44 replies to this topic

[Hana]

I've been on Paxil and Lamictal for 5-6 years. I only have social anxiety (situational) and Paxil worked wonderful. I quit as I felt better and thought I'm not in need for meds. WD symptoms, one of them was very severe anxiety, made me want to go back on meds. WD was prolonged so that's why I gave up. I was put on Brintellix. Since then, I've experienced severe anhedonia (loss of pleasure, interest). quit it then went on Pristiq (2 months), but it did not resolve the problem. I should note that all of these meds worked some on SA but worsened the anhedonia. 

 

Now, I'm back on Paxil (2 days). I feel numb, unmotivated and maybe a bit depresonalized (I did not have these SEs the first time I took Paxil). Do you think if I stayed on it for a couple more months that these SEs will go away and I'll get the enjoyment back? Please tell me I will. I don't want to waste any more time. I'm very hopeless right now. I haven't experienced this s***t called anhedonia ever before.  

 

Btw, I'm not gonna try any illegal substances and antipsychotics. My twin schizophrenic sister is taking APs and they produce a lot of bad side effects. Actually,  Abilify is very expensive and where I live, there's no insurance for mental health illnesses. Amisulpride is not sold here only Sulpride. Also, there are no MAOIs here. I just better kill myself. 

 

P.S This study shows that Paroxetine reverses anhedonia. I hope it's true.

https://www.ncbi.nlm...pubmed/17462866

[PeaceAndProsperity]

No but it will do a great deal to worsen it.

[Hana]

No but it will do a great deal to worsen it.

But how do you know? Did you try it?

 

 

 

-Wait, why does this forum have a limit for posts? Do I need to pay to have unlimited posts? Hell no.

 

Anyway, Just a while ago, I suddenly felt angry for the ones who caused me to have this situation (some family members) and then cried. I'm still angry tho. That means I'm not apathetic but it could be a withdrawal symptom of Pristiq. I'm not feeling any other WD symptoms. 

Edited by Hana, 12 December 2016 - 02:05 PM.

[PeaceAndProsperity]

 

No but it will do a great deal to worsen it.

But how do you know? Did you try it?

 

 

 

-Wait, why does this forum have a limit for posts? Do I need to pay to have unlimited posts? Hell no.

 

Anyway, Just a while ago, I suddenly felt angry for the ones who caused me to have this situation (some family members) and then cried. I'm still angry tho. That means I'm not apathetic but it could be a withdrawal symptom of Pristiq. I'm not feeling any other WD symptoms. 

 

Uhhm. Because anhedonia is not caused by a serotonin deficiency and desensitizing your serotonin receptors won't help you either, I am sure. Besides, even if SSRIs desensitize receptors they still have an effect.

[registered]

what did i just read...

 

what you mean by "there's no insurance for mental health illnesses"

 

ssri doesnt help with anhedonia they can only make it worse

(and ive tried all ssri except sertraline)

[Hana]

what did i just read...

 

what you mean by "there's no insurance for mental health illnesses"

 

ssri doesnt help with anhedonia they can only make it worse

(and ive tried all ssri except sertraline)

 

don't know how to explain it. like there's no monetary assistance for mental health services. You have to pay yourself to get a medication. 

[Hana]

Today, I woke up angry and after I couldn’t stop crying thinking of my suffering with the anhedonia, which was easily preventable have I not ceased use of Paxil the first time, and not going on Brintellix.  This morning, I took Paxil CR 25mg, Lamictal 400mg, cordyceps, fish oil and a multivitamin.The crying didn’t stop until taking Pristiq. Now, my mood is pretty good. I find Pristiq does not worsen the anhedonia neither improve it.

 

 I won’t continue with the Paxil (the reason I keep going back on it is because I remember how I was on it before and be like: "this can’t be it. Maybe it’ll work this time".)  So sad. I’m a recent college graduate and still living with my parents without a fucking job. What also kills me is that I feel no chills nothing when I listen to music. It’s like listening to the damn news. Totally the opposite to how I was before. I wish there was a reset button or something to return.

