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Answers To Curing Anhedonia/numbness/apathy, No. 1


itstrevor

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I really don't agree with saying "you don't feel the way you do pre-anhedonia after recovery" because that is sort of a defeatist statement that is debilitating and I think that the feelings of deep emotions can come back, and we have several examples of this that I have posted in the thread. "Mindfulness" and other approaches are used to reduce or eliminate anxiety spikes which can perpetuate anhedonia, but are often perceived as useless because they do not seem to do anything acutely, and they are only useful for removing perpetuating factors. Time heals anhedonia most of the time it seems, and a person does nothing - the brain does it itself.

I don't view that as a defeatist attitude, there is no limits on how you can feel. I realized in my own struggle that I was chasing this fabricated state of mind of how I felt pre-anhedonia and of course nothing could compare. In fact the only time I felt something was thinking about the past. However the focus should be on the present, what small thing can you do in the present that can make you feel something. For me that was working out, luckily I had that as a momentary escape. Time is also important, healing without fueling the fire. Mindfulness and SSRIs are good for putting out the fire and giving you breathing space to heal and rest.

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Earwaxxer,

Do you still take prozac?

I do take it along with the Wellbutrin. I tried to taper off the prozac while on the wellbutrin without success. I will try again at some point. I do believe the prozac works well with the wellbutrin. I would rather not have prozac numbness, but the main thing is not being depressed, so I'm not messing with it right now.

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@alex617 - I can so relate to the 'self medicate' way of life. I grew up in the 60's, 70's and it was all about self realization and higher consciousness, and personal 'growth' etc. We did believe that drugs could advance ones state of being. Well, 40 years of that made me realize that drugs do not do any of that. Especially street drugs, its just a mirrage of things being better, with things almost always getting worse when the drug wears off. I think, finally, at age 57 I have quit the whole self medicating thing.

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Im in a current state of anhedonia right now, but somehow I feel a sense of being content. I have no real anxieties but I can't feel anything else and I basically have zero sex drive. I also get too tired to really do anything. Sometimes my body is too tired to move. My body is really weak right now and I'm in pain. I'm a 24 year old male, and I think I have some sort of bipolar disorder. The only medication I'm taking right now is 150mg of Lamictal. I've had success with buspirone in the past.

This really has started bothering me starting this weekend. No sex drive makes life confusing.

Anybody have any suggestions? All my friends do is drink alcohol and stay up late chasing girls. That's fun and all but I don't think that lifestyle is working for me right now.

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Im in a current state of anhedonia right now, but somehow I feel a sense of being content. I have no real anxieties but I can't feel anything else and I basically have zero sex drive. I also get too tired to really do anything. Sometimes my body is too tired to move. My body is really weak right now and I'm in pain. I'm a 24 year old male, and I think I have some sort of bipolar disorder. The only medication I'm taking right now is 150mg of Lamictal. I've had success with buspirone in the past.

This really has started bothering me starting this weekend. No sex drive makes life confusing.

Anybody have any suggestions? All my friends do is drink alcohol and stay up late chasing girls. That's fun and all but I don't think that lifestyle is working for me right now.

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@waterboy - it sounds like you need a good Dr./NP to get you on the right track. With all the symptoms you mention it seems you are not in a very good space. You mentioned buspirone - did that make you hyper? - its a thought.

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I created an account just to reply to this topic, which I stumbled on to after learning that what I've been feeling for more than half my life has a name: anhedonia. I don't have the stamina to read 75 pages of forum posts, so I'm hoping that someone will see this and give me some helpful advice. I'm just going to relate my experience. For reference, I am male, caucasian, 31 years old.

I have suffered from anhedonia, and only anhedonia, for over 15 years. I don't know exactly how long because my memory isn't very good. I have never been suicidal, nor have I ever been what people have described to me as depressed. I have never suffered from anxiety, or panic attacks. I simply feel nothing other than physical sensations. I remember that I used to feel strong emotions, but I don't think I really remember what those emotions felt like anymore. In fact, when I was a child I was very emotional, to the point where I couldn't really control my emotions. I assume this is partly because I was a child and didn't have the appropriate experience to do so, but maybe it's indicative of something else also, I don't know. Anyway, I do have brief windows from time to time. For example, I cried for a few seconds last week. It was really nice to feel that sadness, even though it was so brief. And even though it was sadness, it was the nicest thing that's happened in my life in over a year.

