15 replies to this topic

[Answers]

I have been suffering from anhedonia for 5 years now but last year something strange happened.

 

For some reason when I stopped taking amitriptyline last summer, I began to see a noticeable reduction in my anhedonia and could actually enjoy a tv show and feel emotions again. I would rate it roughly at 70-80% remission.

 

Does anyone know why this may have happened? Obviously it seems to have triggered some downstream effect in my brain, but by learning what mechanisms may have been involved here, I can hopefully get closer to beating this dreadful condition.

 

At the time I believe I was taking fish oil and CDP choline, but I have been taking those supplements together since with no reduction in my anhedonia whatsoever.

 

Any ideas?

 

Also on an unrelated note, how could I go about reversing some of the anticholinergic effects from tricyclics?  I was on a high dose of ami for 2 years before going on nortriptyline. I have since ceased that but my memory is still poor. The last few years of my life seem a bit of a blur.

[Junipersun]

Serotonin reuptake inhibition downregulates dopamine downstream. That effect reversed once you stopped your med, which results in less anhedonia. I get the same effect every time I stop SSRis. 

Edited by Junipersun, 13 June 2018 - 11:44 AM.

[Answers]

But stopping fluoxetine never gave me an anti-anhedonic effect, only amitriptyline. I should mention that fluoxetine is what caused my anhedonia in the first place, so naturally you'd assume ceasing that would of provided some degree of relief, but it didn't.

 

 

[Junipersun]

But stopping fluoxetine never gave me an anti-anhedonic effect, only amitriptyline. I should mention that fluoxetine is what caused my anhedonia in the first place, so naturally you'd assume ceasing that would of provided some degree of relief, but it didn't.

 

The reason for that might be the crazy long half-life of fluoxetine compared to amitriptyline.

Edited by Junipersun, 13 June 2018 - 12:47 PM.

[Icarus7]

I took amitrypatline for 2 years for mTBI headaches and sleep problems.  It worked really well.  I was off it for about 2 years and when I attempted to restart, it gave me horrible fog.  

I was just doing some research the other day which stated "amitriptyline can also block the effects of a chemical known as acetylcholine,"  

 

It's definitely a anticholinergic drug so maybe that's it wasn't effective the second time around for me as my levels were depleted. Trying a choline source from either CDP-choline or Alpha-GPC might make sense.  

[ryukenden]

But stopping fluoxetine never gave me an anti-anhedonic effect, only amitriptyline. I should mention that fluoxetine is what caused my anhedonia in the first place, so naturally you'd assume ceasing that would of provided some degree of relief, but it didn't.

Anhedonia is one of the symptoms of clinical depression and Fluoxetine may help by lifting your mood rather than causing it. Why do you take Fluoxetine? Depression or OCD or anxiety?

[Answers]

I took amitrypatline for 2 years for mTBI headaches and sleep problems.  It worked really well.  I was off it for about 2 years and when I attempted to restart, it gave me horrible fog.  

I was just doing some research the other day which stated "amitriptyline can also block the effects of a chemical known as acetylcholine,"  

 

It's definitely a anticholinergic drug so maybe that's it wasn't effective the second time around for me as my levels were depleted. Trying a choline source from either CDP-choline or Alpha-GPC might make sense. 

 

Yeah , it definitely has a strong anticholinergic effect. I have been taking CDP choline but it has not improved my memory at all unfortunately.

 

It seems like for some people drugs don't work so well the second time around. No idea why. Prozac never worked for me again , although I blame it for giving me anhedonia in the first place. My psychiatrist suggested I tried it again.

[Answers]

Anhedonia is one of the symptoms of clinical depression and Fluoxetine may help by lifting your mood rather than causing it. Why do you take Fluoxetine? Depression or OCD or anxiety?

 

I took fluoxetine for depression from 2011-2013. Prior to summer 2013 I had full emotions and could still enjoy things. I lay the blame for my anhedonia squarely at prozacs door.

 

SSRI'S have caused anhedonia in a great number of people and I am not alone.

[ryukenden]

I took fluoxetine for depression from 2011-2013. Prior to summer 2013 I had full emotions and could still enjoy things. I lay the blame for my anhedonia squarely at prozacs door.

SSRI'S have caused anhedonia in a great number of people and I am not alone.

Okay, it may happen. Many psychotropic medications can cause a wide range of side effects. It depends upon the individual.

[MeM]

I also had windows of pleasure when making tapers down from cymbalta, and there is someone on survivingantidepressants who has described the same thing. I agree there is something to this. It definitely shows that the anhedonia/emotionless thing can turn on and off on a dime.

[MankindRising]

I also had windows of pleasure when making tapers down from cymbalta, and there is someone on survivingantidepressants who has described the same thing. I agree there is something to this. It definitely shows that the anhedonia/emotionless thing can turn on and off on a dime.

Its more down to a change in serotoninergic tone/receptor sensitivity rather than a dopaminergic mechanism (though its obvious that serotonin can act like a breakes on the dopaminergic system).

Think the take away from all of this is that no matter what dopaminergic drugs people might feed themselves as long as the hyperserotoninergic state either genetically or induced by ssri's (which are known to cause permanent alterations in serotoninergic systems in some) is present then dopamine (and the reward system) cant function like it should.

[John250]

Correct me if I’m wrong but Anhedonia will only occur if you are lacking a specific neurotransmitter(mainly dopamine or Serotonin) long term ssri’s can deplete Serotonin only when “coming off” correct? Perhaps a lot of Anhedonia during ssri use is due to dopamine depletion(when Serotonin increases Dopamine decreases)?

[Meggo]

It's the histamine sensitization. Pitolisant would be an option.

[MeM]

@meggo can you explain more about this?

[Answers]

It's the histamine sensitization. Pitolisant would be an option.

 

Can you elaborate please?

[Answers]

I have been thinking and believe the reason may be some form of cholinergic rebound. The time frame with my emotional numbness adds up with going on amitriptyline. It has very high anticholinergic properties as we all know. Perhaps stopping it abruptly has some sort of knock on pro cholinergic effect.

 

Also pro cholinergic agents seem to be helping some people with anhedonia on other forums. And I have noticed that many who have ECT without galantamine do not experience remission. Those who have taken it did attain remission. There is evidence to support that galantamine may enhance the antidepressant effects of ECT here, as well as protecting cognition.  But it isn't enough and its effects on anhedonia have not been studied. https://www.ncbi.nlm...pubmed/17681545
 

I plan to try it soon, after bethanechol.