Stimulants help with depression?

[ln009]

Does anyone find that stimulants are helpful in treating depression? Is is only in the short-term or can you take them long-term?

Does anyone do stimulant monotherapy or do you take the stimulant in addition to other meds?

Thank you!!

[sming]

I'm not going to talk about the current data on this. I'm going to talk about my own extensive experience with using methylphenidate-based and amphetaminergic meds to treat my decades-long severely Treatment Resistant Depression.

In a nutshell, the four Adderall doses I take every day afford me brief glimpses of feeling "normal". I briefly want to do things, care about things and feel mostly human basically. Other than those periods, I desperately want to be dead.

And before everyone jumps on the "stimulants are short term, this won't last" wagon, I've been taking this amount of Adderall for over a year. Yes, it is hugely less effective (for my depression) than when first prescribed, but it's still literally invaluable to me for the aforementioned reasons.

I cannot convey how important stimulants are to me in my fight against TRD.

FTR my regimen is Lexapro, Rexulti, Abilify, Trazodone, Buspar, Adderall.

Pete

( X-post from http://dr-bob.org/babble/20190728/msgs/1105693.html )

[Ion]

I haven't used them personally. I included them in a list of possibilities in conversation with my pdoc and he said he never prescribes them as an adjunct for MDD. From my reading, not all pdocs share that stance. Stimulants do get included in some treatment guidelines as a (roughly) third-line adjunct treatment. The research I looked at had fairly mixed results, but I was running low on better options, so I wanted to consider it

[notloki]

Stimulants are sometimes used in cocktails that are overly sedating. I feel amphetamine in my cocktail helps my MDD. Back when MAOI's were used commonly, amphetamine was often added to it as an augmenter.

[ln009]

Thank you for your feedback everyone :)

[mikl_pls]

I don't think I could survive without my stimulant to be honest. The past year and a half I've been on Dexedrine 60 mg has been one of the best years I've had in a long, long time. It is probably one of the main meds that really helps both my ADHD, mood, and motivation. I did kinda crash in February and my pdoc and I are still trying to get my cocktail right (may just found the right combination for now).

[Iceberg]

On 8/11/2019 at 3:49 PM, ln009 said:

Does anyone find that stimulants are helpful in treating depression? Is is only in the short-term or can you take them long-term?

Does anyone do stimulant monotherapy or do you take the stimulant in addition to other meds?

Thank you!!

They help me with motivation and focusing despite my depressive symptoms as well as countering sedation from from other meds. I’ve never heard of stim monotherpy for depression though 

[ln009]

Thank you, I appreciate everyone's replies!

[sming]

On 8/12/2019 at 3:11 PM, notloki said:

Stimulants are sometimes used in cocktails that are overly sedating. I feel amphetamine in my cocktail helps my MDD. Back when MAOI's were used commonly, amphetamine was often added to it as an augmenter.

Nardil + Ritalin and Nardil + Adderall were the best combos I've ever been on, and that's saying something. I felt Normal, energetic, ready to tackle the day, could think laterally, was resilient to failure, robust, interpersonal, witty. It was an amazing period. Then my PDoc got cold feet and stopped prescribing the stimulant and I descended back into hell.

[mikl_pls]

11 hours ago, sming said:

Nardil + Ritalin and Nardil + Adderall were the best combos I've ever been on, and that's saying something. I felt Normal, energetic, ready to tackle the day, could think laterally, was resilient to failure, robust, interpersonal, witty. It was an amazing period. Then my PDoc got cold feet and stopped prescribing the stimulant and I descended back into hell.

Same with me for Parnate + Adderall, but it didn't last long. I was initially on Parnate 20 mg, and after a few months it kinda lost its potency, so my pdoc took me off of Adderall and grudgingly moved me up to Parnate 40 mg (without stimulant), and I crashed through the floor.

[ln009]

18 hours ago, sming said:

Nardil + Ritalin and Nardil + Adderall were the best combos I've ever been on, and that's saying something. I felt Normal, energetic, ready to tackle the day, could think laterally, was resilient to failure, robust, interpersonal, witty. It was an amazing period. Then my PDoc got cold feet and stopped prescribing the stimulant and I descended back into hell.

I'm really sorry to hear that. I hope you have some choices to potentially help.