I don't want to give the impression that my life is terrible. Actually, I have a partner and family who love me very much, my job is stable and pays more than I have ever made before, and I have almost no stress. For a really long time I thought my lack of feelings was some kind of existential crisis, some fundamental division between me and the world I live in. I feel like that sometimes still, but I have tried everything I could possibly think of to change my worldview, to change my situation, to change my outlook and my mental patterns. And in large part I have succeeded in those endeavors. I have travelled extensively, including living long-term in vastly different cultures. I have embraced meditation and introspection as a way of life. I feel very little antagonism most of the time. But still, through all of this self-discovery, after all this time, I still don't feel emotions. If it weren't for the brief windows throughout my life, and the memory of how I used to be, I would believe that I was a psychopath.

It's a weird thing to be writing all of this, because I don't actually care if anyone responds, but I want someone to respond. I think maybe only other people who suffer from this syndrome can understand what I mean by that. Only people who also suffer like this can understand what it's like to have no ambition, no passion, no rage, or love, or joy, or sadness. When I was young I had passions. I made music and wrote stories, I took things apart and put new things together, I learned anything I could. And some of those things stayed habits for a while. Music was the first to fade, I haven't looked up any new music in years and I generally listen to what I have maybe once or twice a month. I used to listen to music every day. I was always going to concerts and looking up new bands and learning new instruments. After that it was reading. About 4 years ago it took me over 6 months to finish a book I could have read in 2 days when I was younger. Since then I haven't read more than a single page of text at a time. I don't hate my job, it pays well, it's physical and I get to be out in the sun. But I also don't care about it at all, and so some days I tell my boss I'm sick because I don't want to do what other people want me to do that day. I would probably get fired if it weren't for the fact that I'm good at what I do when I'm there. I have no desire to learn anything, I have no passion to explore art or science. Aside from a very small, select group of people who understand me and my motivations, I have zero interest in interacting with other people.

Once, about 4 or 5 years ago I saw a therapist a couple times, but their answer to my problems was to tell me that they saw so much light and potential inside me and other new age things and that I should just try positive thinking. Well, I have no problem with positive thinking, I'm just not capable of it in the way that they meant. Clearly, the therapist didn't understand me, and I didn't respect them, so I stopped. To be honest, until I came across this today, I just figured this was permanent. I don't want to be numb and passionless, but nothing I have ever tried has made it any better. I should mention that I have never tried any medications. This is not because I am against them, but rather because I have never had access to them. I haven't had a regular doctor since I was 17, and before that I simply thought I was a misanthropic teenager and never told anyone how I felt. I would be interested in trying something(s) that other people with this syndrome have reported success with. I would be willing to jump through the hoops required to get the prescription if I had something concrete to hope for.

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@Grr - What you articulate quite well, is what many of us have experienced (and are experiencing). I thought that was part of getting old - kind of like how John Mellencamp expressed it in his songs. I'm quite used to it by now, having got used to the prozac sort of way of greyscaling everything. I shouldnt really blame the prozac though, because I was pretty much living like that before prozac as well. I do see that symptom as part of depression though. Sometimes depression is hard to identify. It can take many forms. Its not always 'sadness'. Its mostly supressed anger. Anger is also a tough one to identify. - I think in understanding this thing about yourself, you will learn much that you may not have been aware of - at least thats what we all hope for in our struggles..

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GerPronouncedGrr

You are very inspirational to me. You have a family life, job, have traveled and do meditation. It sounds like you have coped with anhedonia well. Thank you for sharing your experience.

