffer from hypersomnia when non medicated or just medicated with ssri ??
both
> do opiates help you fell normal ??
In my limited experience, they make me feel better. What is it like to feel "normal"? :-)
> do opiates stimulate you but yet you are calm ??
Sort of.
> do any of you get sleepy on opiates ???
Back in the 60's, I found that smoking a lot of opium made me pleasantly sedated & dreamy. But theraputic doses of legal meds, no.
I've found that dopaminergic meds (such as stimulants & Parkinson drugs) help most with anhedonia.
- Bob
Posted by missinglynxx on February 3, 2003, at 6:29:10
In reply to Re: ADHEDONIA QUESTIONS ?? please read , posted by LAURA777 on February 2, 2003, at 20:19:41
> > > hi i am just curious if people who suffer from this have any commonalities ,, here are some questions for you all .. This is for people who suffer from adhedonia naturally and not a result from taking AD drug or meds
> > > what age did you notice it started ???
> > >
> > > did SSRI make it worse ???
> > > Much Worse!
> > > if ssri was augmented with a stimulant like dexadrine or welbutrin , were you a wide awake flat person ???
> > > Dont have the type of depression, mental illness that requires stimulants
> > > do you suffer from hypersomnia when non medicated or just medicated with ssri ??
> > > must worse on SSRIS,, better on Tricyclics
> > > do opiates help you fell normal ??
> > > HELL NO
> > > do opiates stimulate you but yet you are calm ??
> > > HELL NO
> > > do any of you get sleepy on opiates ???
> > > sleepy and depressed and talkative
> > > sorry for all the questions but i would like to see if any of us have commonalities .. i need some info and things to back me up because i am so tired of living in this greyness .. i am 38 years old and this has paralized me long enough .. so if you can please respond .. thanks in abundance laura
> >
> > I enjoy your writing style and personality. NO doubt you are gorgeous and interesting in real life. BE WELL SOON
> > Michael in PDX
>
>
> Michael are you making fun of me ??
> i do hope that you are not .... if you suffer from adhedonia , what medications are working for you ???? ssris for me are just terrible and the augmentation with the wellbutrin just made me a wide awake bored joyless person .. i'd rather sleep !!! thanks , lauraHi there Laura. NO, Im not making fun, I just have an unusual writing style.
Its seems we are nearly identical about the SSRIs.I went to Albertsons after my first dose of 5 mgs of LEXapro a few weeks ago.
I could barely walk thru the store, I had ataxia. It really sucked, Im a weightlifting and IM being killed by 5 mgs of Lexapro LOL,
And everyones faces looked distorted etcetc
All this on one dose...
Right now, Laura Im taking Nortriptyline and Abilify 15mgs.........
Im alot better on the abilify, the NOrtriptyline is worsening my depression so far. Ill give it more time
what are you currently stuggling with. I just want a recovery by April,,,, This is such a merry go Round.. GOOD Luck with you recovery!
Posted by Bill L on February 3, 2003, at 8:51:03
In reply to ADHEDONIA QUESTIONS ?? please read , posted by LAURA777 on February 2, 2003, at 16:53:01
I have had anhedonia since I was 11 years old. I am now 49. A psychiatrist diagnosed me with having anhedonia. I started taking Prozac about 5 years a go. Then Celexa and now Lexapro. Prozac and Celexa worked very well. Lexapro works the best for me with the least side effects. I do not feel depressed while taking ssri's.
As for hypersomnia, I sleep less on ssri's. Before drugs, I liked to stay in bed late since I felt depressed. On drugs, I don't mind waking up and getting out of bed.
Posted by LAURA777 on February 3, 2003, at 9:25:45
In reply to Re: ADHEDONIA QUESTIONS ?? please read , posted by Bill L on February 3, 2003, at 8:51:03
hi bill thanks for the response , now see , this confuses me and it just goes to show you how different we all are and how complicated this all is !!! yuk .. SSRI do make me worse , i am even more Flat.. and when they augmented me with wellbutrin i am just wide awake and bored uninteresed , unmotivated blah blah blah grey grey grey .. push push push to live ... thanks for your time it is well appreciated laura
> I have had anhedonia since I was 11 years old. I am now 49. A psychiatrist diagnosed me with having anhedonia. I started taking Prozac about 5 years a go. Then Celexa and now Lexapro. Prozac and Celexa worked very well. Lexapro works the best for me with the least side effects. I do not feel depressed while taking ssri's.
