Hey, had psych intake today and just wanted feedback. Talked about my recent episodes, past depression and MH issues/addictions etc..keep thinking back on some things he asked and wish I’d answered differently (like he asked me to describe myself and I gave a few good points then went off track and never got to the bad ones ) now my mind has decided he’ll diagnose me with NPD 🙈
Here’s my take away from the appointment: *he said I’ve definitely had hypomanic episodes and meet the criteria *as it’s only happened since starting duloxetine, he’s tapering me off that and titrating citalopram at the same time *he said I have to be treated because there’s a risk I could have a full blown mania otherwise and is putting me on a mood stabiliser (lamictal) once I’m stable on SSRI.
At one point he muttered something about I don’t think you’re bipolar…I’m so confused. Back in a month. Any feedback welcome as I’m brand new to this and don’t know what’s going on really!

Just started it a week ago, tossed lamictal (that drug nearly ruined me) and decided to bite the bullet and just do an SSRI because I am SICK of suffering. I just want my life back and stability.
Comorbidities: Trauma, OCD, C-PTSD anxiety/depression.

I suffer from depression and social anxiety since I can think. Diagnosed since I was 15. I already tried many different meds as well as therapies but still nothing was able to get my symptoms into control or make me functional.
Social anxiety is the biggest issue as it‘s additionally the main cause of my depression.
Just thinking about the next days or years makes me depressed because of the thoughts how to get through that social event, that chat with a friend, that meeting, that career path, that romantic relationship and so on because EVERYTHING has socializing in it.
Socializing affects every aspect of life. My brain chemistry hinders me in every aspect of socializing making me very restricted. Being aware of these restrictions in every aspect of life (career, love life, friendships, sports, hobbies, passions etc.) makes me very depressed. Depression again feeds the social anxiety by zero energy, motivation, drive, anhedonia and so on.
What meds helped you the most with being better in socializing and also having more fun and drive to do so?
Please be aware that I already tried following ones: - 2 analytical depth psychological therapies - 1 cognitive behavioral therapy - SSRI/SNRIs: Escitalopram, Venlafaxine, Sertraline, Paroxetine, Duloxetine - DNRI: Bupropion - Neuroleptics: Promethazine, Quetiapine - Tricyclic: Amitriptyline - MAOI: Moclobemide - Benzos: Diazepam, Lorazepam - Gabapentinoids: Gabapentin, Pregabalin - Others: Mirtazapine, Opipramol, Hydroxyzine
All were without any success in symptoms. Except for Pregabalin. But it‘s still not helping 100% or making life bearable - aside I don‘t think you can use that daily anyways.
Would love to read about your experiences and success with meds for sociability when suffering from depression and social anxiety or any other conditions.

I suffer from depression and social anxiety since I can think. Diagnosed since I was 15. I already tried many different meds as well as therapies but still nothing was able to get my symptoms into control or make me functional.
Social anxiety is the biggest issue as it‘s additionally the main cause of my depression.
Just thinking about the next days or years makes me depressed because of the thoughts how to get through that social event, that chat with a friend, that meeting, that career path, that romantic relationship and so on because EVERYTHING has socializing in it.
Socializing affects every aspect of life. My brain chemistry hinders me in every aspect of socializing making me very restricted. Being aware of these restrictions in every aspect of life (career, love life, friendships, sports, hobbies, passions etc.) makes me very depressed. Depression again feeds the social anxiety by zero energy, motivation, drive, anhedonia and so on.
What meds helped you the most with being better in socializing and also having more fun and drive to do so?
Please be aware that I already tried following ones: - 2 analytical depth psychological therapies - 1 cognitive behavioral therapy - SSRI/SNRIs: Escitalopram, Venlafaxine, Sertraline, Paroxetine, Duloxetine - DNRI: Bupropion - Neuroleptics: Promethazine, Quetiapine - Tricyclic: Amitriptyline - MAOI: Moclobemide - Benzos: Diazepam, Lorazepam - Gabapentinoids: Gabapentin, Pregabalin - Others: Mirtazapine, Opipramol, Hydroxyzine
All were without any success in symptoms. Except for Pregabalin. But it‘s still not helping 100% or making life bearable - aside I don‘t think you can use that daily anyways.
Would love to read about your experiences and success with meds for sociability when suffering from depression and social anxiety or any other conditions.

I suffer from depression and social anxiety since I can think. Diagnosed since I was 15. I already tried many different meds as well as therapies but still nothing was able to get my symptoms into control or make me functional.
Social anxiety is the biggest issue as it‘s additionally the main cause of my depression.
Just thinking about the next days or years makes me depressed because of the thoughts how to get through that social event, that chat with a friend, that meeting, that career path, that romantic relationship and so on because EVERYTHING has socializing in it.
Socializing affects every aspect of life. My brain chemistry hinders me in every aspect of socializing making me very restricted. Being aware of these restrictions in every aspect of life (career, love life, friendships, sports, hobbies, passions etc.) makes me very depressed. Depression again feeds the social anxiety by zero energy, motivation, drive, anhedonia and so on.
What meds helped you the most with being better in socializing and also having more fun and drive to do so?
Please be aware that I already tried following ones: - 2 analytical depth psychological therapies - 1 cognitive behavioral therapy - SSRI/SNRIs: Escitalopram, Venlafaxine, Sertraline, Paroxetine, Duloxetine - DNRI: Bupropion - Neuroleptics: Promethazine, Quetiapine - Tricyclic: Amitriptyline - MAOI: Moclobemide - Benzos: Diazepam, Lorazepam - Gabapentinoids: Gabapentin, Pregabalin - Others: Mirtazapine, Opipramol, Hydroxyzine
All were without any success in symptoms. Except for Pregabalin. But it‘s still not helping 100% or making life bearable - aside I don‘t think you can use that daily anyways.
Would love to read about your experiences and success with meds for sociability when suffering from depression and social anxiety or any other conditions.

I suffer from depression and social anxiety since I can think. Diagnosed since I was 15. I already tried many different meds as well as therapies but still nothing was able to get my symptoms into control or make me functional.
Social anxiety is the biggest issue as it‘s additionally the main cause of my depression.
Just thinking about the next days or years makes me depressed because of the thoughts how to get through that social event, that chat with a friend, that meeting, that career path, that romantic relationship and so on because EVERYTHING has socializing in it.
Socializing affects every aspect of life. My brain chemistry hinders me in every aspect of socializing making me very restricted. Being aware of these restrictions in every aspect of life (career, love life, friendships, sports, hobbies, passions etc.) makes me very depressed. Depression again feeds the social anxiety by zero energy, motivation, drive, anhedonia and so on.
What meds helped you the most with being better in socializing and also having more fun and drive to do so?
Please be aware that I already tried following ones: - 2 analytical depth psychological therapies - 1 cognitive behavioral therapy - SSRI/SNRIs: Escitalopram, Venlafaxine, Sertraline, Paroxetine, Duloxetine - DNRI: Bupropion - Neuroleptics: Promethazine, Quetiapine - Tricyclic: Amitriptyline - MAOI: Moclobemide - Benzos: Diazepam, Lorazepam - Gabapentinoids: Gabapentin, Pregabalin - Others: Mirtazapine, Opipramol, Hydroxyzine
All were without any success in symptoms. Except for Pregabalin. But it‘s still not helping 100% or making life bearable - aside I don‘t think you can use that daily anyways.
Would love to read about your experiences and success with meds for sociability when suffering from depression and social anxiety or any other conditions.