 

This week, I’m gonna suggest to my pdoc adding Wellbutrin to Pristiq and Lamictal (I hope he doesn say I have depression.  I feel like throwing sth at him when he says this. Anhedonia can be triggered by many things even stress. Hell, ADs can trigger it too. The reason it is mistaken for depression is because depressed patients also have low dopamine, the neurotransmitter responsible for pleasure. I have my sympathies for them. No one deserves to live like this.)  Anyway, enough is enough. I hope the WB works. What do you all think?

 

 

oh btw, some people on another forum said that Zoloft+Wellbutrin is an effective treatment for anhedonia. Isn't Zoloft an SSRI that increases serotonin which in turn decreases dopamine?

Edited by Hana, 13 December 2016 - 03:21 PM.

[PeaceAndProsperity]

From my own personal experience: high serotonin causes hyperemotionality and depression (which you seem to describe) but a strong tendency towards total apathy, and in some people anhedonia, and G-d knows a thousand other issues. Acetylcholine is even worsen when it comes to hyperemotionality but I feel most of the same effects form both neurotransmitters. High ach is also linked to depression.

 

Since fish oil raises ach I would stop taking it if I were you. If you are a woman you should already have elevated serotonin and ach because of your hormones, these neurotransmitters probably explain some of the behavioral and personality characteristics of women

 

For depression I think you should focus on raising gaba. If you are a woman you'd probably benefit from increased catecholamines (but with all the genetic mutations Caucasian women have, you probably already have somewhat elevated catecholamines.)

 

 

[Hana]

Now that I think about it, it's actually the fucking Prozac (I took it after coming off Paxil) that caused the anhedonia. Unlike Paxil, Prozac has an effect on both serotonin and dopamine. As long as I was on it, there was no anhedonia but once I came off of it is when the anhedonia started. and I think that's because my natural dopamine (which became dependent on Prozac) can no longer produce on it's own now.  I know someone else who experienced the exact same thing. I'm thinking of going back on Prozac and see if it'll resolve the issue. One thing I don't like about is the severe loss of libido. 

[jaiho]

SSRIs dont cause anhedonia, but they can make depression worse.

Ive heard heaps of people blaming their SSRI for causing anhedonia, but anhedonia is just a more severe form of depression. It needs broad spectrum treatment.

[registered]

im not depressed but have anhedonia

you are confused

[jaiho]

you're confused about what depression is.

being depressed doesn't mean you're sad. It means you can't find pleasure in life anymore.

Edited by jaiho, 30 December 2016 - 09:56 AM.

[registered]

i know whats depression i had that diagnosis 

 

best description of depression gave andrew solomon in his ted talk

he called depression an opposite of vitality (and not the opposite of happines)

 

i also like this infographic

[jaiho]

Do you understand that anhedonia is the #1 symptom of depression?

 

[registered]

its one of necessary symptoms yes

im not depressed but have anhedonia 

Edited by registered, 30 December 2016 - 10:32 AM.

[jaiho]

You cannot have anhedonia independent of depression. You can ask a professional because what would i know

[PeaceAndProsperity]

You cannot have anhedonia independent of depression.

What about brain damage induced anhedonia? Like the people who get in a car crash and suddenly can't experience pleasure anymore?

[jaiho]

It's possible. All forms of Anhedonia are stress induced, suppression of the reward center & neurotransmission, depending on the individual. same as all forms of depression.

[hdl_1]

Based on the extracts below, it seems that SSRIs may be a cause to anhedonia (supposedly created by low-dopamine levels). The inhibition of the reuptake of serotonin suppresses the firing of the dopamine neurons.

 

Low dopamine: Tends to result in symptoms similar to Parkinson’s disease. People with abnormally low levels of dopamine may have difficulties with thinking, memory, and have slow reaction times. They may also experience anhedonia or lack of ability to feel pleasure. They may also feel similar to individuals with negative symptoms of schizophrenia in regards to having no motivation (avolition).

