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Re: Organizing our diag./symptoms & med s-effects

Posted by JohnL on November 2, 1999, at 3:49:52

In reply to Organizing our diag./symptoms & med s-effects , posted by Diane on November 1, 1999, at 20:41:50

OK. I'm in. Hope this isn't too lengthy. I'll try to keep it simple and concise. I don't think reponses will help much in forming a base, because everyone is so different. But it will be interesting to see.

DIAGNOSIS: Double Depression. Dysthymia with overlapping severe depressive bouts. Possible bipolar.

PRIMARY SYMTOM: Anhedonia. Lack of pleasure, enjoyment in normal activities/hobbies. Other textbook depression symptoms too, but anhedonia is the big monster with me.

All the SSRIs. Good for general depressive symptoms, but no benefit at all for anhedonia. Terrible sexual dysfunction with all except Prozac.
TCAs Notriptyline, Protriptyline. Couldn't handle the side effects to give a good trial. Protriptyline worsened tinnitus.
Wellbutrin. Super loud tinnitus. Like a jet plane in the ears. Couldn't give a fair trial. Fantastic sex.
Buspar. Same as Wellbutrin.
Serzone. Worsened depression. Worsened tinnitus. Worsened anhedonia. Excellent sex and sleep.
Effexor. Same as Serzone.
Moclobemide. Worsened depression. Unfair trial.
Lithium. Worsened tinnitus. Unfair trial.
Lamictal. Helpful on all symptoms except the anhedonia. No side effects.
St Johnswort. Same as Lamictal.
Remeron. Fairly helpful, but no effect on anhedonia. Great sleep.
Naltrexone. No effect. Neutral.
Herbs, gingko, ginseng. Mild energy boost, elevated physical endurance, but no mental benefits.

CURRENTLY: Prozac+Remeron. Tapering off Lamictal. Tapering down St Johnswort. Keeping the Prozac because it is generally effective and is the only thing that actually quiets my tinnitus. But anhedonia remains fullblown.

BEST RESULTS SO FAR: Zoloft+Nortriptyline. Zoloft+Buspar. Sadly the Zoloft was just too unfriendly to sex. Buspar very loud tinnitus.

FUTURE: Augment Prozac with something else. Retry Nortriptyline, maybe try Desipramine with Prozac. Add a dompamine selective drug without tinnitus. Like Amisulpride, Pemoline, Bromocriptine.

SUMMARY: Anhedonia I believe is a distinct beast that can occur during depression or occur as a completely seperate monster. Since my other depressive symptoms are under control with Prozac, I am tempted to believe anhedonia is a seperate distinct condition more difficult to treat than depression. Whether it is a function of serotonin, NE, or dopamine is a mystery to me.

So, who out there sounds like me? Who's my Anhedonia Psycho-Buddy? :)




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