I suffer from depression and social anxiety since I can think. Diagnosed since I was 15. I already tried many different meds as well as therapies but still nothing was able to get my symptoms into control or make me functional.
Social anxiety is the biggest issue as it‘s additionally the main cause of my depression.
Just thinking about the next days or years makes me depressed because of the thoughts how to get through that social event, that chat with a friend, that meeting, that career path, that romantic relationship and so on because EVERYTHING has socializing in it.
Socializing affects every aspect of life. My brain chemistry hinders me in every aspect of socializing making me very restricted. Being aware of these restrictions in every aspect of life (career, love life, friendships, sports, hobbies, passions etc.) makes me very depressed. Depression again feeds the social anxiety by zero energy, motivation, drive, anhedonia and so on.
What meds helped you the most with being better in socializing and also having more fun and drive to do so?
Please be aware that I already tried following ones: - 2 analytical depth psychological therapies - 1 cognitive behavioral therapy - SSRI/SNRIs: Escitalopram, Venlafaxine, Sertraline, Paroxetine, Duloxetine - DNRI: Bupropion - Neuroleptics: Promethazine, Quetiapine - Tricyclic: Amitriptyline - MAOI: Moclobemide - Benzos: Diazepam, Lorazepam - Gabapentinoids: Gabapentin, Pregabalin - Others: Mirtazapine, Opipramol, Hydroxyzine
All were without any success in symptoms. Except for Pregabalin. But it‘s still not helping 100% or making life bearable - aside I don‘t think you can use that daily anyways.
Would love to read about your experiences and success with meds for sociability when suffering from depression and social anxiety or any other conditions.

I suffer from depression and social anxiety since I can think. Diagnosed since I was 15. I already tried many different meds as well as therapies but still nothing was able to get my symptoms into control or make me functional.
Social anxiety is the biggest issue as it‘s additionally the main cause of my depression.
Just thinking about the next days or years makes me depressed because of the thoughts how to get through that social event, that chat with a friend, that meeting, that career path, that romantic relationship and so on because EVERYTHING has socializing in it.
Socializing affects every aspect of life. My brain chemistry hinders me in every aspect of socializing making me very restricted. Being aware of these restrictions in every aspect of life (career, love life, friendships, sports, hobbies, passions etc.) makes me very depressed. Depression again feeds the social anxiety by zero energy, motivation, drive, anhedonia and so on.
What meds helped you the most with being better in socializing and also having more fun and drive to do so?
Please be aware that I already tried following ones: - 2 analytical depth psychological therapies - 1 cognitive behavioral therapy - SSRI/SNRIs: Escitalopram, Venlafaxine, Sertraline, Paroxetine, Duloxetine - DNRI: Bupropion - Neuroleptics: Promethazine, Quetiapine - Tricyclic: Amitriptyline - MAOI: Moclobemide - Benzos: Diazepam, Lorazepam - Gabapentinoids: Gabapentin, Pregabalin - Others: Mirtazapine, Opipramol, Hydroxyzine
All were without any success in symptoms. Except for Pregabalin. But it‘s still not helping 100% or making life bearable - aside I don‘t think you can use that daily anyways.
Would love to read about your experiences and success with meds for sociability when suffering from depression and social anxiety or any other conditions.

So I have a history of severe treatment resistant major depressive disorder. I had had many diagnoses over the past 20 years, about 5 of which was Bipolar which was downgraded to "mood instability". The main reason bipolar doesn't really apply is no mania. I have episodes of severe depression and suicidal thoughts, which normalize to a lower-level depression(not mania, more like apathy instead of existential dread).
I've had horrible experiences with SSRIs, SNRIs, Geodon, Lamictal and others(tegretol and lithium were mostly well tolerated, but lithium had a small improvement and tegretol had uncontrollable outbursts where I hit someone without thinking about it)
So the options were Spravato(have to take an SSRI or SNRI with it for insurance to approve, so that was nixed), Latuda or Vraylar. Vraylar was expensive and not very helpful.
I am now on Latuda and have noticed a slight improvement without any side effects. Everything I read online has Latuda for MDD associated with bipolar, but is it common to be prescribed Latuda without Bipolar? It seems to help, so I shouldn't concern myself with it, but was still curious.

I will start by saying...I know the mainstream view is that Bipolar disorder is supposed to be a genetic disease. I am only speaking for myself here, and I know there is no family history, and I responded well to SSRIs. Took Lexapro at highest dose, 20mg, for 6 months, and overall (building dose up over time) for 12-13 months before the hypomania (highly stressful month leading up to that with being lied to by an intimate partner) occurred. I also am aware that a lot of "trauma release" shaking sensations happened in various parts of my body during this hypomania so its unclear to me whether when "traumatic past" is resolved (i.e. "no more trauma being held in the body") if I will still be at risk for hypomanic episodes.
For me, the therapist/psychiatrist I see has not insisted I take any BP medications (I'm fairly "low" on the bipolar scale) but has said I should get off the SSRI I was on before he changed his dx. I went with that advice in spite of the uncertainty I have about the dx.
I am trying Lamictal now, and TBH will probably try these various drugs until I find something that reduces/minimizes depression, or if I find an option that does. (If I find that Lamictal or Lithium or an antipsychotic is tolerable and helpful, I might more strongly accept this dx. I think I understand that if a mood stabilizer helps, then supposedly that is validation that the diagnosis was correct...)
All this said...beyond the choice in possible drug, I don't think my "main" problem(s) is about Bipolar. (I see Complex PTSD as one of the "main" problem(s) for example.)
In any case...I ask this question as I was trying to see a therapist who does a kind of therapy I like that I think would be helpful to me. Then, the BP diagnosis being put on her paperwork, even with the caveat of not being sure how strongly I resonate with it...she ended up saying she doesn't have the skills to give me what I need. Of course she can't prescribe medication but she seemed to also imply that she thinks I need support around the clock and in-person sessions rather than remote (nevertheless that my current therapist/psychiatrist does not provide around the clock support and I do remote sessions with him, and he has never had these concerns that the new therapist I was looking into had).
I'm considering whether moving forward I should only really talk with psychiatrists about the BP dx rather than therapists. I would rather pick the modality I use than have to explain to therapists "I don't really have mania, I had one hypomania, I'm not coming to you to talk about Bipolar since you can't prescribe medication anyway." On the flip side...part of me says "I probably saved myself a headache if this person is this afraid without even talking to me about this topic."
How much do you think this matters? Do a lot of therapists just not take Bipolar diagnosed patients as a blanket thing? It kind of irritated me to see her email about this in the morning and now I'm just like "Oh yeah I guess this is what Borderline PD-er's had to deal with years ago." I'm hoping this just a one-off weird therapist though...thoughts?

