![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Mishal on December 9, 2007, at 2:03:32
A mix of Provigil and Trivastal does wonders for me.(For people in U.S getting Trivastal can be a problem. Mirapex would be an option, since both acts on same receptors.
But Mirapex is not a perfect substitute for Trivastal, since piribedil has actions on noradrenergic receptors too. So, adding a tiny dose of Strattera should be considered. A small dose of 10mg should do the trick.
It is not the end. For OCD sufferers, a dopaminergic is not a viable option, since it can aggravate compulsions in both short and long run.
So, consider taking an SSRI. If you are on any, keep on it. If you are not, and have compulsive tendencies add a small dose of either Prozac or Zoloft. 10mg of Prozac or 25mg of Zoloft would be enough.
For sleeping, a small dose of Neurontin.
My cocktail:
1. Provigil 300mg.
2. Prozac 20mg
3. Trivastal Retard 100mg.
4. Neurontin 600mg.All in the morning except Neurontin. The dose is divided as 300mg bid.
And this has been superb for me so far. I had lost all hopes for overcoming my most stubborn anhedonia. Now, I am adamant; anhedonia is treatable. Be patient enough to get adjusted to your drug. Meanwhile don't ever touch a benzo. They will spoil the fun altogether.
Cheers.
Posted by Phillipa on December 9, 2007, at 12:21:36
In reply to Miraculous Anti-anhedonic Cocktail:, posted by Mishal on December 9, 2007, at 2:03:32
Mishal what do you mean by don't touch a benzo as many babblers are on them are you from the UK? Phillipa know they are antibenzo.
Posted by your#1fan on December 9, 2007, at 13:40:10
In reply to Miraculous Anti-anhedonic Cocktail:, posted by Mishal on December 9, 2007, at 2:03:32
oh man i wish my doctor was going to agree with dopamine agonists. He doesnt, he thinks its too complicated to treat ADHD....
I could be feeling alot better.
Right now im taking Prozac and Duplin (anti-depressant enhancer) its working ok, but its not the best in the world. Anxiety is related to it....so if you know what i mean.
Wish me luck Michal
your#1fan
Posted by bulldog2 on December 9, 2007, at 15:29:10
In reply to Miraculous Anti-anhedonic Cocktail:, posted by Mishal on December 9, 2007, at 2:03:32
>
> A mix of Provigil and Trivastal does wonders for me.
>
> (For people in U.S getting Trivastal can be a problem. Mirapex would be an option, since both acts on same receptors.
>
> But Mirapex is not a perfect substitute for Trivastal, since piribedil has actions on noradrenergic receptors too. So, adding a tiny dose of Strattera should be considered. A small dose of 10mg should do the trick.
>
> It is not the end. For OCD sufferers, a dopaminergic is not a viable option, since it can aggravate compulsions in both short and long run.
>
> So, consider taking an SSRI. If you are on any, keep on it. If you are not, and have compulsive tendencies add a small dose of either Prozac or Zoloft. 10mg of Prozac or 25mg of Zoloft would be enough.
>
> For sleeping, a small dose of Neurontin.
>
> My cocktail:
>
> 1. Provigil 300mg.
> 2. Prozac 20mg
> 3. Trivastal Retard 100mg.
> 4. Neurontin 600mg.
>
> All in the morning except Neurontin. The dose is divided as 300mg bid.
>
> And this has been superb for me so far. I had lost all hopes for overcoming my most stubborn anhedonia. Now, I am adamant; anhedonia is treatable. Be patient enough to get adjusted to your drug. Meanwhile don't ever touch a benzo. They will spoil the fun altogether.
>
> Cheers.
>You have upped the dose of trivastal from 50 mg to 100 mg? what difference have you noticed?
Posted by sonic_gb on December 9, 2007, at 18:05:32
In reply to Miraculous Anti-anhedonic Cocktail:, posted by Mishal on December 9, 2007, at 2:03:32
Mishal,
Very interesting cocktail and I'm glad it works so well for you. Excuse my ignorance on dopaminergics, but how would the effects of piribedel differ from an AD like bupropion which is also supposed to have dopaminergic effects?
Also, I totally agree with you on the benzos. I've made some big mistakes with these that are proving challenging to fix. But I found the same issues with gabapentin, although at a much larger dose. I found it and pregabalin to be dulling, and capable of causing dependance equal to that of the benzos.
Anyways, interesting post, please keep us updated on your progress.
Sonic
>
> A mix of Provigil and Trivastal does wonders for me.
>
> (For people in U.S getting Trivastal can be a problem. Mirapex would be an option, since both acts on same receptors.
>
> But Mirapex is not a perfect substitute for Trivastal, since piribedil has actions on noradrenergic receptors too. So, adding a tiny dose of Strattera should be considered. A small dose of 10mg should do the trick.
>
> It is not the end. For OCD sufferers, a dopaminergic is not a viable option, since it can aggravate compulsions in both short and long run.
>
> So, consider taking an SSRI. If you are on any, keep on it. If you are not, and have compulsive tendencies add a small dose of either Prozac or Zoloft. 10mg of Prozac or 25mg of Zoloft would be enough.
>
> For sleeping, a small dose of Neurontin.
>
> My cocktail:
>
> 1. Provigil 300mg.
> 2. Prozac 20mg
> 3. Trivastal Retard 100mg.
> 4. Neurontin 600mg.
