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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by Cheryl-Lynn on August 8, 2007, at 18:18:21
I'm bipolar and have been suffering with SEVERE anhedonia for the last 7 years. I feel absolutely no joy whatsoever, not even a twinge, it's as if whatever part of my brain is associated with joy has been amputated.
Has anyone else been a long sufferer of this and found any relief and if so, how? I'm losing hope.
Hugs
Cher
Posted by d0pamine on August 8, 2007, at 18:43:54
In reply to Help! Severe anhedonia, posted by Cheryl-Lynn on August 8, 2007, at 18:18:21
> I'm bipolar and have been suffering with SEVERE anhedonia for the last 7 years. I feel absolutely no joy whatsoever, not even a twinge, it's as if whatever part of my brain is associated with joy has been amputated.
> Has anyone else been a long sufferer of this and found any relief and if so, how? I'm losing hope.
> Hugs
> Cher
I'm very sorry, and I think I can very likely relate near perfectly. 2 words, EMSAM. Give the 12mg patch 6 weeks and if your response is like mine and you'll begin feeling much better, and in you'll be a new person 2 months and the memory of what it was like will already have started to fade. Now if you have insurance (or some other way to cover the $511 / month cost) RUN and don't walk to some doctor that will prescribe it for you. and wait..and wait and wait and wait and think nothing is happening then get ready to feel much better.
Posted by brooke484 on August 8, 2007, at 20:25:02
In reply to Re: Help! Severe anhedonia » Cheryl-Lynn, posted by d0pamine on August 8, 2007, at 18:43:54
Is EMSAM the first MAO you tried? I've been on Nardil and Parnate (didn't work) and my doctor said we should try Marplan next. I would have to pay $50 a month for that versus $100 for EMSAM.
brooke
Posted by Cheryl-Lynn on August 8, 2007, at 20:57:11
In reply to Re: Help! Severe anhedonia » Cheryl-Lynn, posted by d0pamine on August 8, 2007, at 18:43:54
> > > > Hugs
> > Cher
> I'm very sorry, and I think I can very likely relate near perfectly. 2 words, EMSAM. Give the 12mg patch 6 weeks and if your response is like mine and you'll begin feeling much better, and in you'll be a new person 2 months and the memory of what it was like will already have started to fade. Now if you have insurance (or some other way to cover the $511 / month cost) RUN and don't walk to some doctor that will prescribe it for you. and wait..and wait and wait and wait and think nothing is happening then get ready to feel much better.
>
>Oh god, you mean there's really hope?! I've begun to wonder if I'll ever feel joy again - it feels like it's been too long, like maybe something's broken in there (my head).
I'm going to research this stuff. How long did you suffer with anhedonia and were you also treatment resistant? And this EMSAM really worked that well - how long did it take?
Sorry for all the questions, I just want so badly to feel again - I'm desperate.
Hugs
Cher
Posted by nickguy on August 8, 2007, at 22:47:51
In reply to Re: Help! Severe anhedonia - dopamine, posted by brooke484 on August 8, 2007, at 20:25:02
> Is EMSAM the first MAO you tried? I've been on Nardil and Parnate (didn't work) and my doctor said we should try Marplan next. I would have to pay $50 a month for that versus $100 for EMSAM.
>
> brooke
Brooke, why did you stop the Nardil/Parnate? Side effects, diet restrictions, or just plain didn't do anyhting?
Posted by d0pamine on August 9, 2007, at 4:26:28
In reply to Re: Help! Severe anhedonia - dopamine, posted by nickguy on August 8, 2007, at 22:47:51
Yes, first MAOI also tried parnate for almost 4 weeks , but couldn't stand it, so today is my first day back with EMSAM.
Posted by d0pamine on August 9, 2007, at 4:38:34
In reply to Re: Help! Severe anhedonia, posted by Cheryl-Lynn on August 8, 2007, at 20:57:11
> Oh god, you mean there's really hope?! I've begun to wonder if I'll ever feel joy again - it feels like it's been too long, like maybe something's broken in there (my head).
> I'm going to research this stuff. How long did you suffer with anhedonia and were you also treatment resistant? And this EMSAM really worked that well - how long did it take?
> Sorry for all the questions, I just want so badly to feel again - I'm desperate.