 

• Source: http://europepmc.org...act/MED/6324981

Selective serotonin (5-HT) reuptake inhibitors (SSRIs) are efficacious in depression because of their ability to increase 5-HT neurotransmission. However, owing to a purported inhibitory effect of 5-HT on dopamine (DA) neuronal activity in the ventral tegmental area (VTA), this increase in 5-HT transmission might result in a suppression of the firing activity of DA neurons. Since the mesolimbic DA system plays an important role in motivation and reward, a potential decrease in the firing of DA neurons may lead, in some patients, to a lack of adequate response to SSRIs.

 

https://www.ncbi.nlm...les/PMC2674976/

[jaiho]

SSRIs reduce DA firing via 5HT2C receptors. Alot of people will get anhedonia relief on SSRIs alone, because 5HT2C downregulated.

But if 5HT2C becomes too activated, it suppresses DA firing. It's like a switch for dopamine.

Thats why everyone should add a 5HT2C antagonist to their SSRI, or a TCA, or Mirtazapine.

[PeaceAndProsperity]

SSRIs reduce DA firing via 5HT2C receptors. Alot of people will get anhedonia relief on SSRIs alone, because 5HT2C downregulated.

But if 5HT2C becomes too activated, it suppresses DA firing. It's like a switch for dopamine.

Thats why everyone should add a 5HT2C antagonist to their SSRI, or a TCA, or Mirtazapine.

Off-topic I know but in case you've tried Mirtazapine, what is your experience with it?

[jaiho]

I haven't tried it for any length of time. It's pretty sedating at low doses. It needs to be combined with an SNRI and ramped up to max dose.

The dreams on it are insane.

[PeaceAndProsperity]

I haven't tried it for any length of time. It's pretty sedating at low doses. It needs to be combined with an SNRI and ramped up to max dose.

The dreams on it are insane.

How about sleep quality? It seems like it might have good enough properties for me to try it but alas it's always better for me to not bother.

[jaiho]

Why not bother? You still suffer anhedonia/no emotions?

You should treat it aggressively with broad drugs.

[PeaceAndProsperity]

Why not bother? You still suffer anhedonia/no emotions?

You should treat it aggressively with broad drugs.

The crap they use has a million offtarget effects. They could eliminate offtarget effects by changing the molecule if they wanted but they clearly don't really care, the drug developers and so on. Once you start taking the stuff you need to slowly get off it if you don't like it. There're always terrible side-effects that offset the therapeutic effects. And then there's the fact that it sometimes takes over 30 years for offtarget effects of a drug to be discovered. You could be poisoning yourself and not even know about it. Several antipsychotics like risperidone have only recently been found out to have specific offtarget effects. Obviously this goes for everything, even herbs.

 

If they can treat blunted emotions then why do they not do so in schizophrenia and schizo-spectrum disorders? I think my own case is more than just quote-on-quote depression.

[jaiho]

They do. insufficient treatment won't allow you to reach your emotions.

Any drug will numb you if its the wrong one. It needs to be compatible with your neurochemistry.

 

It's an internet myth that SSRIs are designed to numb you out. They are designed to reduce depression. When you have severe emotional blunting, some people will get their feelings back just on an SSRI. Others need more aggressive drugs.

 

Im not worried about the long term effects of meds, living with anhedonia without them is far more painful.

[Hana]

SSRIs dont cause anhedonia, but they can make depression worse.

Ive heard heaps of people blaming their SSRI for causing anhedonia, but anhedonia is just a more severe form of depression. It needs broad spectrum treatment.

 

So how do you explain the fact that my anhedonia started only after quitting SSRIs?  I did not have anhedonia before taking meds neither while on meds. If you visit surviving antidepressant.com, you'll see many suffer from anhedonia upon discontinuing ADs (including SSRIs). Do they all now suddenly got depression? I don't think so. Because guess what? Anhedonia is one of the AD withdrawal symptoms. Alcoholics, drug dependents become anhedonic once they withdraw.  http://alcoholrehab....rience-pleasure .