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If I can muster up the motivation, focus and vocabulary needed to describe my experience with depression and anhedonia, this may turn out to be quite the long-winded introductory.

tl;dr- Fighting moderate anxiety and pain since childhood, diagnosed with IBS-D early on and GAD, depression and possibly ADD in summer 2012. Started on fluoxetine 20 mg for IBS-D symptoms and anxiety, augmented with Adderall 20 mg a few months later in order to help with SSRI-induced apathy and fatigue. As a 27 year old man I've found a temporary balance between the symptoms of my disorders and side effects of these drugs with proper nutrition, avoiding stressful and overstimulating situations, and also a mixture of medicating through my GP and myself with fluoxetine 20 mg, Adderall 20 mg, Neurontin 300 mg and various narcotic pain medications.

We are a generation of novelty-seeking bullfrogs, leaping from pad to pad, croaking about any unconventional distraction that crosses our paths. This deep-seated want for constant excitement and stimulation can be seen in the eyes of every first-world citizen with a cell phone or pad or laptop or iPod or WHATEVER damned device is in our hand(s) at the moment. Clicking, scrolling, typing and tapping, that beautiful 1080p Super Amoled screen staring back into our glutamate-fueled retinas and releasing lots of that good ole' pal dopamine into our synapses. But what happens when that screen doesn't look so bright? When the countless number of our friends' Facebook posts begin to run together in a clusterf*ck of pedantic musings? What if that Grande Mocha Latte just doesn't give you that "kick in the ass" that it used to? The music don't sound too great and the ladies ain't lookin' too special anymore, huh? Well, tough tit said the kit. Suck it up and keep on truckin'.

After 6 months (or was it 8 or 10) on fluoxetine, 20 mg, and Adderall 20-30 mg daily (actually much more but this is what I was "prescribed"), that was how I felt. Burnt out, disinterested in hobbies I've had for years, unmotivated and FLAT. Bored with my stressful place of employment, bored with the old stalwarts I've known for years, tired of the endless cycle of trying different supplements and drugs, tired of none of them working the way the "good" ones do. But worst of all, FLAT. Brief windows opened up, as so many people have described here, and provided me with a glimpse of normalcy and motivation. But usually they would only last a few seconds, the damn teasing things.

As a child I was diagnosed with Irritable Bowel Syndrome after suffering from severe stomach cramps, diarrhea and anxiety since early childhood. What can I say, it runs in the family. IBS is a vicious cycle of pain and anxiety, beginning with waking up and having what feels like an Olympic weightlifter placing a vice grip on your lower abdomen, and ending with that incessant little voice asking over and over, "when will it hurt again? will these eggs send me running to the nearest bathroom? why is it so DAMN HOT IN HERE". Having a socially anxious single mother with various health issues of her own didn't help matters either, bless her heart.

Fast forward through 20 years of beautiful ignorance. Sure, my gut hurt almost every day, and I could hardly go out in public or be around members of the opposite sex without sweating profusely, having difficulty speaking to people, or feeling "out of place" and ready to jump out of my skin. Even through all that, I was MOTIVATED. I ENJOYED listening to music obnoxiously loud in my car and flirting with girls, quite awkwardly, albeit. It was EXCITING when I got to see a new movie or get a fat ass paycheck from working some overtime. I've always had a hard time concentrating on topics or tasks that I had no interest in, but when I found something that clicked? Oh yes, hours and days and weeks would go by with that one thing on my mind, that one buoy in a raging sea of thoughts, for lack of a better metaphor.

Got married, had a kid, yada yada. I had discovered the glory of prescription narcotics in my early 20's and needless to say, they have been my crutch ever since. Stomach pain? Grab a Vic. Nerves acting up? Pop a Perc. Sh!tty week with no end in sight to this miserable existence? Down a Methadone (which, as some of you may know, is used in the treatment of severe pain AND for dealing with withdrawal from other opiates such as illegal drug due to it's long half-life and the NMDA-antagonist characteristic of it, but more on that later). But who could possibly sustain this lifestyle of craving opioids every single day, with a tolerance growing steadily year after year, and going through the never-ending ups and downs associated with the highs of an opioid euphoria and the deep, deep lows of the opioid withdrawal? Which brings me to my next foray of pharmaceutical "security".