>
> As for hypersomnia, I sleep less on ssri's. Before drugs, I liked to stay in bed late since I felt depressed. On drugs, I don't mind waking up and getting out of bed.
Posted by LAURA777 on February 3, 2003, at 9:53:10
In reply to Re: ADHEDONIA QUESTIONS ?? please read , posted by missinglynxx on February 3, 2003, at 6:29:10
>
> Hi there Laura. NO, Im not making fun, I just have an unusual writing style.
>
> Its seems we are nearly identical about the SSRIs.I went to Albertsons after my first dose of 5 mgs of LEXapro a few weeks ago.
> I could barely walk thru the store, I had ataxia. It really sucked, Im a weightlifting and IM being killed by 5 mgs of Lexapro LOL,
> And everyones faces looked distorted etcetc
> All this on one dose...
> Right now, Laura Im taking Nortriptyline and Abilify 15mgs.........
> Im alot better on the abilify, the NOrtriptyline is worsening my depression so far. Ill give it more time
> what are you currently stuggling with. I just want a recovery by April,,,, This is such a merry go Round.. GOOD Luck with you recovery!hey michael , i struggle with adhedonia which is the primary reason for lack of motivation and interest .. everything is a push to do ... things like house work laundry are hard for normal people to do because they are not enjoyable , they are even worse for people like me to do because i do not have any balance of joyful things , so it is always a push , sometimes , but very rare i get a break and can do things and it is not so painful as in boring and unfulfiling . How does one explain this??? i know that i will be able to articulate this much better but i have to think about it .. another frustration for me is decisions , i can never decide what to buy in the grocery because nothing appeals to me .. it is maddening , because i have to make dinners and feed the family .. decisions that have sound reasoning like how to pay bills when to pay them , what to spend money on are easy for me , because i have sound reason to base these on , when it comes to decisions about what to do for fun and entertainment i am at a total loss because nothing to me is fun or nothing appeals to me.. i remember feelings of fun before age 12 years .. this depression or whatever you want to call it has made me a deep thinker and an isolater .. i do think alot and the reason i think i isolate is because i can not relate to other people and how they are enjoying life .. i just do not see it .. i think the person who made that bumper sticker " LIFE SUCKS AND THEN YOU DIE" suffered what i suffer from .. i am a very serious person , and i do not know how to have fun .. and that is another problem i have , like as if fun was something that you can learn .. i think it has much to do with feeling more than learning .. this is the best i can do for now with expressing what it is like for me , anyone out there who can relate ??? any one out there who can express it better ?? i would love to hear from you , because then i do not feel so lonely in this and also the validation is nice too .. and better expression of this is great too because then i can better describe to people how this feels .. so please respond away lovely people .. thanks laura
Posted by Bill L on February 3, 2003, at 12:57:45
In reply to Re: ADHEDONIA QUESTIONS ?? please read » missinglynxx, posted by LAURA777 on February 3, 2003, at 9:53:10
Laura- Which SSRI(s) did you try? At what dose and for how long?
The SSRI's are chemically unrelated to each other. Many people try one without success, and then try another which works well.
The duration of use and dosage are also very important. One might try 20 mg of Prozac for 3 months with no success. But if the dose is increased to 40 or 60 mg, it could work very well.
Posted by missinglynxx on February 3, 2003, at 15:06:27
In reply to Re: ADHEDONIA QUESTIONS ?? please read » missinglynxx, posted by LAURA777 on February 3, 2003, at 9:53:10
an Older Tricyclic drug......or perhaps a mini dose of Effexor? It doesnt sound like you are doing great on WELLBUTRIN. or are you? good luck
Posted by jonh kimble on February 3, 2003, at 17:44:28
In reply to Laura have you considered?? , posted by missinglynxx on February 3, 2003, at 15:06:27
Ssri's did NOTHING. Really sugar pills (tried 3) maois, wellbutrin, effexor all nothing. never really tried a good dose of any opiods. Stimulants make me feel great, but i build tolerance so quick.
Really interested in abilify, mirapex, and maybe a combo of the two. Anyone have any comments?
