Posted by JohnL on January 27, 2003, at 14:49:48
In reply to Dysthymia - medication?, posted by btnd on January 27, 2003, at 8:00:03
Hello,
Your type of depression sounds a lot like mine. I've come to believe that there are different breeds of depression. Each different breed tends to respond to certain classes of medications, i.e, serotonin meds, dopamine meds, combination meds, etc. Some breeds are real similar to the negative symptoms of schizophrenia. Some breeds are are primarily reward deficit in nature, or reward deficiency syndrome.
My breed, and possibly yours, involves all of the neurotransmitter systems to some degree, since they are all tied together, but is most heavily influenced by some abnormality in the dopamine D2 system. Just a guess though.
I've tried Amisulpride. It alone did not do the job. But, combined with Adrafinil and Prozac it is miraculous. Oddly, neither Adrafinil or Prozac alone do much good either. Put them all together, and wow. Apparently Prozac and Adrafinil do have indirect effects on D2, while Amisulpride has direct effects. Somehow they all work in harmony as a team, but fail if any one ingredient is missing. Anyway, Amisulpride is a fantastic med for me. I don't take it regularly for one reason. That is, it makes me start going impotent by about day 4 or 5.
With Deprenyl, you can expect a quick great response, followed by tolerance and nonresponse, similar to Adderall. Too high of a dose too soon can cause mania or psychotic features or agitation. Possibly worth a shot though.
Adfrafinil is definitely a good candidate. I take one tab a day.
Another med to consider is Zyprexa. Anhedonia and your other symptoms are sort of similar to the negative symptoms of schizophrenia. I'm not saying you have schizophrenia. I am saying that a certain breed of depression, like mine, looks similar to certain symptoms of schizohrenia, and responds well to Zyprexa.
My anhedonia buster combination is 20mg Prozac, 5mg Zyprexa, 300mg Adrafinil, the herb Rhodiola Rosea, and Amisulpride every once in a while. I can do without the herb. I can do without Amisulpride. But if I go without any of the others, forget it, it doesn't work any more.
John
> Here is my story. 25 yrs old. Self-diagnosed (thanks to the internet) as having dysthymia since 6th grade. Symptoms:
> - low energy, low motivation, low drive to succeed
> - constant fatigue (mostly mental fatigue)
> - concentration problems (ADD?)
> - social anxiety (sociability dropped down)
> - anhedonia
> - constant worrying
> - slight depression (because of above?)
>
> I thought that this was my personality until I tried Adderall. This drug removed all problems above.It made me motivated,energetic,confident,sociable - the way I've always wanted me to be. Because of this, I've read tons of studies and figured out that my problem is dopamine related. Unfortunately after some time Adderall stopped working.
> Right now I'm seeking another solution so I could switch treatments and not develop tolerance. I'm thinking of using Amisulpride for 2 weeks and then Adderall for 2 weeks. What other treatments are of value? Selegiline(Deprenyl)? Adrafinil? I'd really like to try Amineptine (Survector) but it's not obtainable.
> I've also tried Klonopin just for the social anxiety and it works at 1.5-2mgs. But motivation,energy,anhedonia stays the same (low).
> I appreciate your input.
poster:JohnL
thread:137751
URL: http://www.dr-bob.org/babble/20030125/msgs/137789.html