Off the bat, I didn't understand why my GP prescribed me fluoxetine, an antidepressant that also happens to treat OCD, eating disorders and panic attacks. I wasn't depressed, was I? My wife had finally persuaded me into seeing a doctor about my IBS, undoubtedly due to the fact that my opioid use had left me with horrible rebound cramps and an annoying, but not quite debilitating, lack of energy. And of course the more I looked into it on my Adderall-fueled reading binges, the more I began to understand his medical rationalization. After a few months of taking fluoxetine, my IBS symptoms all but disappeared (5-ht3 antagonist properties, possibly?), my anxiety was calmed in a different way than what opioids had provided me, and my social nervousness flew out the window as I began to chat up girls and talk to my peers with a lack of inhibition that rivaled stand-up comedians. But what goes up.....

And I came down HARD. My Adderall tolerance skyrocketed, upwards of 150 mg a day. I became obsessive to the point that I was ignoring my family and social duties, not to mention the effects chronic amphetamine use does to one's health. After running out of my prescription early one month and not being to find more through my little network of others who shared the same vices, I remembered how the use of the OTC cough medicine dextromethorphan paused or even *GASP* REDUCED the tolerance and withdrawal of amphetamine and opioids. So in my desperate state to remain energetic and productive at my job in spite of going through amphetamine withdrawal, I purchased DXM cough gels and caffeine and ephedrine pills to get me through this hump and maybe even come out on top! Well, that didn't end well.

The job I had at the time was rather physical and consisted of packing heavy building supply materials into boxes for 12 hours every night, sometimes clocking in over 70 hours a week. It was hot, dirty, stressful and at times, utterly exhausting. Adderall was the perfect drug for this job, and not having Adderall was detrimental. Unfortunately, there's no other substance quite like amphetamine. After trying my DXM/caffeine/ephedrine combination for a few days on top of taking fluoxetine religiously and trying various "energy" supplements (L-Tyrosine, B vitamins, etc.), I ended up in the ER with severe akathisia, a throbbing migraine, and the worst feelings of depression and hopelessness I've ever experienced. After a few shots of Ativan and (clozapine? clonidine? memory is fuzzy) and a therapist asking me in my sobbing, miserable state if I felt like hurting myself or anyone else, I was released with a pat on the back and a prescription for hydroxyzine. So, yeah. That was the time I learned about how serotonergics, OTC or not, are NOT to be toyed with, especially in conjunction with potent noradrenergics and a drug that blocks up a slew of liver enzymes such as fluoxetine.

To make a long, tedious story short, going through cycles of amphetamine and opioid withdrawals is what triggered the anhedonia that's been nagging me off and on for over a year now. I still take fluoxetine 20 mg because it helps so much with my IBS and somewhat with my anxiety, and Adderall 20 mg, cycled throughout the month to keep my tolerance at a decent level, and Neurontin 300 mg as needed to help stabilize my mood and further help with anxiety. But to be perfectly sincere, I think the thing that helps most in feeling like a regular, emotional, driven human being is to eat well, get out in the sunlight, and try not to FORCE your feelings, or lack thereof. When I had my weight-lifting phase for a couple years before starting fluoxetine, I learned an immense amount about nutrition and supplements. I applied that knowledge to my struggles with mental health and found that adequate mineral intake (Mg, Na, K, Ca) is ESSENTIAL, B vitamins are overrated and caffeine can be your best friend OR your worst enemy, depending on your condition. I've tried so many different medications and supplements, only to feel my best physically AND mentally when I eat good, natural food and keep as active as possible, as cliché as it sounds.

I have more experiences I can share also, regarding combinations of different drugs and/or supplements. These are most of the medications and supplements I've taken, feel free to reply to this or pm me with questions or comments.

