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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by alchemy on January 26, 2012, at 19:03:14
Do these always co-exist? And with depression?
They say it's the dopamine, but of course it isn't that simple. SSRIs can help some people with it & make some people worse. What about parkinson drugs?I think my motivation & anhedonia are worse than my depression. I'm already on Wellbutrin & often take a stimulant. (and have tried almost everything). I'm just starting a trial with Strattera, starting at a very low dose. But I'm not expecting amazing results.
Posted by torrid2 on January 26, 2012, at 20:02:57
In reply to Motivation vs. Anhedonia, posted by alchemy on January 26, 2012, at 19:03:14
low dose statter took my liver out. After just weeks I was swarring to the ER doc that I don't drink
Posted by Phillipa on January 27, 2012, at 10:04:45
In reply to Re: Motivation vs. Anhedonia, posted by torrid2 on January 26, 2012, at 20:02:57
What do you mean? Phillipa
Posted by bleauberry on January 28, 2012, at 8:32:00
In reply to Motivation vs. Anhedonia, posted by alchemy on January 26, 2012, at 19:03:14
I do not believe strattera on its own is going to do what you want. Could even make it worse. Depends on the size of the dose....less is good.
To really turbocharge your odds, take it with an SSRI. I know you've probably tried most of them and maybe they sucked, but they are different when mixed with a norepinephrine med. Best choices for this approach are zoloft and prozac.
Basically I think I'm saying this....
Pure serotonin, as in SSRIs....generally worthless.
Pure NE, as in strattera....generally worthless.
Equal mix of both....now we're talkin.Any med at a dose that is too high is going to squash your emotional spectrum. Even dopamine meds. I have heard multiple times over the years at pbabble folks complain of their wellbutrin making them feel numb. Wellbutrin actually did that to me even worse than SSRIs did. And how bout sex....wellbutrin is almost universally accepted as being good for sex, right? It gave me complete and total impotence and lack of desire. I'm not at all pointing a finger at wellbutrin, just trying to provide some perspective.
Most people do tend to think of anhedonie/motivation as being in the dopamine circuits. Personally, with me, it is more in the norepinephrine circuits. There is a tad little bit in the serotonin and dopamine circuits, but mostly norepinephrine. That's just me. But for anyone, all the neuros are involved, not just any single one of them.
I've pretty much had anhedonia since birth, and of course much worse during depression, and yet even worse on most meds. Meds generally anesthetize emotions, not enhance emotions. The most helpful substances I have encountered for myself are:
Low dose Savella
Low dose Ritalin
Low dose Amisulpride
Low dose Zoloft+Nortriptyline
Low dose Adrafanil+Prozac
Rhodiola Rosea
Resveratrol (only Source Naturals brand 40mg made with Polygonum not grapes).The king of the hill for anhedonia however is widely available to anyone living in a medical marijuana state.....strains of cannabis that are mostly Sativa. There's nothing better on the planet for anhedonia. In the right State a doctor can even prescribe it for that and there are specific strains for it. People who have battled anhedonia forever and want a new chance would do themselves a favor by making their new home California, Vermont, Maine, or other medical cannabis State.
Posted by alchemy on January 28, 2012, at 10:07:20
In reply to Re: Motivation vs. Anhedonia, posted by bleauberry on January 28, 2012, at 8:32:00
Interesting. Low doses can be better; serotonin + norepiniphrine; and wellbutrin isn't always the cure-all. I have actually never tried marijuana, but I thought that it induced more of a lack of motivation?
Ya, I don't have much hopes for Strattera & it actually kind of scares me that it could make me worse. I started out on 1/4 of 10mg - 10mg is the normal starting dose in the pack. Just got to 10mg. It's definitely not helping - but I don't think it's making it worse (so far anyway). I read someone's experience with it that struck me. She had a very positive experience with it for her adhd and could finally "hear the passage of time". What? For me the passage of time is screaming and annoying.
I ordered Trivastal from United Pharmacies and it didn't help, although there were only 10 pills. I'm hoping that they were fake and that I might still have success on Requip or Mirapex.