 

Many are in the same position I am. and I know someone who took Effexor as a pain med. She does not suffer from any mental illness. Upon discontinuing, she got anhedonia along with other horrible symptoms. Psychiatrists tell her that she now has depression, anxiety, etc. Poor her. She believes them.

 

.Anhedonia can be triggered by several factors: schizophrenia, depression, trauma, head injury, severe stress, bipolar, DRUG ABUSE  

 

 .It's a pity that I now have to search for meds for this shitty condition (plus for social anxiety which is my original diagnosis).and there aren't many options like there are for anxiety.

Antipsychotics? Hell no

TCAs? No doctor will prescribe me thes

MAOIs? Not available where I live

 

I've grown more comfortable with using SSRIs, SNRIs. I feel they both are safe and for me, only caused sexual dysfunction. I'm shocked that they actually make my anhedonia worse. My beloved Paxil is acting different now. 

 

I better just die rather than live with this misery. 

[hdl_1]

Look into natural supplements, amino acids, adaptogens, even nootropics. Here is a good post:
http://www.longecity...ting-anhedonia/

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[Mind_Paralysis]

It should be noted here - both Registered and PeaceAndProsperity both have Schizofrenia-spectrum-disorders - Registered in particular have classic, full-blown Schizophrenia, while PeaceAnd has a more atypical, mild form of the disorder.

 

What they describe as anhedonia and flat affect may not necessarily be true for others - the cognitive and emotional effects of schizoidal disorders are diverse and poorly understood.

 

 

Now then, the fact that your sister has Schizophrenia is a bit alarming though - could YOU also have some form of mild symptoms of schizoid behaviour? What you might want to try out, is a combo of a something activating and something inhibiting - have you considered to change your Lamotrigine (lamictal) to either Aripiprazol (abilify) or Brexpiprazol? Both are of the activating type of atypical antipsychotics - what is also known as SDAM's - Serotonin Dopamine Activity Modulator.

If Brexpiprazol is available in your area, that, in particular, could be useful.

 

Next, you could also consider going on a combo of Quetiapine and MODAFINIL.

Or, Quetiapine and REBOXETINE - along with staying on your Paroxetine. You may need a potent Norepinephrinergic effect to get out of this rut.

 

 

And finally, I KNOW you don't think a Dr. will prescribe you a MAOI, but it's worth a shot to at least ask, to pleed that you think you need this - Phenelzine, is a very good option, as such - highly proven in social anxiety - it has serious risk for antihypertensive crisis, if you eat Cheese and other such tyramine-rich products - but if you get rid of them, then the risk is very low.

 

Don't give up!

 

There are tons of options out there - work with us here, tells us how you feel and let us know more about you - specifically, the country you're in! If we know that, then we may be able to help you find a Dr. who has experience with severe cases and prescribing unusual medications.

With a bit of help you CAN beat this! = )

[jaiho]

Negative symptoms of schizophrenia are defeated by broad spectrum drugs, the treatment is the same.

Check this post that was from a schizo forum, two guys 100% cured of anhedonia with the SSRI + TCA combination..

 

 

 

So here is my whole story. It has lots of details, hope that doesn't bother some of you people.

First I wanted to say that i'm still feeling ****ing awesome. The for me started like 5 months ago. I was on a trip to Berlin with friends and the last day I felt like a panic attack was coming. Felt really strange, couldn't sit still, was extremely anxious. In my thoughts I saw myself being hospitalized in a mental institution. Losing all my friends, my life, everything. That night I couldn't sleep. I calmed down a bit (still having an heartbeat of 140) but couldn't sleep. They day after we went back to holland. A 12 hour traintrip. It was terrible. Anxious again etc. But I didn't had a panic attack. Back in holland things where kinda okay. There were some strange things though, I was extremely bored, and sometimes the “panic attack” feeling came back which got me really anxious.
Still slept bad, but for the rest it was doable. After 2 weeks back in holland, the hit the fan. I again felt extremely anxious, and called my mother to say that I felt like I was having a panic attack. She ordered me to get home. I jumped on my bike to go to the railway station, and on my way things were strange. Lights looked scary, I could not tell what it was but something was wrong.