Fluoxetine

Lexapro

Adderall, IR and XR

Vyvanse

Methylphenidate, IR and ER

Strattera

Neurontin

Klonopin

Xanax

Ativan

Clonidine

Hydroxyzine

Hydrocodone

Oxycodone, IR and ER

Methadone

Hydromorphone

Tramadol

Dextromethorphan

Ephedrine

Supplements-

MultiVitamins

Fish Oil

ZMA (Zinc/Magnesium)

L-Theanine

L-Tyrosine

B Complex

Ashwaghanda

Passion Flower

Valerian Root

Melatonin

Choline

Butterbur

Edited by Analogy
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******* had it, escitalopram 10 mg. All I do is sleep and when I wake up I have severe anxiety. Ive survived thanks to some leftover clonazepam. I'll switch it to alcohol soon. Dont like it increasing dopamine though but maybe I can get cocky enough with that to change something in this "life".

I've ordered fluoxetine, Sarcosine wont probably see the light of day.

I'll augment escitalopram with 2.5 mg fluoxetine as I suspect problemreceptor now is HT-2c. Eventually other SSRI downregulate it but everykind of s***drug increasing Serotonin is also increasing cortisol. Why would anyone want to increase cortisol if you have anxiety?

Agomelatine seems tempting at this moment theoretically, And in hindsight, why would anyone want to downregulate HT-2a even more at this rate..

At least I could enjoy music somewhat before gods mistake Mirtazapine.

Thanks Ger and Analogy and welcome to this thread.

Edited by General_Failure
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Thanks, GF. I tried escitalopram a few months back after tapering off fluoxetine for a month. It made me a nervous, emotional wreck. I was disappointed because I had heard great things about it. I was starting a new job at the same time, so that definitely didn't help things. But it did give me insight that serotonin isn't the only issue. I actually have a script for ondansetron, I've been meaning to try it next time I have issues.

That was my theory, that either the 5ht3 receptors were upregulated too much due to a childhood of poor nutrition, and fluoxetine helped to block those, or that it simply downregulated those receptors over time. But I was also prescribed anticholinergics, and had a theory about high aCh receptor density playing a role due to the fact that aCh modulates the release of catecholamines from the adrenal medula, which is why I felt so relaxed and un-tense on opioids, seeing as they also act as anticholinergics.

Acetylcholine is associated with memory formation and recall. All of the posters in this thread seem to be highly intelligent and intuitive people. Who knows, maybe the next set of antidepressants will work on the aCh system, and iirc, Wellbutrin is a nicotinic aCh receptor antagonist.

I've spent the last couple years self-diagnosing and researching, trying different drugs, supps, and combinations, and have burnt myself out on it. For now, staying properly hydrated and eating well, and keeping as active as possible are my main goals.

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A few more points to contribute, in relation to NMDA antagonists and glutamate/stress response in general. Dextromethorphan, ketamine and other NMDA antagonists are recommended for treatment-resistant depression, and from what I understand and have read and experienced, the NMDAR is responsible for the formation of memories in the hippocampus, so in theory, applying NMDA antagonists makes the brain, and the person, "forget" that they are depressed, anxious, or dependent on certain substances.

A close family member died from Alzheimer's, so this subject interests me a great deal. Over-activation of the hippocampal glutamate receptors due to long-term stress is thought to contribute to Alzheimer's, but treating it with an NMDA antagonist seems like "too little, too late". More importantly, the amyloid-beta peptide is the major contributor of Alzheimer's, and leads to excito-toxicity and inflammation of the brain. Interestingly enough, melatonin inhibits the aggregation of amyloid-beta. The OP of this thread noted that his anhedonia symptoms were reduced by sleeping after periods of extended wakefulness, so is it possible that a large influx of melatonin helps to reduce brain inflammation, and therefore depressive symptoms?

The hypothalamus is interesting to me, seeing how it controls body heat, circadian rhythm, appetite, GI stimulation, amongst other functions. I feel like I've always had an overactive hypothalamus, due to having a large appetite, always feeling hot, over-stimulation of the GI, etc. The hypothalamus lacks an effective blood-brain barrier, making it more susceptible to neuro-toxins in the bloodstream. This leads me back to my current post about eating well, staying hydrated and getting plenty of sunlight to help with depression and anhedonia. So maybe depression/anxiety/anhedonia is really just a SYMPTOM of pathogens, toxins and inflammation in the body, and individuals with compromised BBB's are more at-risk.