Posted by LAURA777 on February 3, 2003, at 19:47:26
In reply to Laura have you considered?? , posted by missinglynxx on February 3, 2003, at 15:06:27
> an Older Tricyclic drug......or perhaps a mini dose of Effexor? It doesnt sound like you are doing great on WELLBUTRIN. or are you? good luck
Hey mike , the meds i used so far are .. first prozac 20 mg and then i was upped to 40 mgs , no i do not have time to get into it now but i had what you call pyhco motor agitation and the prozac helped calm me , i was NOT compulsive ..but impulsive and hyper sort of and paradoxically i would get very tired also and in the midst of all this i had no motivation interest , pleasure is muted for me , so when i am asked what i like to do what is fun for me it is hard for me to reply , we tend to repeat behaviors that are pleasurable , like eating , biking , trail hiking , swimming , gardening , running , walking for some , church , there are tons of group activities ect ect ect .. the only thing i can say that comes around that gives me remote relief like sleep is to read books ... and now even this is begining to fade in and out .. like when i was younger before this started , i loved to swim , hang around the streams explore , go sliegh riding , and pleasure always outwieghed the exertion .. i think this is key .. now my pleasure is very muted blunted ...
i tried effexor for 3 months before being put on wellbutrin , and let me tell you that effexor made me anxious keyed up .. Is being anxious and having anxiety the same thing??? what i mean by anxious is keyed up revved and still i was adhedonic , but please let me state i was never manic .. prozac stopped this in me ,the keyed upness that is but did not take away the adhedonia .. so i was put back on prozac 20 mg and wellbutrin was added , and this was not working so i was told to up my prozac once again to 40 mgs .. but what you must understand is that at 40mg i was made even more muted and dull flat flat . I truly do not know how to describe this ..so my conclusion is prozac is incomplete by itself ... and by itself it makes things worse. but i do appreciate the fact that i am not keyyed up revved up . i lived like that a good portion of my life and NO i am ADHD or ADD
because i am able to sleep often 9 hours a nite and then a 3 hour nap to boot provided i am not on wellbutrin that is !!! So with no meds at all some would call me hyper anxious , not able to wait blowing thru life like the wind impulsive when i was awake but with a heavy need for lots of sleep and very bored always very bored .. prozac changed this whole senerio .. but i am still adhedonic !!!! i hope this explains and does not sound so far out and off the wall but it is the truth .. Opiates when i am on them give me energy , but yet i am calm .. i have no need for a nap and can do several tasks in one day .. laundry , shopping , cleaning , cooking and i am also more tolerant with my kids . it is easier to spend time with them and most importantly i WANT to spend time with them it is not a chore . i know this horrible coming from a mom huh .. but i can not deny what i feel . i feel very BLAH and it is hard to do anything in this state .. the calmness that the prozac gives me is good , but this BLAHNESS is horrible and this is what i originally sought out meds for !!! i hope i did a good job explaining ..
As for the tricyclics are they not dangerous !!! side effects and such .. and if they do work can i stay on them indefinitely .. because i know that i will need to .. by the way depression runs in my family with a sprinkling of bipolor and also alcoholism , which i believe is masked depression , well enough said , i was just told by a dr. , that i should try the lithium and moa inhibitors route first before the buprenorphine ,,Does he think i am manic depressive then ???? i do not know guys ,????? thanks laura
Posted by fachad on February 3, 2003, at 21:27:56
In reply to ADHEDONIA QUESTIONS ?? please read , posted by LAURA777 on February 2, 2003, at 16:53:01
Laura,
That's a long post...I'll put in a few things that seem significant...
First, much clinical experience and research supports that anhedonia is best treated with MAOIs. Nardil (phendlzine) and Parnate (tranylcypromine) being the gold standard meds for effective treatment of anhedonia. You may have an easier time finding a doc to write for opiates, however. Pdocs generally hate MAOIs.
As to SSRI's - yes, I definitely think they make anhedonia and anergia much worse. I think the longer they are taken the worse it gets.
After 3 years of Zoloft, I was literally too tired to breathe. It seemed like sooooo much effort to inhale, and then I would feel a tinge of sadness that came from knowing that I would have to expend more effort to exhale.
For me, the only cure came by discontinuing the SSRIs, and adding stimulants. Ritalin, Adderall, or Dextrostat are the ones to try. I do not understand it, but it really seems like pdocs are generally pretty comfortable with prescribing stimulants - much more so than about benzodiazapines, opiates, or MAOIs.
As for the TCAs, I think they may be worth a try. They are safe if used at proper doses, although they do have nuisance side effects. The worst for me was constipation, but if you're thinking about opiates, you are ready to endure that one.
I have had extensive experience with opiates due to a herniated disk in my back. I got hundreds of Vicodin over a few months. For the first few days, it felt really good to be on Vicodin. However, after only a few days the good feeling faded. After a few weeks, I felt very down.