I guess the SNRIs are serotonin + norepinephrine. I've tried those too. I tried Pristiq a year or two ago and I started to have worse cyclothymia - more often & more intense. 2pm or 10am could come around and wham- mood plunge.
I am on 300mg of Wellbutrin. I've been on and off of it before. I think it helps a little. I did try and go up to 400mg once and I didn't like it.
Thanks for responding and for the info.
Posted by alchemy on January 28, 2012, at 10:12:31
In reply to Re: Motivation vs. Anhedonia, posted by torrid2 on January 26, 2012, at 20:02:57
> low dose statter took my liver out. After just weeks I was swarring to the ER doc that I don't drink
Yikes. Didn't know that about Strattera. Plus I take Lamictal which I think is bad. If a drug really helped, I would still take it even if it were hard on my liver. But I don't need to take one that isn't.
Plus I am a heterozygote (one gene) for Wilson's disease, where your body has a hard time getting rid of copper. They say only having one gene is ok, but I would suspect it still has an effect. And yes, I take my zinc to offset the copper.
Posted by alchemy on January 28, 2012, at 12:30:12
In reply to Re: Motivation vs. Anhedonia, posted by bleauberry on January 28, 2012, at 8:32:00
Besides the famous dopamine are endorphins. I haven't heard of legal drugs that help with endorphin problems. To the world: NO, my body does not produce endorphins from exercise. Maybe the body's mechanism that creates them is part of my depression problem.
Posted by SLS on January 28, 2012, at 16:00:29
In reply to Re: Motivation vs. Anhedonia, posted by alchemy on January 28, 2012, at 12:30:12
> Besides the famous dopamine are endorphins. I haven't heard of legal drugs that help with endorphin problems. To the world: NO, my body does not produce endorphins from exercise. Maybe the body's mechanism that creates them is part of my depression problem.
Or perhaps the endorphins are there, but are not being recognized or their circuits not routed properly. Exercise does not improve my depression at all, so I can appreciate the frustration in hearing from all directions how universally effective exercise is supposed to be to treat depression. Just as Prozac doesn't work for everyone, exercise does not work for everyone either.
- Scott
Posted by raisinb on January 28, 2012, at 21:24:08
In reply to Re: Motivation vs. Anhedonia » alchemy, posted by SLS on January 28, 2012, at 16:00:29
I am also sick of hearing that. I have been a serious runner most of my life, and I love it, but I've had many times where intense exercise actually induced a full-on mixed state. I didn't have a bp diagnosis then, and I didn't know what a mixed state was, but I heard so much about the universal benefits of exercise that I felt perhaps I just wasn't giving it my "all." Took me a while to learn how to just stop before I start ruminating, crying, raging, and jumping out of my skin. I think just like sleep, drugs, alcohol, or food, exercise is a mood "hack" and can do either positive or negative, or perhaps nothing, depending on the individual's brain chemistry.
Posted by alchemy on January 29, 2012, at 0:52:24
In reply to Re: Motivation vs. Anhedonia, posted by raisinb on January 28, 2012, at 21:24:08
> I am also sick of hearing that. I have been a serious runner most of my life, and I love it, but I've had many times where intense exercise actually induced a full-on mixed state. I didn't have a bp diagnosis then, and I didn't know what a mixed state was, but I heard so much about the universal benefits of exercise that I felt perhaps I just wasn't giving it my "all." Took me a while to learn how to just stop before I start ruminating, crying, raging, and jumping out of my skin. I think just like sleep, drugs, alcohol, or food, exercise is a mood "hack" and can do either positive or negative, or perhaps nothing, depending on the individual's brain chemistry.
Wow, interesting. I don't like to exercise but I try to do it. It is strange that I need to wait until the evening because that's when I don't feel as "unstable". I was putting my exercise clothes on to just force myself to do a little bit this morning but I was already starting to feel the unstable/wavy stuff. And if I exercise even for a little while it will make it worse. Any ideas why the pm works better for me? I am also much more sensitive to food in the morning. Hell, maybe I should get a night shift job and see what happens.
And who do we get to listen to people that say exercise is not always magical!? My psych Dr didn't even believe me.