People say that if you use them too close together, you can get serotonin syndrome. This is a complete exaggeration, in fact, bufo secretion and B. caapi can be used together within a certain dosage range.
First of all, let me address the claim that the two can't even be used in close proximity. This is just based on information related to synthetic reuptake-type and MAOI type antidepressants, which have ridiculously long half-lives and leave a lingering effect on the body for ridiculously long periods of time.
Five half-lives equates to about five days for most SSRIs except fluoxetine, which can still be significantly active five or more weeks after cessation.[1]
 
Within 30–90 min, platelet MAO-B activity is inhibited by 90% in PD patients, indicative of rapid cellular uptake; recovery of activity requires as long as 40 days [14,64].[2]
Most substances simply don't have this property. MDMA, for example, is likely to cause serotonin syndrome when combined with MAOIs, as it is a releaser of serotonin, the worst MAOI-contraindicated thing. I asked in MAOIs if someone who was taking a reversible MAOI could stop it for a single day in order to take MDMA (i.e. contrary to irreversible MAOIs, which can linger for up to 40 days, as seen in the above quote). Someone replied that he once took his moclobemide in the morning and MDMA in the evening, and he had been taking moclobemide for an entire year.[3] By the way, reversible MAOIs, like the harmalas and the one mentioned have their effect reversed if tyramine is ingested and presumably do not have a lingering effect, whereas the irreversible MAOIs are strictly contraindicated with tyramine and do linger.
Bufo secretion contains almost nothing but 5-MeO-DMT[4] and the effect never lasts more than an hour.
And now to address the subject of using 5-MeO-DMT as a substitute for DMT in ayahuasca.
5-MeO-DMT is one of the most unique psychedelics in that it is primarily active at the 5-HT1A receptor (as opposed to the 5-HT2A receptor). Many people describe the effect as dissociative and minimally visual. 5-MeO-DMT is also unique in that it is a serotonin reuptake inhibitor, furthermore, it may partially convert to 5-HO-DMT (bufotenine) in the body, which is a serotonin releaser.[5][6] As you may be aware, it is always stated that SSRI antidepressants are very dangerous to combine with MAOIs. However, its serotonin reuptake activity is “weak”, almost identical to methamphetamine’s (serotonin reuptake inhibition is only a minor property of methamphetamine).[5] And the crazy thing is that amphetamines are actually safe to use with MAOIs within a certain dosage range,[7] and I've come across 5 reports of people using methamphetamine with MAOIs (and some of them used it with irreversible MAOIs!).[8] So, people have used meth, with its 5-HT reuptake inhibition that is comparable to 5-MeO-DMT’s, as well as its primary effect of dopamine release, on irreversible MAOIs...
Furthermore, combining serotonin reuptake inhibitors with B. caapi isn't that unfamiliar to ayahuasca users: B. caapi, itself, contains a weak SRI: tetrahydroharmine![9] One Shipibo tribe was even observed to boost THH levels in their brews by adding an herb that contains only THH![10]
 
“For his study, Markus mixed a representative of the β-Carbolins (harmin, harmalin, or 6-MeO-harmalan) with a tryptamine (5-MeO-DMT). He found a domain of optimal mixtures in which marked psychoactive productivity was associated with hallucinatory effects. Within certain specific ranges of dosage, the mixture was well-tolerated and there were no serious side-effects.”
A report on the symposium “On the Current State of Research in the Area of Psychoactive Substances”. Hanscarl Leuner & Michael Schlichting. In: C. Rätsch (ed.). The Gateway to Inner Space: A Festschrift in Honor of Albert Hofmann. Bridport, England: Prism Press (page 237) emphasis added
“I have heard very mixed reports from trials employing P. harmala and the second of the biotic tryptamines, 5-methoxy-N,N-dimethyl-tryptamine, or 5-MeO-DMT. Apparently, modest amounts of both components gives a modest experience, but I have had two reports of truly toxic crises with larger quantities.”
Alexander Shulgin. TiHKAL (part 1). Shulgin A, Shulgin A. 1997. 16. Hoasca vs. Ayahuasca, p. 302
Here are comments from several people who have tried the 5-MeO-DMT combined with B. caapi or P. harmala. One person said that it's his favorite way of doing 5-MeO-DMT, another said that it gave he and his friends “the best experiences” ever:
https://www.reddit.com/DMT/comments/15zy7sq/comment/l4zndhl/
 