When I got home my mom gave me one of her benzo's to calm down, but it didn't really work. I was able to sleep, but only for 2 hours. The days following, I was looking up on the internet for panic attacks. How to prevent them, possible medications, I was completely obsessed. There where some things that just weren't right. If I was going to have a panic attack, it would had happen the first time. But it didn't and I still felt bad. I felt like I was trapped inside of my head, very scary. There were some other things also. The last night in Berlin, when I was lying in my bed, I listened to some music to calm down. Feist, which is dreamy singer-songwriter pop. There was one song I constantly skipped, because I got scared of it. Scared by a song? ***. All of a sudden the pieces fit together. I remembered the time I had (drug induced) psychosis back in 2003. The panic attack feeling I felt that night in Berlin was the same feeling I felt when back in 2003, the anxious feeling like something was going to happen (psychosis in this case) All the time I classified that psychosis as a bad trip, but all of a sudden it maked sense. I went to lookup the symptoms of (prodromal) schizophrenia and shivers went up my spine. This was it. I'm going to develop schizophrenia. I was completely shocked. Later I began to hear voices (and visual hallucinations). They were subtle, but they where there. Then I went to see a pdoc who gave me antidepressants (SSRI) because he taught my negative symptoms were caused by depression. Did nothing, lifted my mood kinda so that's the reason I was still taking these AD's. So to sum it all up, i'm prodromal shizophrenia. Never had paranoia or delusions (maybe a bit), hear some occasional voices and visuals. I think the reason I didn't have psychosis is that I was already was on risperdal 2 mg (ADHD). And the negative symptoms ofcourse, they bother(ed) me the most.

They were:

Blunted affect/no emotion: It took like 2 weeks to develop them. All of a sudden, I couldn't feel the punch of the music anymore. I couldn't laugh at the things I found hilarious before. And when I laughed, it just felt, empty. I remember one time laughing with tears in my eyes but not feeling the emotion behind my laugh. That was strange. Stopped watching comedy movies/shows because I got depressed by the fact that I couldn't really laugh.

Anhedonia: Was bored al day. Stopped doing thing I liked before. Occasionaly (wrong spelling I know) I played on my xbox. Liked it to some extent. Somethings I visited friends, but most of the times it just sucked. Lied in my bed all day till 5 pm to eat, went to bed at 11 pm. Was happy when the day was over.

No enthousiasm: Could not be enthousiastic, spontaneous. I was great at faking it to some extent. I used to be a charismatic person.

Poverty of speech: To some extent, yes. When having a bad day I only talked if someone asked me something. I remember being hyped about testforce/sarcosine beginning to work (which was placebo) I felt so good that I went to a party where my friends where Djing. Couldn't feel the music, drank a lot of alcohol out of frustration that it was just placebo, faked the whole night with being spontaneous (to some extent), ended up in a girls bed, because I (thought) I wanted to have sex, but the anti depressants ****ed it al up. I stayed at her place, couldn't sleep because of my (schizophrenia) insomnia. Went to my parents house in the afternoon and crashed HARD. Didn't talk the whole day.

Poor hygiene: Stopped putting stuff in my hair, sometimes I didn't shower for like 3 days, same goes for brushing my teeth. (when I didn't have to leave the house)

Cognitives: Yep, to some extent. Had to read very slowly if I wanted to remember what I've read. One time it took me like 15 seconds to give answer to the question what 12 minus 7 was. Crazy ! That shocked me.

