Posted by JohnL on November 29, 2000, at 3:51:22
In reply to Re: Organizing our diag./symptoms med s-effects , posted by Jon on November 28, 2000, at 9:33:45
Hi,
Wow, I had forgotten about that old post. Since then, a million miles and a million drugs later, I have found some things that work well on my anhedonia.I think you are right that opioid systems could be involved in anhedonia. And there doesn't appear to be any non-addictive way to treat that. But it seems many psychiatric drugs may have indirect actions on opioid systemes, through domino chain reactions.
In general though I've come to believe anhedonia is primarily a dysfunction of the noradrenaline and dopamine systems. Basically what I've gathered indicates that NE is related to drive, while DA is related to pleasure, both of which added together make up components of anhedonia.
I found Adrafinil fairly effective. That would indicate that my alpha-1 receptors are blocked, clogged, or somehow dsyfunctional. NE levels are fine, but the related receptors are not. Merely increasing NE levels does nothing to fix the problem.
Amisulpride also is fairly effective. That would indicate that dopamine is somehow dsyfunctional.
But the best of all is when these two drugs are combined. The sum is greater than the two parts added together. To further complicate the picture, a tiny dose of Prozac in the background further enhances their effects. Obviously the chemistry is complicated, but it has become clear that NE and DA are primary systems in my anhedonia.
It is also surprising to me that it takes a very specific drug to correct the problem. Just any DA or NE drug won't do. For example, Amisulpride stimulates DA. But so do Ritalin and Adderall. But neither Ritalin or Adderall affected my anhedonia, while Amisulpride did. And most NE enhancing drugs actually made me more depressed. Yet by stimulating NE receptors with Adrafinil, rather than increasing NE levels, I felt much better. Go figure.
After all is said and done, the moral of the story is the same as it always has been. That is, we just have to try different things until one works. If one drug in a particular class doesn't work, another might. But generally I've come to believe that if anhedonia is a primary symtom (as in some depressions and some schizophrenics), then focusing on different ways to influence NE and DA is probably the quickest way to find relief. Drugs of varying mechanisms should be tried.
John
poster:JohnL
thread:14407
URL: http://www.dr-bob.org/babble/20001115/msgs/49600.html