Shown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by snubbel on November 24, 2009, at 7:10:33
I'm currently on Moclobemide. My problems are AvPD with anhedonia and dysthymia. I took 300 mg/day in two doses but I am now tapering down (currently at 112.5 mg AM + 75mg PM) because of the emotional flattening (thymoanaesthesia). It really bugs me. When on the oroginal dose (or higher) I feel active and positive, but it doesn't seem 'real' at the same time. It is as if the feelings aren't 'grounded' deep inside me, just floating aroundon the surface. I feel shallow. Also, my capacity for empathy disappear. When I see something horrible on the news I just don't feel any emotional connection with the people it happened to. I went to a movie with an old friend and we saw this movie which ended with documentary photos from a massacre. My friend started to cry openly in the theatre and many others were crying to. I just sat there, fulle aware on an intellectual level that I what I saw was horrible and moving, but the feelings just weren't there. Something must be fundamentally wrong when documentary pictures of butchered children doesn't feel different than watching a soda advertisement. I was NOT like this before, just the opposite. Dang, I even cried (in private) to the scene in Groundhog Day when Bill Murray tries to save that dying homeless guy.
It is like the med has just numbed me all over, and at higher doses just adds a little shallow topping of activeness and not beeing negative.
At this point I am guessing that the flattening effect is from the regulation of Serotonin, and that I will have the same experience on all meds that regulate Serotonin. Actually, I am beginning to think that the emotional flattening effect is _the_ effect of this meds. That is, the strongest emotions are numbed first and when the dosage rises the softer, more subtle emotions also gets numbed. And finding the right dosage with these meds is about finding the point that is the least bad trade-off. Problem comes when you (that's me) don't have much genuine positive emotions to start with. Then the med just numbs the negative feelings and leaves nothing much at all to feel after that. My choice at this point seems to be either to be numbed and feeling that nothing about me is genuine or true, or to have my old negative feelings that are genuine and true even if they suck.
Should I try Buspirone? Venlafaxine? Something stimulating, like for ADD?
Posted by Phillipa on November 24, 2009, at 12:08:59
In reply to what med has the least emotional flattening?, posted by snubbel on November 24, 2009, at 7:10:33
I find what you interesting. Although I take very low dose of luvox and low dose of benzos I too experience the to me not caring. Like what difference does it make each day is the same. Kind of like that? If only could not take any meds at all and be back to the happy person who cried and cared about all. Is this how you also feel? Phillipa
Posted by bleauberry on November 24, 2009, at 17:55:16
In reply to what med has the least emotional flattening?, posted by snubbel on November 24, 2009, at 7:10:33
Moclobemide has a pretty poor track record. Most doctors gave up on it years ago.
You touched on the serotonin thing and I agree with you. While serotonin probably plays a part, it needs to be kept as a minor player, not a major player.
Best ideas I can think of. You mentioned Effexor...not. Too much serotonin. Wellbutrin...maybe. This med doesn't work that great very often, but when it does it works really good.
Best bet as I see it...low dose SSRI with a TCA such as Nortriptyline first, Desipramine second. The TCA+SSRI combo is hard to beat.
If you are into mailorder meds, I have never known a better med for your cluster of symptoms than Amisulpride 25mg.
Adrafinil first, or Provigil second, added to a low doses SSRI is also promising. Sometimes Provigil all by itself.
Some ideas for you. I agree with your hunch that too much serotonin is worsening things for you. If depression truly is a chemical imbalance as they theorize, well, then it has to be balanced out with norepinephrine and/or dopamine as well, not just serotonin.
Posted by Maxime on November 27, 2009, at 14:53:43
In reply to what med has the least emotional flattening?, posted by snubbel on November 24, 2009, at 7:10:33
I find Parnate to have no emotional flattening. When I was on Cymbalta I couldn't even cry if I wanted to. Now I have normal moods.
Posted by Kingston on December 2, 2009, at 15:47:04
In reply to Re: what med has the least emotional flattening? » snubbel, posted by Maxime on November 27, 2009, at 14:53:43
LAMICTAL below 100mg(best anti-depressant on earth but taper slowly. I would take more for great AD effect but cognitive dulling occurs over 100mg). Take it slow with this drug and you won't experience side effects. Augment it with Namenda to keep the dose down. They are synergistic together. Very few psychiatrists, very few, know this yet. Not even sure if it can be found via a Google Search.
Whatever you do, make sure to get brand name Lamictal. If your insurance won't cover brand, you're in luck b/c Jan Drugs in Canada sells GSK brand Lamictal for a ridiculously low cost. Totally legit too. I took 3 months to build up to 50mg but had noticeable AD effects even at 5mg. I now take between 30-50 mg spread throughout the day in 5mg chewable tablets. I found the chewable tablets to be the superior formula for whatever reason...prob b/c they are absorbed sublingually. They hit fast and sort of work like Klonopin wafers but with a nice semi-euphoric mood lift.
Klonopin wafers for social anxiety. Klonopin actually allows me not to be emotionally flat which I would otherwise be b/c of excessive anxiety that i've had since embryo. Klonopin does cause major cognitive dulling but this can be counteracted with exercise, good nutrition, a stimulant like Nuvigil or with anti-cholinergics like Aricept and Namenda. Been on special K for 5 years and my brain is as good as it ever was. Probably has something to do with the ESAM patch I take which doesn't cause emotional flattening either.
This is the end of the thread.
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