> Hugs
> Cher
>
I've only had to deal with it for maybe 15 years and I've tried a pile of other things, but nothing else has really helped except adderall, but it took a very high dose and I think that stuff really started to eat away at my insides after about 6 years. Yes, EMSAM really worked that well for me and I think I've used it for somewhere around 1.5 years (minus 4 terrible weeks). But if you're considering it, make sure you don't start out with the 6mg patch as it seems to be worthless as far as I can tell and the 9mg patch for me is really only enough to tease me about feeling normal, but with the 12 and about 6 weeks after starting it I really began to feel what I believe to be "normal" (if there really is such a thing)..I'm afraid that so many folk have got used to something that makes them feel about half lit up or half turned off that normalcy just doesn't feel quite right, but for me, it's just fine. Don't forget though as far as it starting to work for you goes it really doesn't happen slowly. If it works for you, you'll feel almost nothing for the first 5 weeks or so then somewhere around the morning of the 6th or 7th week you'll wake up one morning and be driving to work and notice how excited you are about getting there. It's nuts.
Posted by Phillipa on August 9, 2007, at 10:06:04
In reply to Re: Help! Severe anhedonia, posted by d0pamine on August 9, 2007, at 4:38:34
How come my pdoc thinks it's too stimulating for me? How does it compare to SSRI's? Love Phillipa
Posted by nickguy on August 9, 2007, at 14:19:19
In reply to Re: Help! Severe anhedonia - dopamine, posted by brooke484 on August 8, 2007, at 20:25:02
> Is EMSAM the first MAO you tried? I've been on Nardil and Parnate (didn't work) and my doctor said we should try Marplan next. I would have to pay $50 a month for that versus $100 for EMSAM.
>
> brookeBrooke, why did you stop the Nardil/Parnate? Side effects, diet restrictions, or just plain didn't do anyhting?
Posted by Cheryl-Lynn on August 9, 2007, at 17:02:59
In reply to Re: Help! Severe anhedonia, posted by d0pamine on August 9, 2007, at 4:38:34
>
> > > >
> I've only had to deal with it for maybe 15 years and I've tried a pile of other things, but nothing else has really helped except adderall, but it took a very high dose and I think that stuff really started to eat away at my insides after about 6 years. Yes, EMSAM really worked that well for me and I think I've used it for somewhere around 1.5 years (minus 4 terrible weeks). But if you're considering it, make sure you don't start out with the 6mg patch as it seems to be worthless as far as I can tell and the 9mg patch for me is really only enough to tease me about feeling normal, but with the 12 and about 6 weeks after starting it I really began to feel what I believe to be "normal" (if there really is such a thing)..I'm afraid that so many folk have got used to something that makes them feel about half lit up or half turned off that normalcy just doesn't feel quite right, but for me, it's just fine. Don't forget though as far as it starting to work for you goes it really doesn't happen slowly. If it works for you, you'll feel almost nothing for the first 5 weeks or so then somewhere around the morning of the 6th or 7th week you'll wake up one morning and be driving to work and notice how excited you are about getting there. It's nuts.
>
>
God I miss that feeling. I remember when I used to drive down the street thinking how beautiful the day was, being excited to meet a friend for coffee, marveling at the scent of a freshly cut lawn. You don't realize how often you have those fleeting little butterflies in your stomach until they're gone. I'm so happy for you that you've found some relief and your posts are giving me hope as well. I'd gladly wait the 5 weeks or more if I knew that there was the slightest chance of there being light at the end of this black tunnel.
I've been trying to find out if EMSAM is available in Canada - I even phoned my pharmacy to find out but the pharmacist never called back so I still don't know. My fingers are crossed that it is available here.
I really appreciate all of your advice.
Hugs
Cher
Posted by Larry Hoover on August 9, 2007, at 17:12:11
In reply to Re: Help! Severe anhedonia, posted by Cheryl-Lynn on August 9, 2007, at 17:02:59
> I've been trying to find out if EMSAM is available in Canada - I even phoned my pharmacy to find out but the pharmacist never called back so I still don't know. My fingers are crossed that it is available here.
> I really appreciate all of your advice.
> Hugs
> CherSorry, it's not approved in Canada. It would be legal to import, though, on your doctor's prescription.
Lar
Posted by brooke484 on August 9, 2007, at 19:54:29
In reply to Re: Help! Severe anhedonia - Brooke484, posted by nickguy on August 9, 2007, at 14:19:19
Parnate made me feel like I was on speed and nardil just made me sick period. There were too many side effects and I decided after 9 weeks I had had enough.
brooke
Posted by Cheryl-Lynn on August 9, 2007, at 22:33:41
In reply to Re: Help! Severe anhedonia, posted by Larry Hoover on August 9, 2007, at 17:12:11
> > I've been trying to find out if EMSAM is available in Canada - I even phoned my pharmacy to find out but the pharmacist never called back so I still don't know. My fingers are crossed that it is available here.
> > I really appreciate all of your advice.
> > Hugs
> > Cher
>
> Sorry, it's not approved in Canada. It would be legal to import, though, on your doctor's prescription.