[1] Switching and stopping antidepressants. Keks N, Hope J, Keogh S. Aust Prescr. 2016 Jun;39(3):76-83. doi: 10.18773/austprescr.2016.039. Epub 2016 Jun 1. PMID: 27346915; PMCID: PMC4919171 (Switching strategies)
[2] MAO-B inhibitors: multiple roles in the therapy of neurodegenerative disorders. Foley P, Gerlach M, Youdim MB, Riederer P. Parkinsonism Related Disorders, 6(1):25-47
[3] https://www.reddit.com/MAOIs/comments/1axoq9w/do_reversibles_require_a_washout/krpm5j
[4] https://www.reddit.com/5MeODMT/comments/1b50e86/for_the_record_b_alvarius_secretions_contain/
[5] Studies using rat brain synaptosomes [63] show that 5-MeO-DMT also inhibits 5-HT re-uptake with an IC50 value comparable to other psychostimulants such as cocaine and methamphetamine, whereas it has little effect on dopamine re-uptake or the release of monoamine neurotransmitters.
[63] Nagai F, Nonaka R, Kamimura K. Satoh Hisashi. The effects of non-medically used psychoactive drugs on monoamine neurotransmission in rat brain. Eur J Pharmacol. 2007;559:132–137. [PubMed] [Google Scholar]
[The IC50 value given for 5-MeO-DMT is 4.1±0.91×10 ^–6 . The IC50 value given for cocaine is 2.1±0.52×10 ⁻ 6 . The IC50 value given for methamphetamine is 4.0±0.97×10 ⁻⁶ .
These values are from table 2 on page 134.]
Psychedelic 5-methoxy-N,N-dimethyltryptamine: metabolism, pharmacokinetics, drug interactions, and pharmacological actions. Shen HW, Jiang XL, Winter JC, Yu AM. Curr Drug Metab. 2010 Oct;11(8):659-66. doi: 10.2174/138920010794233495 (PHARMACO/TOXICOLOGICAL EFFECTS AND DRUG ACTIONS OF 5-MEO-DMT)
[6] The 5-methoxylated version of DMT (5-MeO-DMT, 7) was a weak 5-HT uptake inhibitor (IC50 value=2,184 nM). This was somewhat surprising since the 5-hydroxy analog, 16, was a potent SERT-mediated releaser with an EC50 value of 30.5 nM. 5-OH-DMT (16), also known as bufotenin,
Interaction of psychoactive tryptamines with biogenic amine transporters and serotonin receptor subtypes. Blough BE, Landavazo A, Decker AM, Partilla JS, Baumann MH, Rothman RB. Psychopharmacology (Berl). 2014 Oct;231(21):4135-44. doi: 10.1007/s00213-014-3557-7 (Discussion)
[7] There is now a lot of accumulated experience of the concurrent administration of MAOIs and amphetamine for therapeutic purposes in depression. It is safe when done carefully. Early concerns about frequent hypertension have not materialized and recent clinical reviews indicate judicious use is safe [354, 355].
Monoamine oxidase inhibitors: A review concerning dietary tyramine and drug interactions. Ken Gillman, MD. PsychoTropical Commentaries (2020) 1:1–71 (Releasers (indirectly acting sympatho-mimetics ISAs)) https://psychotropical.com/wp-content/uploads/2020/03/9.2-MAOI_diet_drug_interactions_2020_current_v.pdf
[8] https://www.reddit.com/MAOIs/comments/1cxinm9/curious_to_hear_from_people_who_have_used_meth/
[9] While not a strong inhibitor of MAO, THH possibly contributes neuroactivity by weakly inhibiting the uptake of serotonin (5-hydroxytryptamine, 5-HT) at presynaptic sites, like other 1-methyl-tetrahydro-β-carbolines (Airaksinen et al., 1980). Subse- quently, concentrations of 5-HT increase in the body when both its metabolism by MAOA and presynaptic uptake are simultaneously blocked by these harmala alkaloids.
Pharmacokinetics of Hoasca alkaloids in healthy humans. J.C Callaway, D.J McKenna, C.S Grob, G.S Brito, L.P Raymon, R.E Poland, E.N Andrade, E.O Andrade, D.C Mash. Jun 1999. Journal of Ethnopharmacology, 65(3), 243–256. DOI: 10.1016/S0378-8741(98)00168-8 (1. Introduction)
[10] https://www.reddit.com/anahuasca/comments/17f16ag/calliandra_pentandra_another_source_of/

Hello! This is my first time posting and I am in need of encouragement and help.
I've been diagnosed with VM and PPPD. This started after a bad ocular migraine, woke up spinning and then progressed into my normal migraine. I thought I was fine after but things went severely downhill from there with severe ocular migraines, head pain, dizziness, ear pain/pressure, couldn't stand the slightest of noise, startle reflex, light sensitivity, massive pressure nausea etc
I have been left with a bobbing up and down type of feeling when still as well as the floor wobbles when I stand still, imbalance etc. really bad neck pain.
I have been prescribed amitryptyline - took 10 mg for a month and the head movement dizziness improved within 2 days. But the floor wobbly seemed almost worse! Dr just increased to 20 mg (3 days into higher dose, 5 weeks total on it) but I am still getting the bobbing and swaying and floor moving (almost like a sudden earthquake). Is this pppd? And will amitryptyline not help that type of dizziness? Do I need an SSRI? Dr also prescribed lamictal to try as well due to the ocular and aura migraines. Kind of scared to take that one.
I am grateful for my improvements but am feeling so down about the remaining symptoms. I am functioning at about a 10% level in my house, brain fog is so bad and chores are just so difficult. I am really really depressed as I've Lost all confidence, scared to go anywhere. Want to cry all the time. I do get chronic migraines daily which I'm not sure ami is helping much with but my head overall does feel better with the dizziness (I was feeling waves of bad dizziness in my brain and quick spins just when walking) - I am able to talk to family now and get out of bed, eating a bit more.
For those of you who have had bobbing dizziness and floor movement sensation, what medication or things helped you? I have lost 15 lbs and it's been really hard to eat but I am following the diet as much as I can.
Please only positive encouragement as I have severe anxiety and panic with this as well. Thank you so very much!

Hi all first off I'm a 20-year sufferer of severe painful treatment resistant depression for 3 years ago something amazing happened I stumbled across the combination of parnate and Adderall immediately I noticed a synonym between the two and I got instant relief and had to look back to this coming day upon Awakening I take 40 mg of parnate then IMMEDIATLY after the Adderall and I have effects of in about 5 minutes first euphoria but totally normal euphoria not speed like just total normal or yes very important euphoria second and extreme feeling of serenity and calm fill me up no speeding or hyperness at all from the Adderall is noticeable in fact the Adderall might as well not be non-existent and it has brought me a full relief for 3 years and safety
But I was young and first started my depression mission I was young naive trusting and stupid and went on to comment what I call ssri-med-go-round trying every single SSRI one after another and getting worse after each one until I stop and finally started to hate the damn thing s
My thoughts about SSRI on this from what I understand to be basic they go in the brain Target a specific receptor site and then bombarded with serotonin with no testing of when a so-called serotonin deficiency has been met and increasing us to stop or at least be lowered you just continue to pound and pound and pound to no One serotonin and this just doesn't sound logical or even saved to me at all.
My first thought using logic is if you raise a single neurochemical alone solely by itself too high you're eventually causing a balance of the others and I confirm this in one medical article I read confirm Second that kind of pounding on the receptor site has to be possible to cross some damage and again I confirm it's called cemetonin toxicity
The reason MAOI the one I'm on is the only one I trust and will ever touch in my life again is because of the way it works it doesn't just affect one it affects all three neurotransmitters Serotonin Norepinephrine Dopamine
If a my understanding raises all 3 of these narrow transmitters equally.
Also I don't want to get into complex stuff but I am aware of how it works and the way it raises the three just sounds much much safer than the way ssris hit their target
And again raising a single neurochemical or neurotransmitter significantly I mean really significantly high will result in a bad debt and bad things happening I'm not biased to just sermon Tony I'm a big fan of dopamine I love dopamine and because of it I once ordered liquid deprenyl which for my reading was the maip and unlike others increase one and one only neurotransmitter dopamine but at the time I was so much I thought it was a good idea so I bought it and use it a lot and I must have raised dopamine really really high like in the way they significantly raise serotonin and I reached the limit of too much I had severe anxiety with my hands were twitch I was hypermantic and I didn't sleep at all and I realized I was in bad shape so just so to show you I'm not biased against SSRI or serotonin dopamine the chemical I love to prove my point even raising that one by itself alone significantly isn't a good idea as well just a daughter of raising a single one to no degree it's just not a safe or effective idea and that's just my own personal opinion
Last since the title is liquid deprenyl I was just curious if anyone else has here has tried to look with brand where you drop it on your tongue and what results you got from it thank you for reading God bless