Vicodin definitely caused me to be depressed when taken over time. This was actually worse for me than SSRIs, which caused me to be anhedonic and anergic when taken over time. But with Vicodin, I was genuinely melancholy.
Some here have reported success with opiates. The real problem is finding a pdoc who will write for them. You will of course be suspected of being an opiate abusing drug seeker concocting a story to get dope. Here's a link to a polemic I posted a few months ago on that dilemma:
http://www.dr-bob.org/babble/20020416/msgs/103521.html
That was in response to a post from Elizabeth, who was having trouble finding a pdoc in a new town to write for Xanax and opiates.
> hi i am just curious if people who suffer from this have any commonalities ,, here are some questions for you all .. This is for people who suffer from adhedonia naturally and not a result from taking AD drug or meds
> what age did you notice it started ???
>
> did SSRI make it worse ???
>
> if ssri was augmented with a stimulant like dexadrine or welbutrin , were you a wide awake flat person ???
>
> do you suffer from hypersomnia when non medicated or just medicated with ssri ??
>
> do opiates help you fell normal ??
>
> do opiates stimulate you but yet you are calm ??
>
> do any of you get sleepy on opiates ???
>
> sorry for all the questions but i would like to see if any of us have commonalities .. i need some info and things to back me up because i am so tired of living in this greyness .. i am 38 years old and this has paralized me long enough .. so if you can please respond .. thanks in abundance laura
Posted by bozeman on February 3, 2003, at 23:56:30
In reply to Re: ADHEDONIA QUESTIONS ?? please read to BILL L » Bill L , posted by LAURA777 on February 3, 2003, at 9:25:45
Hi Laura -- Like Bill, SSRI helped me -- I remember being happy when I was younger, but a bad car wreck, back injury, head injury, many drugs and PT later, everything was grey grey grey blah, for many years, couldn't sleep, didn't feel like doing anything but had to, you know how it is, I'm sure. SSRI Lexapro was truly like a magic bullet for me, put the color back in my life. I actually did remember being happy and I feel it again, now, even if not every minute of every day.
My point is keep trying, if I've learned anything reading this board, it's that our brains and situations are all different and everyone responds a little differently. Don't give up, and I hope you find what you need to feel better soon.
bozeman
> hi bill thanks for the response , now see , this confuses me and it just goes to show you how different we all are and how complicated this all is !!! yuk .. SSRI do make me worse , i am even more Flat.. and when they augmented me with wellbutrin i am just wide awake and bored uninteresed , unmotivated blah blah blah grey grey grey .. push push push to live ... thanks for your time it is well appreciated laura
>
>
>
>
>
>
> > I have had anhedonia since I was 11 years old. I am now 49. A psychiatrist diagnosed me with having anhedonia. I started taking Prozac about 5 years a go. Then Celexa and now Lexapro. Prozac and Celexa worked very well. Lexapro works the best for me with the least side effects. I do not feel depressed while taking ssri's.
> >
> > As for hypersomnia, I sleep less on ssri's. Before drugs, I liked to stay in bed late since I felt depressed. On drugs, I don't mind waking up and getting out of bed.
>
>
Posted by LAURA777 on February 4, 2003, at 6:12:21
In reply to Re: ADHEDONIA QUESTIONS ?? please read » LAURA777, posted by fachad on February 3, 2003, at 21:27:56
hey fachad , yes yes yes on everything you said about vicodin , that is why i would not want to go that route ,, but i am very encouraged about the news on tcas . as far as the stimulants do they make you anxious ?? as far as stimulants go the only expierience i ever had with them was cocaine and i absolutely HATED it , sorry for the strong words but the depression that caused was off the charts ..
vicodin does cause me to be depressed afterwards also , and it is not long acting at all , 2 pills of 5/500 will only have me feeling well for 3 hours but the stimulant effect of them seems to last longer , i won't be tired until 7.00 pm or 9.00 pm , if i had taken it at say 8.00 am ..
what are you currently on now ??? can you please let me know , thanks in advance , laura
Posted by fachad on February 4, 2003, at 8:10:11
In reply to Re: ADHEDONIA QUESTIONS ?? please read » fachad, posted by LAURA777 on February 4, 2003, at 6:12:21
Laura777 wrote: "as far as stimulants go the only experience I ever had with them was cocaine and i absolutely HATED it , sorry for the strong words but the depression that caused was off the charts ..."
Yes, I had a similar experience with cocaine. I only tried it three times, but each time it was horrific. I felt great for about 20 minutes, and then I was in hell for hours. I only tried it a second and third time because I thought my negative experiences were a fluke.
