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Re: Stimulants for TRD uncouth

Posted by conundrum on November 13, 2009, at 14:59:31

In reply to Re: Stimulants for TRD, posted by uncouth on November 13, 2009, at 14:41:36

I'm the exact same way and prozac did it to me. Not a stimulant but it is a dopamine/norepinephrine releaser.

Even orgasms don't feel good and that is something that is hardwired to feel good. People think I'm whining when I say I don't enjoy things like I used to but when I say I get no pleasure from sex they seem to understand the seriousness of the situations.

Right now I'm trying to increase reward by boosting dopamine through 5HT1A agonism, 5HT2C antagonism, and alpha 2 adrenergic antagonism. I'm taking 15mg of buspar a day and 5mgs of prozac. The buspar seems to help a little bit with motivation, but not with pleasure. I know that sounds odd, since you would think pleasure and motivation would go hand in hand. Prozac seems to counter this positive effect, but I will continue the expirement.

I would also consider Remeron, which is a drug on should start on a higher dose like 30 mgs and work up to 45mgs.

Other options are Antipsychotics but the side effects profile of parkinson's like shaking and hyperglycemia seem a lot less safe than stimulants.

Some people respond to DA agonists like Mirapex and Requip, but they have their drawbacks as well.

It seems like once the reward system gets used to elevated dopamine it requires that amount to function normally. Do you have sexual anhedonia? Do you also have short term memory and concentration problems that you didn't have before you start treatment?

 

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