Hi all,
Currently going through a severe SSRI withdrawal after multiple serotonin toxicity reactions. I can no longer tolerate serotonergic medication so was prescribed lamictal. I am incredibly sensitive to medication after these bad reactions.
Have been taking 25mg for two weeks. At first it made me incredibly stimulated and wired. This calmed down after the first few days but on day 10 it suddenly felt like I was on speed and taken hard drugs. I was having pins and needles, in arms, aching muscles in legs with twitching, tight swollen throat etc. similar to what I had when I tried pregablin.
Dropped down to 12.5mg today and feeling so much better. Disappointed I had to drop down as was about to go to 50mg but the last few days have been awful with this stimulated/wired feeling.
Anyone experience this before and found 12.5mg effective?

Hello everyone first off brand new to this sub so me state how happy to be here.
Now before my Kratom question a lil bout me I suffered a painful severe depression that started at age 19 at that age I was young stupid and naive and trusting and went on a common ssri -med-go-round trying every single one of them without fail at each one hurt me more than the other I've come to literally hate SSRI s. Flash Forward 20 years or so to the current present time. I stumbled upon a miracle a potent maoi parnate Adderall combo. This combo for over 3 years now has brought me instant robust relief for my depression to the point where I believe I'm in Fuller mission and it's now non-existent and cured and I'm feeling better than ever have ever and this is what 3 years with both defectiveness and safety margin.
I like to pride myself on pharmacology and substances that affect the brain such as drugs meds herbs nootropics etc and I took pride in that and I thought I knew it all until I got here and heard of Kratom I couldn't believe what people were saying about it what a difference the benefits etc so powerful to the point of severe withdrawals that I would also read
So with that I ran out to my local vape store and immediately found a sold in fact Kratom so I bought a bag rushed home at it very excited when I got home open and sorry came in the form of a capsules I was cautious and took a few at first a few hours felt nothing took more for you nothing more for you and by quite some time I had a lot of pills in me enough to a family significantly felt an effect
And here's exactly what I felt first no euphoria at all no mood lift or hot or speed or high no euphoria at all however I felt an extreme and extreme overall sense of calm I mean extreme calm and I thought to myself because of one I forgot to mention it was an extreme calm that felt kind of numbing and darling but yet still there and extreme calm
It was so powerful to come I thought to myself this would be a great med for mood stabilization or possibly any anxiety or maybe even withdrawal but again a very strong sense of calm and peace I know euphoria at all
Because I don't have anxiety issues and I'm over stimulant up a kind of guy in terms of my depression I'm barely not interested in feeling calm and peace not that much but if I was it would definitely be the crate of my board so with this compared to what other people have experience positive benefit wise cuz someone possibly give me insight into what happened with my experience or even if it's a comment question or do it please thank you

Some history, I (32f) have been diagnosed with CPTSD, ADHD, Anxiety (unspecified type), Depression, PCOS, TBI in 2011. Strong suspicion/pursuing diagnosis of: POTS, autism, OCPD.
Current meds: Spironolactone 200mg, Buspirone, 30mg, Vyvanse 30mg, Clonidine .2mg
I have been on just about every psychiatrict medication I have heard of atomoxetine, duloxetine, fluoxetine, methylphenidate, propranolol, concerta, celexa, Klonopin, Wellbutrin, lamictal, Zoloft, paxil, Ativan. All of them either didn't help, made things worse, or had severe side effects (I've gotten violently ill off just about every SSRI I've tried).
Had been on 90mg of propranolol for several months with very little results. Needed to taper off to be do allergy shots (which I turned out not to need -_-) so doc prescribed me clonidine. I started on 5/9, tapered up to the prescribed dose of 0.1mg over the course of about 1.5 weeks. Aside from pretty hefty dry mouth, I didn't really notice any issues during this time.
Last Monday (5/20) I had a really bad meltdown- severe panic attack and SI that resulted in my partner calling the crisis line. My therapist was able to talk me down, and I've been stable, albeit a little drained, since. I struggle to eat on a good day, but since the episode I know I'm not eating enough. Only started logging food today, so I don't have estimates, but I'm sure it's not enough.
Anyway, since the episode, I've been having increasingly distressing side effects. Started to get incredibly dizzy when id stand up or bend over, regardless of time of day or how slowly I did it. Haven't passed out but I've definitely gotten tunnel vision and felt vaguely like being drunk. Started getting really woozy in the shower, and noticing that my heart feels like it's pounding out of my chest, even when my bpm is normal. I've been tracking HRV and have actually seen improvements since starting it. But my already constantly cold hands and feet feel like iscicles, my legs/feet keep swelling (have compression sleeves) and I've started experiencing these awful charlie horse like cramps in the shower that bring me to the ground.
At first, I really felt a little lighter, like this was helping the anxiety. I've noticed more good days and my highs are more high. But lately my ruminating feels like it's worse, like it's not just my head spinning out on things but my body feels all wound up now too. Have also started having nightmares regarding my abusers again (which propranolol at least kept away) I feel like I've had two energy drinks on an empty stomach. I'm shaky, irritable, and frankly, scared...
Does this go away? Do I just need to adjust the dose? I'm so scared to talk to my psych about it Tuesday because if she wants to take me off... I don't really know what's left to try?! She had recommended Seroquel but I've only heard bad things about it. I'm just feeling so overwhelmed and hopeless. I'm constantly having to lie down and take deep breaths and I can't even walk across the apartment without feeling lightheaded and out of breath, let alone up our three flights of stairs.
I had similar issues with exertion on Propranolol, but more only with stairs or working out. When I tried weightlifting (once) on clonidine, my heart rate skyrocketed to 162 and I felt like I was going to black out. I wasn't even doing HIIT?!
Any advice is appreciated. I apologize if this is lengthy, I'm just so confused and scared and hopeless feeling. I read such good things about clonidine, I really wanted this to be the one... 😩