My negative experience with cocaine led me to a paradigm shift in my thinking about depression and it's treatment.
I actually started antidepressants because of my cocaine experiences. I had been very depressed for most of my life, but prior to trying cocaine I would not even consider AD medication.
I was in college at the time and had a professor who thought psych meds were worthless. He would go on an on about how they only treated symptoms, without addressing the underlying causes, which were always cognitive/behavioral/psychodynamic.
At that time, I fully believed that people who took ADs were wasting their time and money, and were only masking the symptoms that they needed to feel to be motivated to address their real problems.
My experience with cocaine totally changed that belief.
The three times I tried cocaine were enough to completely convince me of the chemical nature of affective states. I observed that on cocaine I came down much sooner and much harder than my friends.
The terrible depression that followed cocaine use for me did not arise from "psychodynamic issues" or "behavioral patterns" or "negative thinking" - it was purely a chemical/biological state. And it was not helped by any amount of insight, or rational thinking...it was just pure biological depression.
That experience gave me the insight that depression could be genuinely biologically based, and the fact that cocaine affected me differently than my friends was further evidence for me that there were neurochemical factors contributing to my lifelong depression. I don't know how long it would have taken me to figure that out, or if I would have ever even considered medication, if it had not been for those hours of hell following cocaine use.
Posted by fachad on February 4, 2003, at 9:16:36
In reply to Re: ADHEDONIA QUESTIONS ?? please read » fachad, posted by LAURA777 on February 4, 2003, at 6:12:21
> hey fachad , yes yes yes on everything you said about vicodin , that is why i would not want to go that route , but i am very encouraged about the news on tcas.
I think TCAs can help a lot of people that are not helped, or are actually harmed, by SSRIs. They really do have nuisance side effects, which is why SSRIs are so popular, but if they work, and SSRIs don't...
Nortriptyline and Desipramine are probably the ones to try. They are the mildest in terms of side effects and the most potent in terms of reuptake inhibition. Low dose doxepin or trimipramine are great for sleep.
>as far as the stimulants do they make you anxious ??
No, they don't really make me anxious, but then I'm not prone to anxiety. I've always said there is not enough energy in my nervous system to be anxious. I suppose if I took very high doses stimulants could cause me anxiety, but at normal doses they just relieve lethargy and apathy. I do get some somatic side effects from stimulants, like faster heartbeat and dry mouth, but not worry type anxiety.
>as far as stimulants go the only experience I ever had with them was cocaine and i absolutely HATED it , sorry for the strong words but the depression that caused was off the charts ..
Me too. see above post.
> vicodin does cause me to be depressed afterwards also , and it is not long acting at all , 2 pills of 5/500 will only have me feeling well for 3 hours but the stimulant effect of them seems to last longer , i won't be tired until 7.00 pm or 9.00 pm , if i had taken it at say 8.00 am ..
Vicodin only causes me to be depressed if it is used several times a day for several days in a row. Otherwise it just relieves pain and does not cause any depression when it wears off.
I was not sure how you could possibly experience stimulation from opiates. Yesterday my back was hurting quite a bit (my disk is herniated, but not ruptured, so they will not operate - I just have to live with it) and I took 1/2 of a 5/500 Vicodin about 5pm.
I was extremely exhausted from a long day at work. Curiously enough, I did feel less exhausted when the Vicodin kicked in. I wouldn’t call it stimulation, but it definitely lessened the experience of exhaustion. It could never be a long term solution for me, because as I said before, if I take it for a few days in a row I start feeling melancholy. But at least I kind of understand how someone could say it relieves anhedonia/anergia.
> what are you currently on now ???
Dextrostat 40 mg/day
Prozac 5mg/day
Ambien 10 mg at bedtimeI have tried Ritalin, Adderall, and Dextrostat and for me Dextrostat is the best. I posted my rational for preferring Dextrostat here:
http://www.dr-bob.org/babble/20020718/msgs/112993.html
About the Prozac 5mg/day. After the Vicodin fiasco, I found myself very depressed so I went back on Prozac 20mg/day out of panic and desperation. Then when I tried to quit Prozac, I had withdrawal or discontinuation or whatever they are calling the misery when you quit SSRIs. Yes, Prozac is not supposed to cause this because of long half life, active metabolites, blah blah blah. But it does.
So I've gradually tapered down to 5mg/day, and seem stuck there for awhile.
