Psycho-Babble Medication | about biological treatments | Framed
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My vote for anhedonia relief

Posted by andrewb on August 15, 1999, at 12:43:37

In reply to Re: While my guitar gently rusts, posted by JohnL on August 15, 1999, at 8:33:50

> Thanks all for great ideas. Keep em coming if you can. My psychiatrist will write a precip for anything. No prob. He's been around a long time, worked with lots of heavy hitters, and I think he knows that often times finding the right treatment is about the same as throwing darts, throwing the dice, picking straws. He is well aware that what ends up working may or may not have any logical reason as to why. Body chemistries are just so different. No way to predict. He helps me weigh the pros and cons of choices. But he, like me, is willing to try anything that makes some sense. He did mention Ritalin once. So, getting a prescrip is no prob. Deciding what to do is. Meanwhile, the guitar does gently rust (good one Stephan!) Very grateful for your ideas and support. Thanks. JohnL.

John,
After more than a month of usage, I continue to have good results and euthymic effect from amisulpride. As you know amisulpride is specific to the D2-D3 receptors, mainly those in the limbic system. I think that pramipexole (Mirapex), though it hasn't been studied as thoroughly for depression as amisulpride, would have a similar effect with the added benefit of being available in the US. Since pramipexole acts more preferentially on the striatum D2-D3 than amisulpride it may have more of an anxiolytic effect and it has certainly been noted for that. Another good thing about these med.s is that they act quickly. You have no reason to take amisulpride longer than a week to decide whether or not it is helping you.
It certainly seems possible that other medicines could combat anhedonia even if the key lies in the D2-D3 pathways. I've read that SSRIs and classic antidepressants increase the responsiveness of D2-D3 receptors over time, possibly by increasing receptor density.
I've tried amineptine and it can be effective. However it seems to stimulate unnecessary parts of the dopaminergic system causing unwanted side effects like agitation or muscle tension and visual distortion. I only tried selegiline at a low dose (5-10mgs.), with and without phenylalanine. I did not experience good effect. Phenylalanine by itself I found to be unpleasantly stimulating.
I use buprenorphine (the sublingual form that isn't available in the US) very occasionally for pain. From what I've read there are some cases where it has been effectively used to treat depression. But be warned that it seems there is some potential for habituation and even abuse. I believe its mode of action is via occupation of opiate receptors.
By the way I hear it mentioned here and there in posts that Wellbutrin (bupropion) acts through dopaminergic mechanisms. I'm confused on this. How does bupropionís dopaminergic effect compare in significance to the med.s effect on norepinephrine. I've also read that while it inhibits the reuptake of dopamine, bupropion also diminishes the release of dopamine. Does that make its net effect on the dopaminergic system a wash? Should bupropionís energizing effects be attributed to norepinephrine or dopamine action?
John glad to hear you are feeling better. Best of luck finding relief for your anhedonia. From reading your posts it seems that your approach to recovery serves you well.



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poster:andrewb thread:10100
URL: http://www.dr-bob.org/babble/19990814/msgs/10140.html