Some history, I (32f) have been diagnosed with CPTSD, ADHD, Anxiety (unspecified type), Depression, PCOS, TBI in 2011. Strong suspicion/pursuing diagnosis of: POTS, autism, OCPD.
Current meds: Spironolactone 200mg, Buspirone, 30mg, Vyvanse 30mg, Clonidine .2mg
I have been on just about every psychiatrict medication I have heard of atomoxetine, duloxetine, fluoxetine, methylphenidate, propranolol, concerta, celexa, Klonopin, Wellbutrin, lamictal, Zoloft, paxil, Ativan. All of them either didn't help, made things worse, or had severe side effects (I've gotten violently ill off just about every SSRI I've tried).
Had been on 90mg of propranolol for several months with very little results. Needed to taper off to be do allergy shots (which I turned out not to need -_-) so doc prescribed me clonidine. I started on 5/9, tapered up to the prescribed dose of 0.1mg over the course of about 1.5 weeks. Aside from pretty hefty dry mouth, I didn't really notice any issues during this time.
Last Monday (5/20) I had a really bad meltdown- severe panic attack and SI that resulted in my partner calling the crisis line. My therapist was able to talk me down, and I've been stable, albeit a little drained, since. I struggle to eat on a good day, but since the episode I know I'm not eating enough. Only started logging food today, so I don't have estimates, but I'm sure it's not enough.
Anyway, since the episode, I've been having increasingly distressing side effects. Started to get incredibly dizzy when id stand up or bend over, regardless of time of day or how slowly I did it. Haven't passed out but I've definitely gotten tunnel vision and felt vaguely like being drunk. Started getting really woozy in the shower, and noticing that my heart feels like it's pounding out of my chest, even when my bpm is normal. I've been tracking HRV and have actually seen improvements since starting it. But my already constantly cold hands and feet feel like iscicles, my legs/feet keep swelling (have compression sleeves) and I've started experiencing these awful charlie horse like cramps in the shower that bring me to the ground.
At first, I really felt a little lighter, like this was helping the anxiety. I've noticed more good days and my highs are more high. But lately my ruminating feels like it's worse, like it's not just my head spinning out on things but my body feels all wound up now too. Have also started having nightmares regarding my abusers again (which propranolol at least kept away) I feel like I've had two energy drinks on an empty stomach. I'm shaky, irritable, and frankly, scared...
Does this go away? Do I just need to adjust the dose? I'm so scared to talk to my psych about it Tuesday because if she wants to take me off... I don't really know what's left to try?! She had recommended Seroquel but I've only heard bad things about it. I'm just feeling so overwhelmed and hopeless. I'm constantly having to lie down and take deep breaths and I can't even walk across the apartment without feeling lightheaded and out of breath, let alone up our three flights of stairs.
I had similar issues with exertion on Propranolol, but more only with stairs or working out. When I tried weightlifting (once) on clonidine, my heart rate skyrocketed to 162 and I felt like I was going to black out. I wasn't even doing HIIT?!
Any advice is appreciated. I apologize if this is lengthy, I'm just so confused and scared and hopeless feeling. I read such good things about clonidine, I really wanted this to be the one... 😩

Bakgrunn

For kontekst gikk jeg inn i en depressiv fase for 4 år siden. De depressive symptomene gikk over etter ca ett år, men jeg hadde fortsatt milde symptomer på anhedoni hengende igjen. Disse symptomene ble gradvis sterkere som tiden gikk, å jeg ble ikke bevisst over det før starten av 2023.
Anhedoni = Redusert evne til å føle glede og nytelse (sammenheng med belønningssystemet). Det er kategorisert som et symptom, å ikke en diagnose i seg selv.

Min tilstand i dag

I dag går jeg praktisk talt i sirkler fordi hjernen min ikke har funksjonen til å motta stimuli fra verden rundt meg. Verken fra sosialisering, tv, spill, trening, onani og alle andre aktiviteter som skal skape positive følelser i form av nytelse, interesse eller glede. Jeg er også emosjonelt utvannet for både positive og negative følelser. Jeg føler verken glede, fristelse, sinne, tristhet, bekymring, angst, opphisselse, romanse, empati, adrenalin osv. Jeg sliter også med kognitive vansker.
Med andre ord er jeg helt flat, og hjernen min responderer ikke på omgivelsene rundt meg. Dette er de eneste depressive symptomene jeg har.

Forskning og min delte mening

Det er studier som viser at denne varianten av depresjon ikke responderer bra på vanlig behandling. Utdrag ser du her. De viktigste uttalelsene er markert med tykk skrift:

«50% of patients undergoing antidepressant pharmacotherapy experience clinically significant improvements in depressive symptoms; however, symptoms such as cognitive deficits and anhedonia are typically resistant to first-line antidepressant treatments (Buckner et al., 2008; Ho and Sommers, 2013).»https://www.sciencedirect.com/science/article/abs/pii/S0278584618309175
«Anhedonia is a predictor of poor long-term outcomes, including suicide, and poor treatment response. Because extant psychological and pharmacological treatments are relatively ineffective for anhedonia, there is an unmet therapeutic need for this high-risk symptom. Current psychological and drug treatments for anxiety and depression focus largely on reducing excesses in negative affect rather than improving deficits in positive affect. Recent advances in affective neuroscience posit that anhedonia is associated with deficits in the appetitive reward system, specifically the anticipation, consumption, and learning of reward.»https://pubmed.ncbi.nlm.nih.gov/27699943/
«Conclusion: Anhedonia often persists in depressed patients despite on SSRI anti-depressant treatment.»https://pubmed.ncbi.nlm.nih.gov/25874350/

Personlig vil jeg si at disse studiene gir gode nok indikasjoner på at vanlig behandling for min del vil være bortkastet tid. Tilstanden ødelegger ikke bare deler av livet mitt, det står praktisk talt på pause inntil dagen jeg er frisk. Jeg har ikke noe liv i det hele tatt så lenge belønningssystemet mitt ikke fungerer. Fra et fundamentalt perspektiv er belønningssystemet hovedkomponenten som manipulerer adferden vår og gjør livet meningsfullt. Jeg har ikke lyst til å kaste bort mange år av livet mitt på å teste mange forskjellige antideprressiver som er forskningsmessig dokumentert at med god sannsynlighet ikke vil fungere.
Siden anhedoni er et symptom og ikke en egen diagnose er forskningen svært mangelfull. Det er dermed få offisielle bahandlinger for det:

«Anhedonia and depressed mood are key diagnostic criteria for a major depressive episode (MDE) as part of MDD according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) (NIMH, 2018).»https://www.sciencedirect.com/science/article/abs/pii/S0278584618309175
«Although pharmacological interventions are most commonly used in the treatment of MDD, the effect of antidepressants on anhedonia have been insufficiently studied. Based on the impact of anhedonia on quality of life and functional outcomes in MDD, a better understanding of the effects of available antidepressants on measures of anhedonia would be clinically useful (Vinckier et al., 2017).»https://www.sciencedirect.com/science/article/abs/pii/S0278584618309175
Selvom det er et umettet behov for behandling av anhedoniske symptomer, er det fortsatt studier der ute som viser til behandlinger med tilfredstillende god effekt:
«Among treatment-resistant depression (TRD), we identified anergic-anhedonic clinical presentations (TRAD) as putatively responsive to pro-dopaminergic strategies. Based on the literature, non-selective monoamine oxidase inhibitors (MAOI) and dopamine D2 receptor agonists (D2RAG) were sequentially introduced, frequently under the coverage of a mood stabilizer. This two-step therapeutic strategy will be referred to as the Dopaminergic Antidepressant Therapy Algorithm (DATA). We describe the short and long-term outcomes of TRAD managed according to DATA guidelines. (...) Results: At the end of DATA step 1, 25 patients were in remission (QIDS <6; 52% [38–66%]). After DATA step 2, 37 patients were in remission (77% [65–89%]) to whom 5 patients with a QIDS score = 6 could be added (88% [78–97%]). Many of these patients felt subjectively remitted (GAF = 74 ± 10). There was a significant benefit to combining MAOI with D2RAG which was maintained for at least 18 months in 30 patients (79% [62–95%]).»https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2023.1194090/full
«Previous studies testing the antidepressant efficacy of pramipexole in non‐PD depression have been promising for both unipolar and bipolar depression (4), but effect sizes, in this unselected and heterogeneous group of depression, have been too small for broader clinical recommendations. In a series of 42 cases with unipolar or bipolar depression, Fawcett et al. described their clinical experience with adjunctive, high dose pramipexole (5). In this treatment‐resistant sample they reported a clinically meaningful response in more than 75% of the patients that persisted over an average follow‐up time of 16 months. Based on their clinical experience and the dopamine agonistic effects of pramipexole, Fawcett et al. suggested that this treatment may be particularly efficacious in a subtype of depression with a symptom profile of anhedonia and lack of motivation.»https://prcp.psychiatryonline.org/doi/10.1176/appi.prcp.20210042
Majoriteten av antidepressivene på markedet har en dempende effekt, noe som virker mot sin hensikt til behandling av anhedoni. Som oftest har medisinene som virker for anhedoni helt andre egenskaper enn de vanligste antidepressivene. Ofte er ikke disse medisinene kategorisert som antidepressiver i det hele tatt.
F.eks. så er premipexel i studien over brukt til behandling av Parkinsons sykdom. Psykiateren min sier hun ikke kan skrive ut dette fordi den ikke er ment for depresjon, selvom studier støtter den til behandling av mine symptomer. MAOI-medisiner som vi finner i den andre studien er et antidepressiv. Disse medisinene er ikke markedsført i Norge, og er ofte brukt som siste alternative utvei grunnet ulike risikofaktorer ved bruk av medikamentet. De er fortsatt omtalt til å være svært effektive mot behandlingsresistent depresjon.

Problemstilling

Psykiateren min sier at det er nødvendig at psykologen min kommer til bunns i hva som ligger bak symptomene mine før hun kan ta mer tilrettelagte tiltak. Men det er jo forholdsvis åpenbart at symptomene stammer fra depresjonen som jeg kom ut av for 3 år siden. Bare at nå har jeg ingen andre symptomer på depresjon enn anhedoni. Personlig tror jeg at hjernen bare har blitt slik. At den har etablert seg en ny kjemisk balanse av molekylært kompliserte grunner. En årsak som ikke kan kategoriseres. Personlig oppfatter jeg symptomene som en egen sykdom. Hvorfor skal jeg vente på en potensiell Parkisons diagnose for å få behandling når medisinene virker uavhengig av pasientens underliggende årsak i studiene?
Jeg vet ikke helt hva jeg skal gjøre. Er det sant at det er umulig for meg å få særskilt behandling? Jeg trodde at psykiatere kunne sende søknad om slikt. Å hvis det er mulig, burde jeg kanskje gå privat for å finne en dyktigere psykiater? Hadde satt pris på om noen kunne komme med forslag. Jeg har ikke lyst til at behandlingen skal ta lengre tid enn nødvendig, bare pågrunn av den lovpålagte måten psykiatere skal gå frem på. Psykologen min har brukt et halvt år på utredningen min nå. Det går drit tregt. Jeg har alt prøvd noen av disse "first-line" antidepressivene. Effekten de har på meg er lite imponerende. Jeg tror det er forholdsvis lite kunnskap og prioriteringer rundt anhedoni, noe som har medført en dårlig forming og tilrettelegging av lovverket.

Bakgrunn

For kontekst gikk jeg inn i en depressiv fase for 4 år siden. De depressive symptomene gikk over etter ca ett år, men jeg hadde fortsatt milde symptomer på anhedoni hengende igjen. Disse symptomene ble gradvis sterkere som tiden gikk, å jeg ble ikke bevisst over det før starten av 2023.
Anhedoni = Redusert evne til å føle glede og nytelse (sammenheng med belønningssystemet). Det er kategorisert som et symptom, å ikke en diagnose i seg selv.

Min tilstand i dag

I dag går jeg praktisk talt i sirkler fordi hjernen min ikke har funksjonen til å motta stimuli fra verden rundt meg. Verken fra sosialisering, tv, spill, trening, sex og alle andre aktiviteter som skal skape positive følelser i form av nytelse, interesse eller glede. Jeg er også emosjonelt utvannet fra både positive og negative følelser. Jeg føler verken glede, fristelse, sinne, tristhet, bekymring, angst, opphisselse, romanse, empati, adrenalin osv. Jeg sliter også med kognitive vansker.
Med andre ord er jeg helt flat, og hjernen min responderer ikke på omgivelsene rundt meg. Dette er de eneste depressive symptomene jeg har.