>
> All in the morning except Neurontin. The dose is divided as 300mg bid.
>
> And this has been superb for me so far. I had lost all hopes for overcoming my most stubborn anhedonia. Now, I am adamant; anhedonia is treatable. Be patient enough to get adjusted to your drug. Meanwhile don't ever touch a benzo. They will spoil the fun altogether.
>
> Cheers.
>
Posted by tecknohed on December 9, 2007, at 20:02:00
In reply to Miraculous Anti-anhedonic Cocktail:, posted by Mishal on December 9, 2007, at 2:03:32
>Now, I am adamant; anhedonia is treatable. Be patient enough to get adjusted to your drug. Meanwhile don't ever touch a benzo. They will spoil the fun altogether.
Firstly, congratulations on your success. Sounds like you've worked hard for it!
Just a comment on the benzos. Whilst I agree that they can aggravate anhedonia (& depression in general) there are drugs & supplements that can help solve this. A good antidepressant is obviously important, preferably one that enhance DA, like an MAOI. But I take take 3mg/day Klonopin & until recently I did indeed feel 'numb'. But what has solved the problem for me is nootropics (esp. vinpocetine). Now I have no head fog at all, and can experience plenty of feeling as required. And yes, anhedonia has always been a big symptom of my depression.
There are ways around these issues if you can find them. And I have little choice but to take my benzos as I'd never leave the house without them.
Posted by Mishal on December 9, 2007, at 23:00:59
In reply to Re: Miraculous Anti-anhedonic Cocktail:, posted by bulldog2 on December 9, 2007, at 15:29:10
> You have upped the dose of trivastal from 50 mg to 100 mg? what difference have you noticed?An increase in libido. More anti-anhedonic effect.
No side effects at all except a slightly disturbed sleep. That's no big deal since I can arrest this problem with either Ativan or Ambien, but I am very reluctant to take them. I don't think I would dose any sedative as I am sure sleeping problems would go away getting adjusted to this med. Sleeping was okay yesterday BTW.
cheers.
Posted by Mishal on December 9, 2007, at 23:15:50
In reply to Re: Miraculous Anti-anhedonic Cocktail: » Mishal, posted by sonic_gb on December 9, 2007, at 18:05:32
> how would the effects of piribedel differ from an AD like bupropion which is also supposed to have dopaminergic effects?
I have taken Wellbutrin too. I would say there is a huge difference. Bupropion did nothing for me, but aggravated my depressive symptoms after a week or so. Piribedil on the other hand started to show its positive effects right away, though it took a week or so to reap the full benefits of it.
> Also, I totally agree with you on the benzos. I've made some big mistakes with these that are proving challenging to fix. But I found the same issues with gabapentin, although at a much larger dose. I found it and pregabalin to be dulling, and capable of causing dependance equal to that of the benzos.I am no huge fan of benzos, but I never found it hard to withdraw any benzo. Have been on Valium, Librium, Clobazam, Klonopin, Xanax, Ativan. They are the most friendly meds for me. I can take and give them up without any prior notice. Anyway, this might not be true with many people here.
The reason I hate benzos now is they add to already existing anhedonia. That's all.
Cheers
Posted by Mishal on December 9, 2007, at 23:20:19
In reply to Re: Miraculous Anti-anhedonic Cocktail: » Mishal, posted by tecknohed on December 9, 2007, at 20:02:00
> I take take 3mg/day Klonopin & until recently I did indeed feel 'numb'. But what has solved the problem for me is nootropics (esp. vinpocetine). Now I have no head fog at all, and can experience plenty of feeling as required. And yes, anhedonia has always been a big symptom of my depression.> There are ways around these issues if you can find them. And I have little choice but to take my benzos as I'd never leave the house without them.
I never write off benzos. They are extremely effective meds. Besides, I never had any withdrawal problem with them contrary to many post here.
Glad you are doing well on Klonopin. You might be lucky to have such a positive experience with Vinpocetine. I too tried a nootropic (Piracetam) while I was on benzos, but that didn't solve the problem for me. Anyway, we are all different.
Posted by bulldog2 on December 10, 2007, at 10:42:27
In reply to Re: Miraculous Anti-anhedonic Cocktail: » bulldog2, posted by Mishal on December 9, 2007, at 23:00:59
>
> > You have upped the dose of trivastal from 50 mg to 100 mg? what difference have you noticed?
>
> An increase in libido. More anti-anhedonic effect.
>
> No side effects at all except a slightly disturbed sleep. That's no big deal since I can arrest this problem with either Ativan or Ambien, but I am very reluctant to take them. I don't think I would dose any sedative as I am sure sleeping problems would go away getting adjusted to this med. Sleeping was okay yesterday BTW.
>
> cheers.
>
>
>Did you find an increase in anxiety when you raised the dose?
Posted by conundrum on March 28, 2010, at 20:44:47
In reply to Miraculous Anti-anhedonic Cocktail:, posted by Mishal on December 9, 2007, at 2:03:32
Bumping this thread since anhedonia has been a recent topic. Maybe this will give some hope and ideas to readers suffering with this problem.
Posted by economist on March 30, 2010, at 23:54:58
In reply to Re: Miraculous Anti-anhedonic Cocktail:, posted by conundrum on March 28, 2010, at 20:44:47
I've taken a note of this, however I'm in no rush to order the meds the original poster mentioned, as I'm pretty sure they will not work for my treatment-resistant anhedonia.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.