>
> Lar
Thanks Lar, I was afraid of that. I've never ordered a drug over the internet - it might be time to start.
Hugs
Cher
>
>
Posted by mike lynch on August 9, 2007, at 22:33:59
In reply to Re: Help! Severe anhedonia - nick, posted by brooke484 on August 9, 2007, at 19:54:29
Does anyone feel this anhedonia was caused by ssri's or other meds? Or have you experienced this lack of joy before the meds? I think this is important to figure out. SSRI's numb emotions, thus they can cause this lack of joy and emotion. For me it was permanent.
Posted by Jedi on August 10, 2007, at 23:58:19
In reply to Re: Help! Severe anhedonia - nick, posted by mike lynch on August 9, 2007, at 22:33:59
> Does anyone feel this anhedonia was caused by ssri's or other meds? Or have you experienced this lack of joy before the meds? I think this is important to figure out. SSRI's numb emotions, thus they can cause this lack of joy and emotion. For me it was permanent.
Mike,
The SSRI Apathy or Amotivational Syndrome has been fairly well documented. I experienced it on both SSRIs and SNRIs.
Be Well,
JediReference:
J Psychiatr Pract. 2004 May;10(3):196-9.
SSRI-induced apathy syndrome: a clinical review.
Barnhart WJ, Makela EH, Latocha MJ.
Department of Behavioral Health and Psychiatry, North Colorado Medical Center, Greeley 80631, USA.The authors review the literature pertaining to selective serotonin reuptake inhibitor (SSRI)-induced apathy syndrome. A literature search of Medline and International Pharmaceutical Abstracts from 1970 to the present was performed for relevant articles. Twelve relevant case reports and one open-label treatment trial were identified. An amotivational, or apathy, syndrome has been reported in a number of patients receiving SSRI treatment over the last decade. This adverse effect has been noted to be dose-dependent and reversible, but is often unrecognized. This phenomenon has caused significant negative consequences for adults as well as social and academic difficulties in adolescents.
PMID: 15330228 [PubMed - indexed for MEDLINE]
Posted by nickguy on August 11, 2007, at 15:08:44
In reply to Re: Help! Severe anhedonia - nick » mike lynch, posted by Jedi on August 10, 2007, at 23:58:19
I tried SSRI's in the past, but for me, the apathy was there long before.
Posted by Cheryl-Lynn on August 11, 2007, at 18:08:54
In reply to Re: Help! Severe anhedonia - nick, posted by mike lynch on August 9, 2007, at 22:33:59
> Does anyone feel this anhedonia was caused by ssri's or other meds? Or have you experienced this lack of joy before the meds? I think this is important to figure out. SSRI's numb emotions, thus they can cause this lack of joy and emotion. For me it was permanent.
This is a great question. I'd tend to think the problem is pre existing and the SSRI's exacerbate it.
Posted by Fivefires on August 11, 2007, at 18:40:55
In reply to Re: Help! Severe anhedonia, posted by d0pamine on August 9, 2007, at 4:38:34
It looks like EMSAM is getting a good rap here, and including in its comparison to Nardil and Parnate.
My understanding is there are less stringent dietary restrictions w/ EMSAM than other MAOIs.
Is EMSAM usually taken alone or has it been found to be more effective in any particular combo?
I've experienced extreme anhedonia, I believe, in direct response to SSRIs, and to a lesser extent, to an SNRI. They rob me of rational thinking, i.e., I'll have 'bad thoughts', and the 'rational link between thought and action disappears', putting me at risk of 'acting upon bad thoughts'.
In the past, besides SSRIs and SNRI, have tried trazodone, norpramin, and desipramine (tricyclics), w/o significant relief. Of all, Effexor-XR, Celexa, and maybe (can't remember for sure which one) got a tinge of relief from one of the tricyclics, but, 'never anything to write home about'! I always had to be careful the AD wasn't increasing anxiety, as anxiety is probably more of a problem, than depression, for me.
But now, including all meds in prior paragraph, nothing offers relief of my depression w/o an onslaught of bad side effects.
Isn't 'the whole patch idea' considered more effective because it reaches blood stream w/o having to go through the whole metabolizing process, the latter of which differs so vastly in us, and, if so, I'm not getting why it would take 5-6wks to feel the relief. Seems like relief would be realized sooner.(?) Whenever a med is available in patch form, it works better for me than pills, I think because it bypasses by fast metabolization, and, I've been told, don't have enough body fat to store med, so lose it quickly. Any comments about this?
I'm feelin' like Cheryl-Lynn. Bless you heart; you deserve some relief.