Forskning og min delte mening

Det er studier som viser at denne varianten av depresjon ikke responderer bra på vanlig behandling. Utdrag ser du her. De viktigste uttalelsene er markert med tykk skrift:
«50% of patients undergoing antidepressant pharmacotherapy experience clinically significant improvements in depressive symptoms; however, symptoms such as cognitive deficits and anhedonia are typically resistant to first-line antidepressant treatments (Buckner et al., 2008; Ho and Sommers, 2013).»https://www.sciencedirect.com/science/article/abs/pii/S0278584618309175
«Anhedonia is a predictor of poor long-term outcomes, including suicide, and poor treatment response. Because extant psychological and pharmacological treatments are relatively ineffective for anhedonia, there is an unmet therapeutic need for this high-risk symptom. Current psychological and drug treatments for anxiety and depression focus largely on reducing excesses in negative affect rather than improving deficits in positive affect. Recent advances in affective neuroscience posit that anhedonia is associated with deficits in the appetitive reward system, specifically the anticipation, consumption, and learning of reward.»https://pubmed.ncbi.nlm.nih.gov/27699943/
«Conclusion: Anhedonia often persists in depressed patients despite on SSRI anti-depressant treatment.»https://pubmed.ncbi.nlm.nih.gov/25874350/
Personlig vil jeg si at disse studiene gir gode nok indikasjoner på at vanlig behandling for min del vil være bortkastet tid. Tilstanden ødelegger ikke bare deler av livet mitt, det står praktisk talt på pause inntil dagen jeg er frisk. Jeg har ikke noe liv i det hele tatt så lenge belønningssystemet mitt ikke fungerer. Fra et fundamentalt perspektiv er belønningssystemet hovedkomponenten som manipulerer adferden vår og gjør livet meningsfullt. Jeg har ikke lyst til å kaste bort mange år av livet mitt på å teste mange forskjellige antideprressiver som er forskningsmessig dokumentert at med god sannsynlighet ikke vil fungere.
Siden anhedoni er et symptom og ikke en egen diagnose er forskningen svært mangelfull. Det er dermed få offisielle bahandlinger for det:
«Anhedonia and depressed mood are key diagnostic criteria for a major depressive episode (MDE) as part of MDD according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) (NIMH, 2018).»https://www.sciencedirect.com/science/article/abs/pii/S0278584618309175
«Although pharmacological interventions are most commonly used in the treatment of MDD, the effect of antidepressants on anhedonia have been insufficiently studied. Based on the impact of anhedonia on quality of life and functional outcomes in MDD, a better understanding of the effects of available antidepressants on measures of anhedonia would be clinically useful (Vinckier et al., 2017).»https://www.sciencedirect.com/science/article/abs/pii/S0278584618309175
Selvom det er et umettet behov for behandling av anhedoniske symptomer, er det fortsatt studier der ute som viser til behandlinger med tilfredstillende god effekt:
«Among treatment-resistant depression (TRD), we identified anergic-anhedonic clinical presentations (TRAD) as putatively responsive to pro-dopaminergic strategies. Based on the literature, non-selective monoamine oxidase inhibitors (MAOI) and dopamine D2 receptor agonists (D2RAG) were sequentially introduced, frequently under the coverage of a mood stabilizer. This two-step therapeutic strategy will be referred to as the Dopaminergic Antidepressant Therapy Algorithm (DATA). We describe the short and long-term outcomes of TRAD managed according to DATA guidelines. (...) Results: At the end of DATA step 1, 25 patients were in remission (QIDS <6; 52% [38–66%]). After DATA step 2, 37 patients were in remission (77% [65–89%]) to whom 5 patients with a QIDS score = 6 could be added (88% [78–97%]). Many of these patients felt subjectively remitted (GAF = 74 ± 10). There was a significant benefit to combining MAOI with D2RAG which was maintained for at least 18 months in 30 patients (79% [62–95%]).»https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2023.1194090/full
«Previous studies testing the antidepressant efficacy of pramipexole in non‐PD depression have been promising for both unipolar and bipolar depression (4), but effect sizes, in this unselected and heterogeneous group of depression, have been too small for broader clinical recommendations. In a series of 42 cases with unipolar or bipolar depression, Fawcett et al. described their clinical experience with adjunctive, high dose pramipexole (5). In this treatment‐resistant sample they reported a clinically meaningful response in more than 75% of the patients that persisted over an average follow‐up time of 16 months. Based on their clinical experience and the dopamine agonistic effects of pramipexole, Fawcett et al. suggested that this treatment may be particularly efficacious in a subtype of depression with a symptom profile of anhedonia and lack of motivation.»https://prcp.psychiatryonline.org/doi/10.1176/appi.prcp.20210042
Majoriteten av antidepressivene på markedet har en dempende effekt, noe som virker mot sin hensikt til behandling av anhedoni. Som oftest har medisinene som virker for anhedoni helt andre egenskaper enn de vanligste antidepressivene. Ofte er ikke disse medisinene kategorisert som antidepressiver i det hele tatt.
F.eks. så er premipexel i studien over brukt til behandling av Parkinsons sykdom. Psykiateren min sier hun ikke kan skrive ut dette fordi den ikke er ment for depresjon, selvom studier støtter den til behandling av mine symptomer. MAOI-medisiner som vi finner i den andre studien er et antidepressiv. Disse medisinene er ikke markedsført i Norge, og er ofte brukt som siste alternative utvei grunnet ulike risifaktorer ved bruk av medikamentet. De er fortsatt omtalt til å være svært effektive mot behandlingsresistent depresjon.

Problemstilling

Psykiateren min sier at det er nødvendig at psykologen min kommer til bunns i hva som ligger bak symptomene mine før hun kan ta mer tilrettelagte tiltak. Men det er jo forholdsvis åpenbart at symptomene stammer fra depresjonen som jeg kom ut av for 3 år siden. Bare at nå har jeg ingen andre symptomer på depresjon enn anhedoni. Personlig tror jeg at hjernen bare har blitt slik. At den har etablert seg en ny kjemisk balanse av molekylært kompliserte grunner. En årsak som ikke kan kategoriseres. Personlig oppfatter jeg symptomene som en egen sykdom. Hvorfor skal jeg vente på en potensiell Parkisons diagnose for å få behandling når medisinene virker uavhengig av pasientens underliggende årsak i studiene?
Jeg vet ikke helt hva jeg skal gjøre. Er det sant at det er umulig for meg å få særskilt behandling? Jeg trodde at psykiatere kunne sende søknad om slikt. Å hvis det er mulig, burde jeg kanskje gå privat for å finne en dyktigere psykiater? Hadde satt pris på om noen kunne komme med forslag. Jeg har ikke lyst til at behandlingen skal ta lengre tid enn nødvendig, bare pågrunn av den lovpålagte måten psykiatere skal gå frem på. Psykologen min har brukt et halvt år på utredningen min nå. Det går drit tregt. Jeg har alt prøvd noen av disse "first-line" antidepressivene. Effekten de har på meg er lite imponerende. Jeg tror det er forholdsvis lite kunnskap og prioriteringer rundt anhedoni, noe som har medført en dårlig forming og tilrettelegging av lovverket.

I have social anxiety and depression and I use Cymbalta (120 mg) & Paxil (40 mg). I still have some depression and a loss of motivation but my social anxiety is manageable. My doctor suggested adding Lamictal at 50 mg as he thinks it will help with depression. I however think that this dose is a bit high for a starter. I read that people usually start with 25 mg and see improvements.
Does anybody have a similar experience or any suggestions?
I appreciate it.

I have recurrent biological depression. Relapsed after successful ect 6 months ago. Sertraline 200 clearly dusnt work at all anymore . Failed a lot of ssri,s and venlafaxine in the past , I think I have bipolar disorder as ect has caused hypomania this time round after only 5 sessions , has anyone found any success using an maoi , seems my best option or a tricyclic when ssris are like sugar pills . Amitryptline was tried long time ago but don't think it helped . My depression caused extreme fatigue, muscle aches weakness, feeling slowed down , lack of interest in food or anything , just feel like a zombie , any idea what maoi might be worth trying . Thanks