7 hours ago, mikl_pls said:

Same with me for Parnate + Adderall, but it didn't last long. I was initially on Parnate 20 mg, and after a few months it kinda lost its potency, so my pdoc took me off of Adderall and grudgingly moved me up to Parnate 40 mg (without stimulant), and I crashed through the floor.

I'm sorry. I hope for all of us we can find some answers.

[sming]

19 hours ago, ln009 said:

I'm really sorry to hear that. I hope you have some choices to potentially help.

Thank you, that's kind of you to say. I hear tomorrow whether I'm suitable for VNS, which is about the only thing I've got left to try. 

Edited August 15, 2019 by sming

[ln009]

I wish you the best...please keep us posted.

[sming]

 

On 8/15/2019 at 2:53 PM, ln009 said:

I wish you the best...please keep us posted.

A bit tardy, but here's my update. The TRD squad at Mount Sinai, NYC said I had to try Ketamine first. Cue huge insurance faff w.r.t. esketamine that lasted weeks, end result being I had to switch to infusions. I've done the 4 "foundational" infusions and despite the profound, amazing experiences, am no better. Hence the TRD squad are to cogitate this Thursday w.r.t. VNS/DBS. Please cross your proverbials for me.

Pete

[sming]

Update #2: I tried Ketamine and whilst it was an amazing experience, it did absolutely nothing. Now the TRD squad are insisting I try an SCS device (for my chronic pain) before I try DBS ¯\_(- -)_/¯  I am gutted about this because my depression is much more incapacitating and devastating than my chronic pain is, and if the SCS device works, I won't be able to get DBS  

Edited January 11, 2020 by sming

[Blahblah]

29 minutes ago, sming said:

Update #2: I tried Ketamine and whilst it was an amazing experience, it did absolutely nothing. Now the TRD squad are insisting I try an SCS device (for my chronic pain) before I try DBS ¯\_(- -)_/¯  I am gutted about this because my depression is much more incapacitating and devastating than my chronic pain is, and if the SCS device works, I won't be able to get DBS  

hey @sming do you know what the official criteria is for TRD? Does this mean that you have had zero benefit from most meds, and it's severe depression that does not let up (even a few days?) Doctors I've met seem to think a person must be completely incapacitated (i.e. not able to work/function) and have no response to any treatments, in order to be treatment-resistant

Edited January 11, 2020 by Blahblah

[sming]

@Blahblah Off the top of my head, I do not. My doctors have no problem describing me as TRD when I show them the list of some 70+ medications and treatments that have failed me!

OTOH they are generally puzzled that I'm able to hold down a job. As am I, TBH. I'm astonished I haven't been fired more often (3 times so far). I also have kids which confounds doctors somewhat. Having kids, whilst I dearly love them (when able to), in the cold hard light of day, was probably a big mistake.

Pete

Edited January 11, 2020 by sming

[Blahblah]

3 minutes ago, sming said:

@Blahblah Off the top of my head, I do not. My doctors have no problem describing me as TRD when I show them the list of some 70+ medications and treatments that have failed me!

OTOH they are generally puzzled that I'm able to hold down a job. As am I, TBH. I'm astonished I haven't been fired more often (3 times so far). I also have kids which confounds doctors somewhat. Having kids, whilst I dearly love them (when able to), in the cold hard light of day, was probably a big mistake.

Pete

Just curious, what are the residual symptoms you deal with? Is it more apathy / anhedonia or more severe, labile, compulsive, suicidal ideation episodes?

[sming]

6 minutes ago, Blahblah said:

Just curious, what are the residual symptoms you deal with? Is it more apathy / anhedonia or more severe, labile, compulsive, suicidal ideation episodes?

Sure. It's both. Every day, precisely as my Adderall wears off, deep & powerful feelings of worthlessness and emptiness fill me - until my next dose. I also experience dysthymia, all-encompassing negative, distorted cognitions and beliefs, extreme anhedonia and "lack of energy" e.g. reaching for my glass of water feels like running a marathon.

When my meds are in transition for example, also add on top derealization, horrific feelings of terror, visions of terror, feelings of impending doom, visual darkness - the works.

From the little I know about you, you're somewhat on the same tracks (unfortunately) ?

PS - completely forgot to mention my TR pure OCD. The topic of my OCD is <drum roll>... the fear that I'll spontaneously kill myself if I allow myself to feel even slightly hurt or depressed. FFS.