The Ambien is for the insomnia cause by the Prozac. Before my last episode of depression I was sleeping fine taking 60mg/day of Ritalin. When I started Prozac, I immediately got insomnia. Ambien is expensive, but it does work well and does not cause any side effects for me.
Posted by not exactly on February 4, 2003, at 9:49:55
In reply to Listening to Cocaine, posted by fachad on February 4, 2003, at 8:10:11
Wow. That's quite a story.
I, too, hated cocaine. Tried it a few times back in my street-drug experimentation "phase" back in the late 60's / early 70's. Couldn't understand why such a stupid drug was so popular. I didn't even like the acute "up" part of the experience. It made me feel uncomfortably "out of control". I'd act without thinking, say the wrong words, pace around, tap my fingers, and generally do things without any reason/intent. It felt "wrong" even while it was happening, not just in retrospect. Unfortunately, I never made the connection you did. My lifelong depression continued untreated for another 25 years.
My epiphany came from a different DA-enhancing drug: pramipexole. I volunteered to participate in a double-blind antidepressant evaluation trial at a local "mental" hospital, not because I thought I was depressed, but because I was curious and thought that the experience might be "fun". Of course in those days, my concept of "fun" was different from most people's - an "interesting diversion", but not something to be truly enjoyed (whatever that might mean). I figured I could "fake" enough symptoms to qualify for inclusion. But when interviewed for the study, I found that I could answer the questions honestly and still give the "impression" of being depressed (I had always been good at "quizmanship", and certainly understood what depression was - I just never thought it applied to me, since I was obviously functional and not wallowing in despair).
After the questionnaire was completed, the pdoc said "Well, you are an ideal candidate for this study, since you have suffered from Chronic Major Depression for your entire life, and have never been treated for it." Talk about a paradigm shift - this was a doozy! Maybe reality didn't suck after all. Maybe it was "all in my head"! Rather than being devastated by this information, I was actually pleasantly surprised and hopeful. Unlike "sucky reality", I believed that depression could be "cured" (at least symptomatically).
Weeks later, when the pramipexole kicked in (fortunately I didn't get the placebo), I suddenly felt like "the fog had lifted". Is this how others experience life? I started to be able to experience real happiness (not constantly - I was never manic on the stuff - just from time to time in a way that felt "appropriate" and "normal"). Coping with life's everyday hassles became so easy that I felt like I was "cheating", since I could still remember how it had always been a struggle just to exist.
When the study ended and the drug was discontinued, my depression rapidly returned. But now that I knew a better life was possible, the state became intolerable for the first time. I've often described the experience with the following metaphor:
Imagine you had been born in a cage and had lived your entire life there. You couldn't see out of the cage, and no one ever told you there was a big wonderful world outside. You didn't even realize you were in a cage because that's the only thing you'd ever experienced. One day, someone came along, opened the door, and said "OK, you can come out now." Once outside, you suddenly realized what you'd been missing, and how awful the cage had really been. Weeks later, when the memory of the cage had started to seem like just a bad dream, you are told "Sorry, it's time to go back in your cage." No! Anything but that!
At that time, pramipexole was still an unapproved experimental drug, so it couldn't be prescribed. I spent the next few years "clawing at the door of my cage", trying one unsuccessful (or worse) AD after another.
I've managed to "escape the cage" a few times since, but it never lasted very long, and the "cage" has always been nearby and threatening. But I haven't given up hope. The quest continues...
- Bob
Posted by Jack Smith on February 4, 2003, at 11:59:56
In reply to Re: Listening to Cocaine » fachad, posted by not exactly on February 4, 2003, at 9:49:55
I unlike you guys always liked cocaine. I have only done it around 10 times. . . . However, the most recent was about five months ago. I did a whole bunch of it one night and a day later I crashed back into a bad depression which I am still trying to get out of. Before that, I had been successfully treated on Celexa for around 2 years. Since the coke episode, the celexa does not seem to do much, even after doubling my dose. Now, I am on WB and Celexa but will soon be trying at least a new ssri--if not just quitting everything and moving to an maoi. So, I learned my lesson, depressed people, or at least me, should not f--- around with coke.
Just my two cents,
Jack
Posted by not exactly on February 4, 2003, at 15:39:54
In reply to More on Cocaine, posted by Jack Smith on February 4, 2003, at 11:59:56
Although cocaine has no direct effect on serotonin (it is generally understood to be a reuptake inhibitor of dopamine, and to a lesser extent NE), I suspect it's capable of dramatically altering the balance among *all* of the mood-related neurotransmitters. I offer the following anecdote (which your SSRI + cocaine experience reminded me of) as further evidence of that theory.