I've given up on the ADs, anti-psychs, and mood-stabs, and pretty much decided I'm treatment resistant.
I'm pretty sure I've never been on an MAOI.
I'd been pondering Nardil and Parnate, know little about Marplan, but now EMSAM might be a way to go. (It's often fear of meds that holds me back.)
My Pdoc knows I'm pretty much treatment resistant, and only mentioned EMSAM in saying hasn't used much, but hadn't heard a lot of bad, so if I went w/ it, I'd be a guinea pig sts.
I'm not on any AD currently, just something for my high anxiety, but recently my depression is overwhelming., and I really need some direction. Pdoc hasn't responded to phone messages x3.
I think if no one follows up my post, it'll get lost amidst other threads somehow, so will someone pls followup? :)
I hope you can get a scrip for EMSAM a try it CL. Let us know.
ApologizeIfRepeatSelf, 5f
Posted by d0pamine on August 11, 2007, at 21:13:48
In reply to Re: Help! Severe anhedonia, posted by Fivefires on August 11, 2007, at 18:40:55
I'm not sure that more of us shouldn't have a greater "fear of meds that holds me back" ....Sometimes I wish I'd never tried the first med.... The whole concept feels like a toxic treadmill sometimes. And I say to myself "If I'd just gone in to ditch digging or something else physical I'd prolly have been just fine"
Posted by Phillipa on August 11, 2007, at 22:10:32
In reply to Re: Help! Severe anhedonia » Fivefires, posted by d0pamine on August 11, 2007, at 21:13:48
I'm surprised dopamine that you say this as I thought you were doing okay. So in my case excercise is the best antidepressant for me are you saying physical excercise was better for you too? Love Phillipa
Posted by d0pamine on August 12, 2007, at 6:38:02
In reply to Re: Help! Severe anhedonia » d0pamine, posted by Phillipa on August 11, 2007, at 22:10:32
> I'm surprised dopamine that you say this as I thought you were doing okay. So in my case excercise is the best antidepressant for me are you saying physical excercise was better for you too? Love Phillipa
I'm blessed beyond comprehension and I'm doing better than I deserve but... I'm saying that all these chemical cocktails are simply band aids for something. Maybe it's a lack of exercise, maybe it's a lack of some vitamin or mineral that's not of sufficient quantity or quality in my modern diet. Maybe it's a lack of D from a lack of sun exposure. Perhaps it's something toxic in the environment. Maybe it's the long term result of some vaccination that I was given in my younger days. Perhaps it's the result of years of exposure to bisphenol A (BPA) from plastic containers. Perhaps it's the result of breathing so much toxic pollen from genetically altered plants. I don't know what it is, but I am confident that I was never intended to have to live life with a plastic patch stuck to my arm to make what really is a very pleasant life situation bearable. Maybe it's reversible maybe it isn't, but I'm determined to never think of living with chemicals as my best possible option.
Posted by Phillipa on August 12, 2007, at 22:19:58
In reply to Re: Help! Severe anhedonia, posted by d0pamine on August 12, 2007, at 6:38:02
Dopamine well said and I agree. Love Phillipa ps don't some say there is really a cure for cancer but so many people would lose money that we'll never know? Enviornmental causes cause a lot of that too. Love Phillipa ps and a host of other diseases.
Posted by Cheryl-Lynn on August 12, 2007, at 22:50:45
In reply to Re: Help! Severe anhedonia, posted by Fivefires on August 11, 2007, at 18:40:55
> It looks like EMSAM is getting a good rap here, and including in its comparison to Nardil and Parnate.
>
> My understanding is there are less stringent dietary restrictions w/ EMSAM than other MAOIs.
>
> Is EMSAM usually taken alone or has it been found to be more effective in any particular combo?
>
> I've experienced extreme anhedonia, I believe, in direct response to SSRIs, and to a lesser extent, to an SNRI. They rob me of rational thinking, i.e., I'll have 'bad thoughts', and the 'rational link between thought and action disappears', putting me at risk of 'acting upon bad thoughts'.
>
> In the past, besides SSRIs and SNRI, have tried trazodone, norpramin, and desipramine (tricyclics), w/o significant relief. Of all, Effexor-XR, Celexa, and maybe (can't remember for sure which one) got a tinge of relief from one of the tricyclics, but, 'never anything to write home about'! I always had to be careful the AD wasn't increasing anxiety, as anxiety is probably more of a problem, than depression, for me.
>
> But now, including all meds in prior paragraph, nothing offers relief of my depression w/o an onslaught of bad side effects.