Edited January 11, 2020 by sming

[Blahblah]

13 minutes ago, sming said:

Sure. It's both. Every day, precisely as my Adderall wears off, deep & powerful feelings of worthlessness and emptiness fill me - until my next dose. I also experience dysthymia, all-encompassing negative, distorted cognitions and beliefs, extreme anhedonia and "lack of energy" e.g. reaching for my glass of water feels like running a marathon.

When my meds are in transition for example, also add on top derealization, horrific feelings of terror, visions of terror, feelings of impending doom, visual darkness - the works.

From the little I know about you, you're somewhat on the same tracks (unfortunately) ?

PS - completely forgot to mention my TR pure OCD. The topic of my OCD is <drum roll>... the fear that I'll spontaneously kill myself if I allow myself to feel even slightly hurt or depressed. FFS.

Yikes. Yeah, I can relate to much of this. Do stimulant holidays help at all? I'm trying to power through a 2-month one....2.5 more weeks to go....

[ln009]

On 1/11/2020 at 3:42 PM, sming said:

Sure. It's both. Every day, precisely as my Adderall wears off, deep & powerful feelings of worthlessness and emptiness fill me - until my next dose. I also experience dysthymia, all-encompassing negative, distorted cognitions and beliefs, extreme anhedonia and "lack of energy" e.g. reaching for my glass of water feels like running a marathon.

When my meds are in transition for example, also add on top derealization, horrific feelings of terror, visions of terror, feelings of impending doom, visual darkness - the works.

From the little I know about you, you're somewhat on the same tracks (unfortunately) ?

PS - completely forgot to mention my TR pure OCD. The topic of my OCD is <drum roll>... the fear that I'll spontaneously kill myself if I allow myself to feel even slightly hurt or depressed. FFS.

Dear sming,

Sorry to jump in here...I noticed you mentioned the derealization, feelings of terror, impending doom, and visual symptoms. I have similar feelings of horror/terror, feeling like I can't accept my current reality or tolerate the way I'm feeling, impending doom, etc.  Do you happen to know what this set of symptoms is related to? It seems only a few of us experience this within depression. Do you think it's "just" depression, or is it depression plus something else? Could it be part of OCD? (I have that also.)

My pdocs look at me like I'm an alien when I try to describe these symptoms, and they've never been much help in explaining them.

Sorry again, and thanks!

 

[sming]

On 1/16/2020 at 1:08 PM, ln009 said:

Dear sming,

Sorry to jump in here...

no worries @ln009

Quote

I noticed you mentioned the derealization, feelings of terror, impending doom, and visual symptoms. I have similar feelings of horror/terror, feeling like I can't accept my current reality or tolerate the way I'm feeling, impending doom, etc. 

 wouldn't wish it on my worst enemy

Quote

Do you happen to know what this set of symptoms is related to? It seems only a few of us experience this within depression. Do you think it's "just" depression, or is it depression plus something else? Could it be part of OCD? (I have that also.)

I sometimes think it's part of PTSD (I went through a period where I thought I was going to top myself). Sometimes I think it's just my biological makeup. To answer - I'm just not sure and I wish I knew.

Quote

My pdocs look at me like I'm an alien when I try to describe these symptoms, and they've never been much help in explaining them.

Sorry again, and thanks!

It's almost impossible to explain to people. I also get funny looks and misinterpretations e.g. I'm psychotic or BPD (which I'm definitely not). If you ever find out what it is or how to describe it, let me know!

Edited January 17, 2020 by sming

[thebakerbunny]

On 1/17/2020 at 4:00 PM, sming said:

no worries @ln009

 wouldn't wish it on my worst enemy

I sometimes think it's part of PTSD (I went through a period where I thought I was going to top myself). Sometimes I think it's just my biological makeup. To answer - I'm just not sure and I wish I knew.

It's almost impossible to explain to people. I also get funny looks and misinterpretations e.g. I'm psychotic or BPD (which I'm definitely not). If you ever find out what it is or how to describe it, let me know!

I noticed immediately the crossover of those same feelings with OCD, and then later the mention of ptsd. I definitely suffer mdd, possibly bpd, definitely OCD and ptsd. The closest I can explain it is a spectrum running from hate of self, to hate of self expectations, to hate of people, to hate of other's expectations, to nihilistic endpoint. I'd say it also runs a line of passivity to activity for me. Passive ideation (I just don't want to BE anymore), to reactive ideation (how is this my life? Is this all my life? How much longer can i let this be my life?), to active ideation (I have to put an end to this pain). So may be it's all just the cycle of being so depressed, and needing control, without understanding any of the in-between.