And the rest is history. I've tried some things. Sarcosine. Glycine. Panax Ginseng. None of them helped. I saw the NRI/SSRI topic very early since I was filtering for the negative symptoms tags. I was impressed by the topic, but wanted to save the heavy things (drugs) for later, first the supplements. I was on nortril (nortriplyne) for 6 days when I started to feel kinda strange, like psychosis was going to happen. I was like “**** it, i'm going do this even if psychosis occurs, since it helped CarlRose tremendously”. The strange feeling faded away. Last Thursday (11th day) I felt something better, it was subtle. The day after (MY 27TH BIRTHDAY!!) I was going to my room in the other city I lived in (130 km away from my parents) to have my birthday party with my roomies and best mates. When I was waited on the train, I mentioned something strange. It felt like I felth the music again. It worked for some tracks and for others it didn't so I gave no attention to it, prob' placebo. When arrived at my house I had the (first) great evening/night since 5 months. I laughed like I never laughed before, and the feeling with the laughing was back. Party stopped at 4 am, i stayed awake for 4 more hours, just to listen to music, with earplugs in. I listened 1 hour to the SAME SONG. Just because I was so hyped up that my negs were gone, I could FEEL the music again, music is the number 1 thing in my life since like I was 6.

I went to bed kinda depressed. What if this feeling is gone tomorrow? Stood up, and the feeling was still there. The anxious feeling kinda stayed for 2 days but now i'm positive. I feel ****ing awesome. My negs are all gone. All of them. Nothing left. Strangely all of my cognitives are gone also! (but they were not that severe as my negs).

I just want to make one thing clear. I'm not bragging about me feeling great just because I feel great. I'm bragging because I wanted to give some of you people hope. Negs are terrible. I experienced it myself. But i'm the living proof that things CAN change. And CarlRose is also, since 3 of his negs (anhedonia, blunted affect and alogia) were completely gone also. That's more than the 30% some trials said. He said “I feel human again”. That's what we all want right? And it can happen to all of us. Just try the NRI/SSRI combo. Start with a SSRI (fluvoxamine (wrong spelled) gives the best results, but I used cipramil/citalopram, 40 mg) for like a month, then start with 50 mg nortrilen/nortriptylen. It took 1,5 week for me to work, it took CarlRose 1 month so don't be anxious when it doesn't work after a week. It you don't feel anything after 2 weeks, go to 100 mg nortrilen. It will help you some kinda way anyway, maybe 100% like me. And if it doesn't work, don't lose hope. If it didn't work for me I would try minocycline. It's been said to have some side affect, but i'm like “**** that”. If your going to take minocycline, talk to your pdoc first, ask what he is thinking. Print some trials of the minocycline and take them with you. Don't lose hope people. I think rg1678 has alot of potential also. I truly believe schizophrenia (or at least the negs) can be cured within a couple of years. DON'T LOSE HOPE!!!! I had lots of suicidal thoughts the last months but i've never considered really doing it. Because I had hope and I couldn't do it to my family who I love.

Nickthird: I'm sorry to hear that the nri/ssri didn't work for you. Maybe a stupid question, but did you ever tried wellbutrin? When I was in my 5th week of cipramil my pdoc said he had something that works for apathy wich he wanted he save for the last. First 2 days I didn't feel anything, but then I couldn't sleep for 3 days (an that wasn't because it was a stimulant, it had something to do with the schizophrenia insomnia, i'm sure). I also felt kinda strange, so I stopped at day 5. I was in the beginning very enthousiastic because i've read a story on the international depression forum from a guy who had like abulic depression. First he had severe clinic/chronic depression but just like you, it snapped all of sudden and all of his emotions were gone. Since you're not schizophrenic
it would be safe for you to try (since it raises dopamine levels) and worth a shot. But I wouldn't be surprised if you allready tried it. 

As for me, I will stay active on this forum. I want to see your guys progress. I can sincerely say that I feel for you people, since i've experienced the same. Things will work out fine eventually. And I hope that mobc1990 have results with this NRI/SSRI thing. Don't give up hope son, never!

I wish you all the ****ing best, may God be with you. (says an atheist, hehe)