6 replies to this topic

[kingj24]

I now believe what I'm suffering from is Anhedonia and not true ADD. I've tried every ADD medication out there besides Dex AMP and none have worked. I also suffer from positive and negative symptoms of some form of psychosis and comorbid OCD. The positives would be (Hallucinations/Delusions) the negatives would be anhedonia which is the inability to experience pleasure from activities usually found enjoyable, e.g. exercise, hobbies, sexual activities or social interactions. (wikipedia). I'm currently on 4mg of Risperdal 40mg of Prozac and .25mg of Clonazepam. Now I know both Risperdal and Prozac can make anhedonia worse but I need Risperdal for a form of psychosis and Prozac for depression. Plus I've been experiencing anhedonia way before I was put on any type of medicine so it can't be Prozac or Risperdal induced (the medicine might make it worse but it still wasn't started by them).

Here's how I would explain my anhedonia as a kid I could sit somewhere for hours an play a video game,read a book etc... but now a days I just can't do it. I recently downloaded the Hunger Games and can't even get past chapter 3 without losing interest or becoming extremely bored or when it comes to a video game I can't sit there for more then an hour or two without going on to something else. That's what anhedonia is, the inability to experience pleasure from activities once/usually found enjoyable. Now I don't want to get anyone confused ADD and anhedonia are different disorders but look alike on paper. For years I've been misdiagnosing myself with ADD when it truly was/is anhedonia.

You see someone explained it to me quite well ADD people crave stimulation and have trouble sitting still (I know not all people with ADD have trouble sitting still) while people with anhedonia can and usually do hallucinate become delusional etc.. (They usually suffer some form of psychosis). I would venture to say 90-99% of people with ADD don't suffer from any form of psychosis. Anhedonia to me is the inability to 'feel' dopamine (pleasure,reward). While ADD is a general lack of dopamine. I think people with ADD still feel the pleasure/reward it's just takes more dopamine stimulation to 'feel' it.

Now that I've explained all this can someone help me out with how to treat anhedonia? I've already tried Abilify and it didn't cut it for either the positive symptoms or negative ones. I've tried every stim out there besides dex-AMP and none have worked for the anhedonia but they didn't make my positive symptoms any worse. I was originally put on 6mg of Risperdal but the motor side effects were to great so I was bumped down to 4mg and during that 1 day process the feeling of dopamine came back the side effects went away but the next day I returned to the regular old me anhedonia in full swing. So what can be done to treat this? Fish oil @360mg EPA and DHA 240 3x a day helped years ago before I was put on any medication but now I believe the effects are being blocked by the Risperdal.

Originally posted @ADDForums.com

Edited by kingj24, 27 March 2012 - 07:58 PM.

[jadamgo]

Wow, I'm sorry you're going through such a rough time, especially not finding any medications to help. I've experienced anhedonia from mild to severe intensities due to major depressive disorder, but I've never had psychosis so I can't comment with personal experience on psychosis. Nonetheless, I can make some suggestions based on research into anhedonia.

Number one recommendation: if you can tolerate the side effects and afford the blood tests, try clozapine instead of risperdal. It's the only antipsychotic currently shown to improve negative symptoms that other antipsychotics have failed to treat.

Does the prozac help you with the obsessive/compulsive symptoms? If so, great. But if not, you could try Effexor XR, or one of the MAOIs to treat those symptoms. They stand a greater chance of improving the anhedonia, as they are stronger antidepressants. The SSRIs simply aren't your friends when it comes to anhedonia, at least not if the anhedonia is caused by something other than standard depression/anxiety.

Long term use of benzos like Clonazepam can cause depression, which of course causes anhedonia. But 0.25mg isn't that high of a dose, so you'll probably do fine as long as you don't escalate the dose without doctor's permission.

You could look into the 4 main racetam drugs to improve anhedonia, but there's no guarantee any of them will work. Only anecdotal reports.

If you keep up a regular exercise routine, you may experience less anhedonia. The same could apply to using bright light treatment.

Lastly, have you looked into CBT for Psychosis? It's a pretty new treatment and most doctors and patients still haven't heard of it. Ever since the mid 20th century, everyone assumed it was impossible for a psychotherapy to help psychotic people. But that's just because psychoanalysis failed. Good old Aaron Beck has been working on a modern psychological therapy for psychoses for about 15 years (I think), and it's a huge hit. In the UK, there are multi-year-long queues of people waiting to get CBT-P because everyone wants it, but they don't have enough therapists there. If you live in the US, it may be easier to find someone who knows about CBT-P. Most people who receive CBT-P say it was life-changing because they don't have to take as much antipsychotic medication anymore, so they don't have to put up with so many side effects.

So if you get CBT-P, you may be able to reduce your Risperdal dosage even further, which gives a great chance of knocking out the anhedonia.

[Byllie]

l-tyrosine.

Only taken it for a few hours but working a treat already

[medievil]

Id replace risperdal with somethi

ng else for positive symptio

ns a

nd add i

n dex amphetami

ne wich will work; i used to be i

n the same boat; shizo a

nd most thi

ngs that should work for a

nhedo

nia did

nt do shit; thats because shizo's ca

nt really feel MU i

nduced reward but o

nly glutamate i

nduced reward.

Jeezes chris why does the layout allways fuck up

Edited by medievil, 14 April 2012 - 08:29 PM.

[hippocampus]

don't worry, it looks like (post)modern poetry.

[nupi]

Effexor sounds like a patently silly idea to treat anhedonia. Yes, it's a potent anti depressant (potentially saved my life back when I took it) but mainly it just flatlines your emotions on a comfortable level, quite the opposite of what you would want for anhedonia. And it has a nasty side effect profile (although s has Prozac from what I understand).

I am starting to believe anhedonia is largely a dopamine thing but then, you have already tried just about all common dopamine agonists for ADD so maybe in your case a MAOI would be worth a shot

[hippocampus]

maybe turmeric with black pepper (or curcumin with piperine) would help.