Posted by bleauberry on January 29, 2012, at 8:09:08
In reply to Re: Motivation vs. Anhedonia » bleauberry, posted by alchemy on January 28, 2012, at 10:07:20
> Interesting. Low doses can be better; serotonin + norepiniphrine; and wellbutrin isn't always the cure-all. I have actually never tried marijuana, but I thought that it induced more of a lack of motivation?
Let me clarify. I am not endorsing cannabis. Just sayin, for the symptoms in question, it is an option and in certain States is a legal option. Now, cannabis species vary a lot, the same as SSRI species vary a lot. Lexapro does not feel like Prozac, right? For motivational symptoms, specific species from the Sativa class are the ones. Species from the Indica class will certainly land you on the couch like a potato and you wouldn't care if you had motivation or not. That's not the right kind.
>
> Ya, I don't have much hopes for Strattera & it actually kind of scares me that it could make me worse. I started out on 1/4 of 10mg - 10mg is the normal starting dose in the pack. Just got to 10mg. It's definitely not helping - but I don't think it's making it worse (so far anyway). I read someone's experience with it that struck me. She had a very positive experience with it for her adhd and could finally "hear the passage of time". What? For me the passage of time is screaming and annoying.
>
> I ordered Trivastal from United Pharmacies and it didn't help, although there were only 10 pills. I'm hoping that they were fake and that I might still have success on Requip or Mirapex.
>
> I guess the SNRIs are serotonin + norepinephrine. I've tried those too. I tried Pristiq a year or two ago and I started to have worse cyclothymia - more often & more intense. 2pm or 10am could come around and wham- mood plunge.Well, the SNRIs really are not serotonin + norepinephrine. They do hit norepinephrine a tiny bit, just barely enough that from a marketing point of view they could say SNRI. Here are the ratios for SNRIs:
Cymbalta 9 parts serotonin to 1 part norepinephrine.
Effexor 30 parts serotonin to 1 part norepinephrine.
Savella 2 parts serotonin to 3 parts norepinephrine.So the only true SNRI in that list is Savella. Another one is Clomipramine. The others are marketing gimmics.
>
> I am on 300mg of Wellbutrin. I've been on and off of it before. I think it helps a little. I did try and go up to 400mg once and I didn't like it.
>
> Thanks for responding and for the info.
>
Posted by herpills on January 29, 2012, at 10:54:13
In reply to Re: Motivation vs. Anhedonia » alchemy, posted by bleauberry on January 29, 2012, at 8:09:08
Here are the ratios for SNRIs:
>
> Cymbalta 9 parts serotonin to 1 part norepinephrine.
> Effexor 30 parts serotonin to 1 part norepinephrine.
> Savella 2 parts serotonin to 3 parts norepinephrine.
>
> So the only true SNRI in that list is Savella. Another one is Clomipramine. The others are marketing gimmics.Is the ratio for Pristiq the same as Effexor?
Posted by rculater on January 29, 2012, at 11:16:04
In reply to Re: Motivation vs. Anhedonia » alchemy, posted by bleauberry on January 29, 2012, at 8:09:08
> Cymbalta 9 parts serotonin to 1 part norepinephrine.
> Effexor 30 parts serotonin to 1 part norepinephrine.
> Savella 2 parts serotonin to 3 parts norepinephrine.
>
> So the only true SNRI in that list is Savella. Another one is Clomipramine. The others are marketing gimmics.
> >> >
>
>
What is your source for these ratios ? I thought Venleflexine ratio on Se and Ne was dose dependant.
Do you have any figures for combo of say Zoloft and Nort at 50mg/10mg ?I hope your keeping well.
Posted by raisinb on January 29, 2012, at 11:55:03
In reply to Re: Motivation vs. Anhedonia » raisinb, posted by alchemy on January 29, 2012, at 0:52:24
It might have something to do with circadian rhythms. I can't really force myself to do anything hard in the morning either. When afternoon and evening start rolling around, I feel much more motivated and positive and energetic. I think some of us just work that way.
I don't know if your brain works this way, but anything I have to "force" myself to do--that is, anything that generates more self-hatred and self-conflict than I already generate on my own--well, it's better to let it go.
This is the end of the thread.
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