[psychwardjesus]

Up to this point, I would say I was almost completely psychostimulant naïve, not even recreationally in college, or otherwise, and no non-pharceutical stimulant use either — no, cocaine, methamphetamine, etc. Closest to a stimulant I'd ever taken previously was modafinil (and it didn't do anything, even at 400mg), so I doubt that counts. 

Anyway, I had some hope for this medication, but was very overwhelmed overall. At doses up up 60mg BID, I felt like I had a bit more energy and maybe drank a little less coffee, but didn't notice anything else remarkable otherwise. I still take it now and then, usually 60mg, but only once a day. Still don't notice much of anything.  I'm almost a little bit curious to try a higher dose, 90mg or 120mg, just to see if I'd notice any difference and to finally put to bed, once and for all, the question of whether it just doesn't work or it's not at a high enough dose.

 

[JJ17]

On 5/13/2020 at 6:35 PM, psychwardjesus said:

Up to this point, I would say I was almost completely psychostimulant naïve, not even recreationally in college, or otherwise, and no non-pharceutical stimulant use either — no, cocaine, methamphetamine, etc. Closest to a stimulant I'd ever taken previously was modafinil (and it didn't do anything, even at 400mg), so I doubt that counts. 

Anyway, I had some hope for this medication, but was very overwhelmed overall. At doses up up 60mg BID, I felt like I had a bit more energy and maybe drank a little less coffee, but didn't notice anything else remarkable otherwise. I still take it now and then, usually 60mg, but only once a day. Still don't notice much of anything.  I'm almost a little bit curious to try a higher dose, 90mg or 120mg, just to see if I'd notice any difference and to finally put to bed, once and for all, the question of whether it just doesn't work or it's not at a high enough dose.

 

Wait, what? You have NEVER taken anything similar to Adderall before, and yet you are hardly feeling anything from up to 60mg?! Those meds have VERY potent effects on the dopamine system, and you felt almost nothing? Just drinking less coffee?

You should have had an immediate  response after a single dose or two. Having no response probably means your dopamine system is normal, so why take something to stimulate it (among many other things it stimulates) What are you even taking it for, ADHD or depression?
 

Going up on the dosage is a terrible idea from the info in your above post.

[psychwardjesus]

On 9/30/2020 at 3:04 AM, JJ17 said:

Wait, what? You have NEVER taken anything similar to Adderall before, and yet you are hardly feeling anything from up to 60mg?! Those meds have VERY potent effects on the dopamine system, and you felt almost nothing? Just drinking less coffee?

You should have had an immediate  response after a single dose or two. Having no response probably means your dopamine system is normal, so why take something to stimulate it (among many other things it stimulates) What are you even taking it for, ADHD or depression?
 

Going up on the dosage is a terrible idea from the info in your above post.

Yup. I'm sure it sounds very strange to people on here who take it and have a measurable, beneficial effect, but that's exactly what happened. But taken in context with everything else in my mental health history, it's also not terribly surprising for me as I, historically, have never gotten a robust response from medications other people might describe as energizing or stimulating — whether SSRI's, SNRI's, modafinil/armodafinil, etc. 

Yes, I was taking it off-label to see if it would work any of my symptoms of major depression — more specifically anhedonia. I didn't have high expectations that it would work or (even if it did work) be sustainable and a practical way to manage major depression. 

I don't know if I'm misreading your words or what, but you come across as a touch antagonistic bordering on hostile. You may want to look back at what you wrote and reflect. I don't know what I did to deserve such a response. I thought I was just sharing my personal experience and not providing any sort of actionable advice. Nevermind the fact that no one in their right mind should listen to anyone on the internet and not take whatever they're saying with a rock of Gibraltar size grain of salt. 

And for the record: is there inherent risk in taking amphetamines, especially increasingly higher doses of amphetamines? Yes. Absolutely. I wouldn't encourage anyone else to do it without guidance from their doctor, if ever. But I had my doctor's blessing to play with the dosage and scheduling, have never shown signs of any underlining bipolar or primary psychotic disorder and never known anyone in my family to suffer from either one of those, and they were one-time trial doses, which were unlikely to set off anything, even transient drug-induced mania or psychosis.