>
> Isn't 'the whole patch idea' considered more effective because it reaches blood stream w/o having to go through the whole metabolizing process, the latter of which differs so vastly in us, and, if so, I'm not getting why it would take 5-6wks to feel the relief. Seems like relief would be realized sooner.(?) Whenever a med is available in patch form, it works better for me than pills, I think because it bypasses by fast metabolization, and, I've been told, don't have enough body fat to store med, so lose it quickly. Any comments about this?
>
> I'm feelin' like Cheryl-Lynn. Bless you heart; you deserve some relief.
>
> I've given up on the ADs, anti-psychs, and mood-stabs, and pretty much decided I'm treatment resistant.
>
> I'm pretty sure I've never been on an MAOI.
>
> I'd been pondering Nardil and Parnate, know little about Marplan, but now EMSAM might be a way to go. (It's often fear of meds that holds me back.)
>
> My Pdoc knows I'm pretty much treatment resistant, and only mentioned EMSAM in saying hasn't used much, but hadn't heard a lot of bad, so if I went w/ it, I'd be a guinea pig sts.
>
> I'm not on any AD currently, just something for my high anxiety, but recently my depression is overwhelming., and I really need some direction. Pdoc hasn't responded to phone messages x3.
>
> I think if no one follows up my post, it'll get lost amidst other threads somehow, so will someone pls followup? :)
>
> I hope you can get a scrip for EMSAM a try it CL. Let us know.
>
> ApologizeIfRepeatSelf, 5fYou have nothing to apologize for dear one - you are not alone - if you only knew how I annoy those around me because I repeat myself so often *sigh*. It's part of the illness, I'm sure.
Rest assured that if I have an opportunity to try EMSAM, I'll keep you posted. I may have to order it online, it's not available here in Canada. At this point I'm willing to try anything - I have nothing to lose. I've been so low for so long and there's absolutely no quality to my life as it is. The years are ticking by and I'm in a hellish limbo. I find that I used to think constantly of getting better and now I think more often of wanting to die than of getting well. I've promised my family I'll keep trying so I will continue to keep seeking relief somehow, but in reality there's a big part of me that wants to give up.
My heart goes out to you, I know exactly how you must be feeling. What is happening to us?! I've heard some ponder that it may be a build up of calcium on the brain, but there are just educated guesses so far, no real answers and surprisingly little seeming to be done to get those answers. This may sound morbid but, with the prevalence of depression and MI these days, I'm surprised that more of us sufferers aren't encouraged to donate our brain(s) after death for research purposes. I know I'd donate mine in a heartbeat if it could help someone else - it sure isn't doing me any good!
Bless you too dear and thank you for your kind post.
Hugs
Cheryl-Lynn
Posted by fuzz54 on August 13, 2007, at 15:11:01
In reply to Re: Help! Severe anhedonia - nick, posted by Cheryl-Lynn on August 11, 2007, at 18:08:54
> > Does anyone feel this anhedonia was caused by ssri's or other meds? Or have you experienced this lack of joy before the meds? I think this is important to figure out. SSRI's numb emotions, thus they can cause this lack of joy and emotion. For me it was permanent.
>
>
> This is a great question. I'd tend to think the problem is pre existing and the SSRI's exacerbate it.
>I had moderate to severe Anhedonia for 2 to 3 years before I went for individual therapy, and then SSRI's a year later combined with therapy. I also had several severe depressions, social anxiety, and some s******* ideation during the years of Anhedonia. The SSRI's did numb me a bit, but they allowed me to get over the anxiety that was keeping me from changing my life and getting to a better place. This helped the depression lift, which in turn relieved %70 of my Anhedonia. For me, the more relevant question is whether depression came before anhedonia? I think I've concluded it was the depression after looking back at everything. I'm now at the point where I'm lowering my meds to hopefully get on a minimal dose of SSRI, or even none. Even if there are some permanent effects from the SSRI's, I'm okay with them since they allowed me to get my life back on track. I don't mean to invalidate other people's experiences with SSRI's though. Everyone is different.
Posted by mike lynch on August 14, 2007, at 23:51:46
In reply to Re: Help! Severe anhedonia - nick » mike lynch, posted by Jedi on August 10, 2007, at 23:58:19
> > Does anyone feel this anhedonia was caused by ssri's or other meds? Or have you experienced this lack of joy before the meds? I think this is important to figure out. SSRI's numb emotions, thus they can cause this lack of joy and emotion. For me it was permanent.
>
> Mike,
> The SSRI Apathy or Amotivational Syndrome has been fairly well documented. I experienced it on both SSRIs and SNRIs.
> Be Well,
> Jedi
>Yes I know, I should have clarified I meant PERMANENT, lasting during and even after the medication stops.
This is the end of the thread.
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