Back in the 70's, some of my college buddies experimented with psychoactive "recreational" drugs. One of the favorites was DMX (dextromethorphan, the active ingredient in non-Rx cough medicines). In large doses (e.g. chugging 2 full bottles of cough syrup - yuk!) it acts as a psychedelic "dissociative". The euphoriant properties are most likely related to the fact that it stimulates serotonin release and inhibits its reuptake (DMX is not a narcotic and doesn't significantly affect opioid receptors). One evening, my friend John was enjoying a blissful DMX "trip" when he announced that he was going to try adding some cocaine (unlike myself, John had always liked cocaine). "Gee, I dunno, John; that doesn't seem like a good idea," I advised, but he insisted on performing the experiment. Minutes later, he appeared stunned and extremely disappointed. "Damn! It's gone! The high just vanished! Now I want something..." he remarked. He was severely depressed for the remainder of the evening, and as I remember it took him several days to recover. The cocaine had somehow cancelled & reversed the serotonin-induced euphoria.
Decades later, John was diagnosed with Chronic Major Depression, and responded well to SSRI therapy. However, I don't think the above incident "caused", "triggered", or even significantly contributed to John's lifelong depression. He was clearly depressed beforehand, and I believe that he (like many others) was in effect "self-medicating" his depression (temporarily) by the use of recreational drugs. Sometimes, such attemps can backfire.
- Bob
Posted by jumpy on February 4, 2003, at 16:55:13
In reply to Listening to Cocaine, posted by fachad on February 4, 2003, at 8:10:11
> That experience gave me the insight that depression could be genuinely biologically based, and the fact that cocaine affected me differently than my friends was further evidence for me that there were neurochemical factors contributing to my lifelong depression. I don't know how long it would have taken me to figure that out, or if I would have ever even considered medication, if it had not been for those hours of hell following cocaine use.
Hey Fachad,
That is a fascinating story. I also believe depression is 100% biological in origin ... well, at least major depression, as opposed to "problems of everyday living". Thanks for the information.
Jumpy
Posted by missinglynxx on February 4, 2003, at 18:33:02
In reply to Re: ADHEDONIA QUESTIONS ?? please read » LAURA777, posted by fachad on February 4, 2003, at 9:16:36
Hi there Facad.. I enjoyed your post on the TCAS.. why dont you ditch the Prozac, and start of Desiprimine or Nortriptyline.. I take Nortriptyline and Abilify as a combination,,Im sick to death of being sick to death from my SSRI "trials". Man, I get crazy paranoid and physically ILL on taking a half dose of ZOloft or Paxil..So therefore, I refuse anymore . Abilify is very USER friendly!!
Im far more content with my Nortriptyline. why arent you calling him up and requesting a TCA..good luck on your healing
Posted by LAURA777 on February 4, 2003, at 19:31:48
In reply to Listening to Cocaine, posted by fachad on February 4, 2003, at 8:10:11
> Laura777 wrote: "as far as stimulants go the only experience I ever had with them was cocaine and i absolutely HATED it , sorry for the strong words but the depression that caused was off the charts ..."
>
> Yes, I had a similar experience with cocaine. I only tried it three times, but each time it was horrific. I felt great for about 20 minutes, and then I was in hell for hours.First let me begin by telling you all how interesting you all are ,, i have a problem finding interesting people ..people to me are mostly surface where i think more deeply and do not care for the surface stuff much it bores me , but then again i think having this malady has maybe caused me to be this way ???!!!! who knows , but that is niether here nor there because the damage is done .. i like profound things and i like to think , i find that most people do not , or at least the ones i run into , which is not many since i tend to isolate , and this i do because i can't relate to what is so exciting about this life ...i spend alot of time in my head.. can anyone else get this ??? let me know !!!
Bob your story is very amusing , you write very well as do all of you .. i love the metaphor about the cage it is outstanding... truly ..
Fachad that is exactly how i felt about cocaine 20 minutes of so called pleasure was not worth the greuling hours of off the charts blackness ,, tell me something.... do cold medications that contain psudoephedrine effect you in the same way but on a smaller scale ???
i can not take cold meds with that ingrediant ,, i feel like i am coming off cocaine but on a smaller scale but enough to not go near them no matter how bad a cold i have .. i wonder ????today the doctor, my primary, put me on modafinil provigil .. my psychologist called my primary and explained my situation to her , he has seen me for over 3 years once a week and knows me pretty well , he knows this is a biological thing .. there is depression and bipolor in my family and she knows this as well .. any way i went to see her and further explained myself and she is willing to try this drug with the ssri .. but she BELIEVES me NOT to be depressed !! She said that she thinks i am "discontented" get that one .. would you say that people that are depressed are discontented ???