[JJ17]

On 10/8/2020 at 12:01 PM, psychwardjesus said:

Yup. I'm sure it sounds very strange to people on here who take it and have a measurable, beneficial effect, but that's exactly what happened. But taken in context with everything else in my mental health history, it's also not terribly surprising for me as I, historically, have never gotten a robust response from medications other people might describe as energizing or stimulating — whether SSRI's, SNRI's, modafinil/armodafinil, etc. 

Yes, I was taking it off-label to see if it would work any of my symptoms of major depression — more specifically anhedonia. I didn't have high expectations that it would work or (even if it did work) be sustainable and a practical way to manage major depression. 

I don't know if I'm misreading your words or what, but you come across as a touch antagonistic bordering on hostile. You may want to look back at what you wrote and reflect. I don't know what I did to deserve such a response. I thought I was just sharing my personal experience and not providing any sort of actionable advice. Nevermind the fact that no one in their right mind should listen to anyone on the internet and not take whatever they're saying with a rock of Gibraltar size grain of salt. 

And for the record: is there inherent risk in taking amphetamines, especially increasingly higher doses of amphetamines? Yes. Absolutely. I wouldn't encourage anyone else to do it without guidance from their doctor, if ever. But I had my doctor's blessing to play with the dosage and scheduling, have never shown signs of any underlining bipolar or primary psychotic disorder and never known anyone in my family to suffer from either one of those, and they were one-time trial doses, which were unlikely to set off anything, even transient drug-induced mania or psychosis.

I wasn’t trying to sound hostile, my bad,  I was just very surprised. Once you mentioned trying 90mg to 120mg (that’s way above the max daily dosage) I figured I had to ask. 

I actually have taken these meds for 11 years now - Adderall, Dexedrine, Ritalin, basically all the ADHD meds. Enough to basically DESTROY my entire dopamine system. 
Now I have a “milder” form of Anhedonia since I have stopped taking these meds, after 10 years or so. Zero motivation, hardly able to feel pleasure or happy, almost complete apathy. 
I did stop taking them cold turkey for 10+ months now and am STILL feeling worse. I might have to go back to taking them just to have motivation to do well......anything 

Also you don’t have to take my word for it but Dopamine has a strong connection to Anhedonia. That’s why I’m surprised you have little to no response from large doses. Unless dopamine reuptake inhibitors simply do not work for you. Or it’s probably something more complex, but still likely dopamine regulation is a key factor. Have you tried other meds that work on dopamine? Unfortunately taking anything long term carries it risks, even L DOPA supplement (direct precursor to dopamine mainly used for people with PD, a dopamine related disease) can have long term effects. It sucks 

Quote: “Anhedonia has been linked to dysfunctions in the reward system, and in particular the dopamine (DA) system” -Oxford university 

 

 

   

 

 

Edited October 14, 2020 by JJ17

[Blahblah]

6 hours ago, JJ17 said:

 

I actually have taken these meds for 11 years now - Adderall, Dexedrine, Ritalin, basically all the ADHD meds. Enough to basically DESTROY my entire dopamine system. 
Now I have a “milder” form of Anhedonia since I have stopped taking these meds, after 10 years or so. Zero motivation, hardly able to feel pleasure or happy, almost complete apathy. 

I did stop taking them cold turkey for 10+ months now and am STILL feeling worse. I might have to go back to taking them just to have motivation to do well......anything

Quote: “Anhedonia has been linked to dysfunctions in the reward system, and in particular the dopamine (DA) system” -Oxford university 

 

 

@JJ17 This is what scares me....Do you ever wish you had never started stimulants?

I've been taking ritalin for the last 3 years or so, in the beginning, it was a godsend. The only thing that put a dent in my depression & motivation, and with no side effects. I had tried all the SSRIs, SNRIs, A/Ps, etc with no benefit.

Then my tolerance went up, I tried taking long breaks & then re-starting. Now, effects are really inconsistent. Often it's like I've taken nothing. My apathy has grown MUCH worse.  I have unbearable fatigue despite sleeping 12 hours per day.

Sure, I can increase my dose, or start popping them every 3 hours, but what's the point, because it's diminishing returns!   I worry I'm "destroying" my dopamine system as well. Or it's already destroyed.  

