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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by uncouth on November 12, 2009, at 20:27:30
Genetics, years of mental abuse, bipolar disorder, smoking, and psychotropic medication I believe has seriously messed up my reward system, and this is a main cause of my depression and why I can't seem to get better or make changes in my life.
What would one look for if they wanted to "normalize" their reward system. I have enormous trouble getting work done, going after long term rewards, being optimsitic about outcomes, saying "no" to immediate fake-rewards like smoking, internet use, and food.
I'm guessing this is dopamine related, and i know it's genetic as I see it in my father as well. I am already on bupropion -- a high dose -- 600mg, which has helped the depression somewhat (turned offf thoughts of suicide) but hasn't given me the kick in the pants I would have liked.
What else is there?
Is this actually a treatable condition separate from depression as I am assuming?
Stimulants? I tried those...seemed to just make me even more overfocused on immediate rewards (like internet use for example).I'm struggling with my aimless, goal-less behaviors....
Help.
Thanks
Uncouth
Posted by SLS on November 12, 2009, at 22:04:03
In reply to Repairing my reward system, posted by uncouth on November 12, 2009, at 20:27:30
Wellbutrin can be combined with Parnate.
- Scott
Posted by conundrum on November 13, 2009, at 6:58:43
In reply to Repairing my reward system, posted by uncouth on November 12, 2009, at 20:27:30
I have similar problems and I believe they are dopaminergic as well.
Which stimulants have you tried?
Posted by uncouth on November 13, 2009, at 9:18:16
In reply to Re: Repairing my reward system » uncouth, posted by conundrum on November 13, 2009, at 6:58:43
Focalin and Adderall, both at low-to-medium doses.
I think if i had to choose i'd go back to Focalin, but that could just be it felt most pleasurable. I'm wondering if very high doses would do the trick, or if that would just mess me up bigtime and distrort things further.
Posted by conundrum on November 13, 2009, at 10:50:39
In reply to Re: Repairing my reward system, posted by uncouth on November 13, 2009, at 9:18:16
Well if you want to cure anhedonia then you will need a drug that increases pleasure. Dexmethylphenidate(focalin) or dextroamphetamine(dexedrine). Make sense in that regard. I've haven't taken a stimulant, but if you do some searches about creativity and stimulants you'll find that most feel that methylphenidate makes a person focus on one thing and that happens to be whatever is directly in front of them. I think amphetamines do this less.
I've found that buspar makes me more productive and motivated towards long term goals. I think this maybe because it boosts norepinephrine and to a lesser extent dopamine. So you might find that drugs that increase norepinephrine can help.
Also, I've found that making lists and crossing things off is the best way to keep organized and get things done. Once I cross out a few items in the morning I'm on a roll and can get more things done throughout the day.
Posted by Phidippus on November 13, 2009, at 16:51:37
In reply to Repairing my reward system, posted by uncouth on November 12, 2009, at 20:27:30
Pramipexole is a nonergot dopamine agonist with high relative in vitro specificity and full intrinsic activity at the D2 subfamily of dopamine receptors, binding with higher affinity to D3 than to D2 or D4 receptor subtypes.
D3 receptors are heavily expressed in brain regions involved in mood, behavior, and reward.
Then there's Namenda which is a glutamate antagonist and D2 agonist which could also help you out.
P
Posted by elanor roosevelt on November 17, 2009, at 21:35:31
In reply to Re: Repairing my reward system » uncouth, posted by Phidippus on November 13, 2009, at 16:51:37
doesn't abilify help with dopamine? I too am on a desperate quest for my long lost reward system. Please let me know if you find something that works for you.
Posted by Phidippus on November 18, 2009, at 12:44:24
In reply to Re: Repairing my reward system, posted by elanor roosevelt on November 17, 2009, at 21:35:31
Abilify is a D2 partial agonist.
P
Posted by SLS on November 18, 2009, at 14:23:40
In reply to Re: Repairing my reward system » elanor roosevelt, posted by Phidippus on November 18, 2009, at 12:44:24
> Abilify is a D2 partial agonist.
And D3.
- Scott
This is the end of the thread.
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