Posted by antennastoheaven on July 1, 2013, at 16:54:31
In reply to Does Apathy Ever Go Away?, posted by Trevpr on July 1, 2013, at 16:07:28
Besides drugs that can only be used once in a while (serotonergic psychedelics, ecstasy), marijiuana was probably the most effective drug for me in treating anhedonia in the short term, but the positive benefits didn't last long and after a while it just led to even more anhedonia (and anxiety). And it caused increased apathy from the start. GHB and analogs/prodrugs would probably work for anhedonia and apathy at the right dosage, but would cause dependence; I have never taken it on a regular basis. Given the complications, risks, and legal status, none of these are good options.
A combination of Wellbutrin and doing something other than sit in front of a computer/TV screen all day helps reduce apathy a bit for me. Therapy is useful in overcoming cognitive barriers to being more active. I also find Wellbutrin to increase libido. I find getting out more often also helps a little with anhedonia. Occasional Adderall helps me as well, but I've come to the conclusion that the combination of NRI in Wellbutrin and NE effect of levoamphetamine is too anxiogenic, so I am trying to get something dextroamphetamine-only.
There are some other medications that might help. Some report Abilify (an atypical antipsychotic that is a partial dopamine D2 agonist) to be activating; I found it to be slightly helpful at the low dose I took, but not for very long and not nearly as much as Wellbutrin. Tianeptine, an SSRE (SSR enhancer) is said to reduce anhedonia; it did nothing for me. There are a few other drugs I have not tried but have noted as interesting for anhedonia (not available in US or not indicated for any condition I have): agomelatine, memantine, amispulride, pregabalin. Mirtazapine is a unique serotonergic antidepressant I've read about before, not sure how helpful it would be for treating apathy or anhedonia.
Have you considered TMS (transcranial magnetic stimulation)? It might be an option, but a post on this site made me doubtful currently available technology would help with anhedonia or motivation. http://www.dr-bob.org/babble/20130501/msgs/1043160.html It's also not covered by all health plans, and seems to cost $6,000-12,000 for a recommended course of a month's worth of treatment five days a week. It was recommended to me, and I could pay for it, but I'm not confident enough it would be worth it (I'd try at-home tDCS first)
poster:antennastoheaven
thread:1046180
URL: http://www.dr-bob.org/babble/20130617/msgs/1046183.html