Ya know my husband suffers from this and is totally unaware of it , he just thinks that this is what life is !!! And i love when people tell me that " It could be worse " what the hell is that ??? hey man "IT could be better " this i know .. or they say " you should be grateful you have a house everyone is healthy " so because i am not dying of cancer nor are my kids but i am miserable as hell inside i should just live with it ??? " yea right what hay wagon did you fall off of "???? or how about the people who say you do not pray or go to church enough ??? or you just need to get out there and do something !!! love that one !!!! i say one word to all these things CLUELESS!!!!!! These people have to be clueless .. And this last one being very shaming but so very untrue " if you are bored you are boring " i just don't know i can not relate to alot of people .. do any of you suffer this ??? do you spend alot of time thinking cause theres nothing else to do ?? i do read alot or used to but i tell you it has NOT helped my spelling at all , i thought it was supposed to ... it just goes to show you misconceptions abound ..
Any way ..SSris calmed me down made me less impulsive and hyper .. but before i started taking them i would never watch tv , just a select few shows mostly off the main networks as well .. i would read books all kinds of books , but ones that in my opinion were well written , both fiction non fiction as well , anyway a half a year of doing ssris i found myself watching mindless sitcoms , The only picture i can give you is someone with a lobotomy drooling in front of the television set ... "Time to take your meds cheswick !!!"
talk to you all soon and if any of you have tired provigil to augment an ssri please let me know .. and how was it ?? thanks , laura
Posted by bee happy on February 4, 2003, at 20:15:48
In reply to Re: Listening to Cocaine AND TO ALL OF YOU !!! » fachad, posted by LAURA777 on February 4, 2003, at 19:31:48
Hey Laura. You're going to think I'm stalking you. Provigil was the last drug I tried before the Buprenorphine...no I'm sorry, it was Tramadol for just a day or two. But before that, it was Provigil. I am soooo suseptible to stmulants that I could only take a tiny bite of the 200 mg pill. Any more than that and I felt a whizzing through a metalic-windtunnel out of control feeling like I felt on cocaine when I experimented with it in my 'yung yooth'.This was semi helpful in getting out of bed in the morning but really did nothing for the anhedonia.I read that you had a confab with your family doc and psychologist.... did you discuss a trial of Buprenorphine yet and if so what was their response?
Posted by bee happy on February 4, 2003, at 20:53:05
In reply to Re: Listening to Cocaine AND TO ALL OF YOU !!! » fachad, posted by LAURA777 on February 4, 2003, at 19:31:48
Oh yes, I also had a very unpleasant reaction to cold remedies and cough syrups containing that alphabet soup ingredient!!! Once years ago while riding in the back seat on a long drive to San Francisco I just absolutely froze. I thought my husband and son were speaking a forein language in the front seat. I could barely speak...but managed to get out the fact that I thought i was having a bad reaction to the cough syrup. It was awful...almost out of body experience.I thought 'this must be what it's like to be really crazy.' I have never taken anything with that stuff since. Also you mentioned hating it when people tell you your life is good. I know this feeling very well. I live half the year in the West Indies and have what most would construe as a fairy tale existence. I liked the cage metaphor also...even in this beautiful place I couldn't feel my life. I do now and wow, what took me so long. Don't believe your husband when he says this is all there is. There's more, Laura. And you will find it. Keep well
Posted by LAURA777 on February 4, 2003, at 21:04:47
In reply to Re: Listening to Cocaine AND TO ALL OF YOU !!!, posted by bee happy on February 4, 2003, at 20:53:05
hey bee , i do not believe she thinks i am depresive , despite very much thought on my end on how to articulate this condition , and i did a good job ,, but people who have never been here , it is hard for them to know .. my primary thinks i am just discontented ,, not depressed , but the more i read this board the more i know i am , there are several types and i am one type .. i am going to try the meds they gave me today and see what happens , i will not forget about the bup . i am going to try and biochemically prove in some fashion that this opiate thing is real ,, after all i do belive all though i can not prove it , we self medicate before we get the help .. and we mostly choose what we need .. although i would never condone using street drugs and such .. Addiction is intolerable and is just as bad as this place , and i know you know this too , i will keep you informed and am thankful you come back on here for the hope .. love ya , laura
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