After looking at the connection between serotonin and the HPA axis, I found that serotonin activates the HPA axis through the 5ht2c receptor. This would help to explain why fluoxetine helps with my IBS-D, and why some SSRI's can induce an anhedonic state through over-activation of the HPA axis.

http://www.jneurosci.org/content/27/26/6956.abstract

Edited by Analogy
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I dont think that ssris induce anhedonia through hpa axis over activation at all via 5ht2c. More often than not ssris are anxiolytic. Ssri can sometimes induce anxiety with 5ht2c activation in the begining, but this is usually short lived and last no more than 2-3 weeks. I think ssri anhedonia has way more to do with 5ht2a downregulation which happens over time. When i was on paxil, i had almost no anxiety, yet the anhedonia kept getting bigger and bigger months after months. It seems that any drug that effect 5ht2a has the capacity of inducing anhedonia. 5ht2c may play a role too there but its more likely 5ht2a.

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Yeah, I also still suspect HT-2a antagonism evidenced specially by usage of Mirtazapine. Antagonism of HT-2a also seems to reduce dopamine(release?). The reason I mentioned HT-2c was due to the increased anxiety of escitalopram. An anxiety I didn't recall from Fluoxetine which has a HT-2c antagonism. I've waited for the "anxiolytic" effect of escitalopram 10 mg for 2 weeks now and the only thing it has given is increased anxiety. And yet again even though downregulation of HT-2c may decrease anxiety why the **** would anyone want to increase cortisollevels to archieve that? Increasing cortisollevels may help for atypical depression though.

If one wants to try something before for Ethanol or benzodiazepine for anxiety then maybe Agomelatine may be reasonable or so to give bigpharmas a welldeserved shaft (servier hellas in this case) perhaps combine low dose Fluoxetine (2.5) with Melatonine.

I'll try to get of my Doc from his powertrip which he is in due to depriving me of my Clonazepam. If that doesn't happen I'll let everyone know his sadistic policies turned me into an alcoholic.

Sure there's some room for being rational. I could keep on taking 10 mg escitalopram and use ethanol for 1-2 weeks and see if that HT-2c receptor has been knocked out. I could also lower escitalopram to 5 mg and wait for the Fluoxetine shipment and try adding 2.5 mg fluoxetine to escitalopram and then increase escitalopram. Another option is to wait for my slow doc to augment escitalopram with Agomelatine but knowing him he finds another stupid reason for not doing that like he did with MAO-I Inhibitors.

Trying to get along with 10 mg escitalopram definitely won't help anhedonia (if there's any HT-2aR left after Mirtazapine + Clomipramine ) though.

Edited by General_Failure
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Well 2 weeks is still early. Ssris suposedly takes 4-6weeks to work. I guess if this anxiety is still there after 5-6 weeks its useless to keep on taking it. Doc should really be willing to prescribe benzo in the early stage of ssris. Also as you said, ssri will definetely downregulate 5ht2a over time. Thats what they all do.

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I guess a good strategy for anhedonia/anxiety would be 5ht2c antagonism/downregulation and 5ht2a upregulation. Unfortunately there isnt much strategies available to upregulate 5ht2a. Even for ect, ive seen reports saying it upregulate 5ht2a and others that say it downregulate it. In any cases, ect seems like a drastic solution that has absolutely no guarantee to work and who knows what the hell it can do to your brain. Ect is like playing russian roulette, tho for some it may be their last chance.

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A lot of this also depend on specific brain regains, since agonizing 5ht2c receptors in the hypothalamus seems to have an anxiogenic effect, and agonizing 5ht2c receptors in the ventral tagamental area decreases the firing rate of dopaminergic neurons. Fluoxetine antagonizes 5ht2c in lower doses, which is why it's properly referred to as the most stimulating antidepressant. Here's a good read on these specific sites-

http://books.google.com/books?id=6q1WjjDsS7QC&pg=PA447&lpg=PA447&dq=accumbens+5ht2c&source=bl&ots=99BmXo0OyG&sig=2jXB_SMYdFu_9Y5Lg39UWKEPKQY&hl=en&sa=X&ei=17TGU8y7JZKkyATi8ICoBw&ved=0CEMQ6AEwBg#v=onepage&q=accumbens%205ht2c&f=false

Seems like even 5ht3 receptor antagonists can attenuate dopamine release in the NA.