I used to be able to feel pleasure from some things, now it's impossible..... It's Hell.

 

 

 

Edited October 14, 2020 by Blahblah

[JJ17]

18 hours ago, Blahblah said:

 

@JJ17 This is what scares me....Do you ever wish you had never started stimulants?

I've been taking ritalin for the last 3 years or so, in the beginning, it was a godsend. The only thing that put a dent in my depression & motivation, and with no side effects. I had tried all the SSRIs, SNRIs, A/Ps, etc with no benefit.

Then my tolerance went up, I tried taking long breaks & then re-starting. Now, effects are really inconsistent. Often it's like I've taken nothing. My apathy has grown MUCH worse.  I have unbearable fatigue despite sleeping 12 hours per day.

Sure, I can increase my dose, or start popping them every 3 hours, but what's the point, because it's diminishing returns!   I worry I'm "destroying" my dopamine system as well. Or it's already destroyed.  

I used to be able to feel pleasure from some things, now it's impossible..... It's Hell.

Wish I had never taken them. The tolerance is basically permanent along with your dopamine receptors getting desensitized more and more. So far I have tried taking L Dopa (sometimes) and recently started “wild green oat extract” which is an MAO B inhibitor (which involves breakdown of dopamine) but only felt results for a couple of days, then they went away. I will continue to try the “natural” MAO B inhibitor I am taking the min dose. I felt it super strong the first day but it faded. I also don’t like the idea of taking anything long term that involves the dopamine system. 

Tried Wellbutrin (after taking a tolerance break from Ritalin/adderall for many months) but the motivation/desire to do things only returned for a few days when on Wellbutrin, then it went back to feeling worse again. I continued to take the Wellbutrin but I continued to feel worse and worse and gave up after a month or two. Probably because my brain is desensitized and drained from the constant dopamine/NE reuptake. 

My tolerance is very low right now, so even a 5mg tablet would have a major effects on me. Previously I was on 20mg tablets, 3X daily but went off cold turkey for 8+ months. Not sure on exact date, but for basically all of 2020 that I have taken a full tolerance break.

I took Concerta 18mg (equal to 5mg Ritalin 3X daily) after taking this long T-break and it lasted for 5 hours or so before I felt it starting to wear off. I felt focused, motivated, and happy again. Well that is for about 5-8 hours or so. It definitely wasn’t 12 hours as my tolerance is still always there. Plus the crash and feeling worse after, just not worth it. If I go back to taking it I will simply rebuild my tolerance back eventually, and end up needing it more and more often. Not worth it. 

I just really don’t want to take these damn pills anymore and I have gone virtually all of 2020 without them.

^I also had one point where Adderall was starting to cause “reverse effects” after taking them for 2-3 years daily. This was when I was new to taking them and felt the burn-out around the same time you did/are. So instead of feeling focused, energized, motivated, happy, etc from the medication I would feel the opposite. I would feel drained and sick after taking them. My guess is my brain was completely desensitized to the meds, and for all I know it also messed up my adrenal glands and other related organs. Will eventually get them tested..... once I have enough motivation. I stopped taking them cold turkey for a long time (1-2 years?) and I haven’t had that problem since. Although simply taking a 1-2 years break isn’t possible when it helps depression. Yet you cannot take them daily either, so yeah...
If they could find a way to make these medication(s) work without causing a tolerance, then it would be a miracle. 

Edited October 15, 2020 by JJ17

[Blahblah]

5 hours ago, JJ17 said:

I just really don’t want to take these damn pills anymore and I have gone virtually all of 2020 without them.

^I also had one point where Adderall was starting to cause “reverse effects” after taking them for 2-3 years daily. This was when I was new to taking them and felt the burn-out around the same time you did/are. So instead of feeling focused, energized, motivated, happy, etc from the medication I would feel the opposite. I would feel drained and sick after taking them. 

My guess is my brain was completely desensitized to the meds, and for all I know it also messed up my adrenal glands and other related organs. Will eventually get them tested..... once I have enough motivation. I stopped taking them cold turkey for a long time (1-2 years?) and I haven’t had that problem since.

Although simply taking a 1-2 years break isn’t possible when it helps depression. Yet you cannot take them daily either, so yeah...
If they could find a way to make these medication(s) work without causing a tolerance, then it would be a miracle. 

