Posted by JohnL on March 2, 2001, at 2:30:29
In reply to Wellbutrin -- anhedonia (long), posted by blackjack on February 27, 2001, at 21:50:35
Hi Blackjack,
Me and Ann Hedonia have known each other a long time. We go way back.In my experience there are two classes of drugs that seem particularly helpful in treating the 'blahs' you described. Stimulants, and antipsychotics.
In your case I would not stop the Wellbutrin. I would instead add the following to it:
Zyprexa 2.5mg to start, then up to 5mg or 10mg. Any daytime sedation disappears in about a week or so.
Risperdal .5 to 2mg.
Amisulpride 50mg to 100mg.
Adrafinil 300mg to 600mg.
Ritalin 5mg as needed.
Adderall.Of them all, the most helpful for my longstanding anhedonia have been Amisulpride, Zyprexa, Adrafinil. But any of them seem to work best with a little Prozac in the background.
Adding Prozac to your Wellbutrin is also an option. It is the least likely of all the SSRIs to cause emotional blunting, which you certainly don't want more of.
So you do have some choices. They all have strong potential in my opinion. In clinical studies Prozac+Zyprexa has been proving to be a powerful combination for anhedonia. The antipsychotics have strong potential, since part of schizophrenia is exactly like the blahness you described.
In your shoes I would try each of the above meds for 2 weeks each, and then choose the favorite(s) in that short time to continue for longer trials. The ones you don't like in two weeks--either due to intolerable side effects or worsening of mood--could be dumped or maybe return to some other day. I would put them on the back shelf though. Stick with the ones that you like in a short trial.
I think what makes the anhedonia situation confusing is that we often think of it as part of depression. It is part of depressin. BUT it can also be part of something else. AND it can be a separate thing altogether. So merely trying to treat depression in general can miss the whole anhedonia thing. For anhedonia, I have discovered in my own trials that meds other than antidepressants are by far the most helpful. You could try every antidepressant out there for the next 20 years and it would not surpise me if none of them helped your anhedonia.
John
poster:JohnL
thread:55049
URL: http://www.dr-bob.org/babble/20010221/msgs/55295.html