Edited by Analogy
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My adderall dosage has made me anxious lately, racing thoughts and overstimulation as opposed to increased focus and motivation. Took .5 mg of xanax today soon after my adderall dose this morning to see if it would help the anxiety without compromising the beneficial aspects of adderall, but instead it made me disintered, unmotivated and lethargic. Gaba is inhibitory on most brain regions to dopamine release, and I've always felt like this with xanax and klonopin. Could SSRI's induce an increased release of gaba to balance out the increase of monoamines, thereby causing or contributing to anhedonic symptoms? I haven't studied much into the gabaergic system's effect on monoamine release, but they certainly induce a flat and bored feeling in me.

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Well i think no one react the same. Some people can get high on benzos. Everyone react differently. But i guess usually benzo dont make people more interested in stuff, it just relax you and make you a little dumber. There is no doubt that 5ht2c is considered a bad receptor, whether for anhedonia or anxiety. Probably only obese people would enjoy having their 5ht2c receptors agonized since it reduce eating considerably. However the key to empathy and emotions imo is 5ht2a.

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I remember on my only m€scaline experience years ago, i was walking outside and saw a little girl riding a bike with her dad. I saw her and i could feel what she was feeling. She seemed to be very happy to be there with her dad. I did smile at her and she smiled back at me. She seemed to be in a similar open state as i was. It seems most kids are naturally like that, very open what is happening in the world, fueled with empathy and connectedness. I guess anhedonia is the complete opposite of being a kid. You become completely closed from the world and your own self. I remember being a kid i was so carefree and everything seemed to be magic and meaningful. Why did i had to grow up damn :-(

Main reason i believe that the biochemical root of anhedonia is 5ht2a and not low dopamine is that no amphetamine/meth/coca!ne or any dopamine drug will make you feel that empathy/meaningful feeling. They may give you more energy or will power but if anything they are more likely to turn you into an ego centered @sshole. True will power comes from the soul and anhedonia just crush your soul.

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I'm going the endocrine route right now and just had all this tested...


Cortisol

Dehydroepiandrosterone (DHEA) Sulfate

Estradiol

Follicle-stimulating Hormone (FSH) and Luteinizing Hormone (LH)

Growth Hormone, Serum

Hemoglobin (Hgb) A1c

Insulin

Insulin-like Growth Factor 1 (IGF-1)

Progesterone

Prolactin

Prostate-specific Antigen (PSA), Serum

Testosterone, Free and Total

Thyroid-stimulating Hormone (TSH)

Thyroxine (T4), Free, Direct, Serum

Vitamin D, 25-Hydroxy


It will be 3-4 days for results.

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Ackording to Essential Psychopharmacologhy Rev 3 an 4(Stephen M Stahl) the thing with HT-2c antagonism is increasing norepinephrine and dopamine in prefrontal cortex by some sort of detaching of GABAinterneurons from the serotoninterminals. So supposely HT-stimulation would activate GABA indirectly however people seems to get anxiety if anything at the beginning of SSRIinsertion. Maybe HT->GABA "rule" doesn't apply everywhere, maybe inhibitation of some circuits causes anxiety but as benzodiazepine has a relaxing effect for most people the increase of cortisol by serotoninincrease could be suspected. Maybe a combination. Smoking grass seems to increase cortisole but I guess yet feels calming for most.

Yeah I believe one could expect some kind of weak numbing GABAeffect from SSRI in the limbicsystem if not the blunting is from HT-2c antagonism activating prefrontal cortex so it gets "better" control over amygdala. Former is more likely (can't of course exclude combinations) as it didn't "work" here or at most very very slightly with Mirtazapine or Clomipramine here, even taken together.

Which in turns probably would mean something nonserotinergic like Agomelatine probably won't work for me if there's not any other magic involved. But other less amygdaloidchallenged may have better luck ofcourse.

Edited by General_Failure
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