 

Yes, I took a long break, but then when i re-instated, the effect is nothing like the first year I took them. Feels like a reverse effect! I have chronic fatigue now, and taking these damn meds just makes it worse. If I take instant release I crash harder, but if I take extended, it only lasts like 2 hours (versus 5) and then my energy crashes.

I'm in the same boat, it's the only med I initially felt REALLY helped my mood, motivation and cognition. Serotonin-based meds all give me brain fog and extreme apathy (to the point I'm numb, i stop caring about anything) Now I probably have adrenal fatigue, I take supplements/vitamins and I don't notice much benefit.

I often wonder if there is a way to "reset" your brain, like with ECT or something? Sounds extreme, but I'm sooooo sick of this med go round....They seem like temporary band-aids and then you get dependent on them, must keep increasing dose (despite the fact they are not even working properly). Then often, they poop-out and then you're back in the hospital, full on breakdown, back to square one and worse off than ever.

For me, i think meds are better episodically for 3-6 months,  but it's not a life long solution....

 

Edited October 15, 2020 by Blahblah

[notloki]

I take 90 mg/day and find a few days off them restores their potency. I have been taking amphetamine for over a decade and took ritalin as a child. 

[psychwardjesus]

On 10/13/2020 at 11:20 PM, JJ17 said:

I wasn’t trying to sound hostile, my bad,  I was just very surprised. Once you mentioned trying 90mg to 120mg (that’s way above the max daily dosage) I figured I had to ask. 

I actually have taken these meds for 11 years now - Adderall, Dexedrine, Ritalin, basically all the ADHD meds. Enough to basically DESTROY my entire dopamine system. 
Now I have a “milder” form of Anhedonia since I have stopped taking these meds, after 10 years or so. Zero motivation, hardly able to feel pleasure or happy, almost complete apathy. 
I did stop taking them cold turkey for 10+ months now and am STILL feeling worse. I might have to go back to taking them just to have motivation to do well......anything 

Also you don’t have to take my word for it but Dopamine has a strong connection to Anhedonia. That’s why I’m surprised you have little to no response from large doses. Unless dopamine reuptake inhibitors simply do not work for you. Or it’s probably something more complex, but still likely dopamine regulation is a key factor. Have you tried other meds that work on dopamine? Unfortunately taking anything long term carries it risks, even L DOPA supplement (direct precursor to dopamine mainly used for people with PD, a dopamine related disease) can have long term effects. It sucks 

Quote: “Anhedonia has been linked to dysfunctions in the reward system, and in particular the dopamine (DA) system” -Oxford university 

 

 

   

 

 

I tried (and am still on) 450mg Wellbutrin XL. I noticed a benefit in the beginning, but as I'm sure you can imagine it tapered off over time. 

At one point, I'd brought up to my pdoc about possibly trying pramipexole (Mirapex) or ropinerole (Requip). He didn't shoot it down immediately, but talked about not having experience using it. 

We'd also talked aripiprazole (Abilify), but I'm hesitant to try it mainly because of possible weight gain. I'm 6'2" and 260lbs.

On 10/15/2020 at 4:57 AM, Blahblah said:

 

Yes, I took a long break, but then when i re-instated, the effect is nothing like the first year I took them. Feels like a reverse effect! I have chronic fatigue now, and taking these damn meds just makes it worse. If I take instant release I crash harder, but if I take extended, it only lasts like 2 hours (versus 5) and then my energy crashes.

I'm in the same boat, it's the only med I initially felt REALLY helped my mood, motivation and cognition. Serotonin-based meds all give me brain fog and extreme apathy (to the point I'm numb, i stop caring about anything) Now I probably have adrenal fatigue, I take supplements/vitamins and I don't notice much benefit.

I often wonder if there is a way to "reset" your brain, like with ECT or something? Sounds extreme, but I'm sooooo sick of this med go round....They seem like temporary band-aids and then you get dependent on them, must keep increasing dose (despite the fact they are not even working properly). Then often, they poop-out and then you're back in the hospital, full on breakdown, back to square one and worse off than ever.

For me, i think meds are better episodically for 3-6 months,  but it's not a life long solution....

 

ECT has been explained to me before as like a "reset" of your brain neurotransmitters, but I'm not sure that's exactly what it does or it would have a noticeable effect on dopamine.