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  1. #1
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    Default English Anhedonia sufferers

    I'm a male living in the UK.

    So I've not been that motivated or interested in anything for years(it took me years to go from graduating to a proper career). I'm 28 now but even at school when I was about 13 people used to think I was always stoned as I was so passive/mellow. As a child though I could play with lego for hours and would literally not be able to stay awake on Christmas Eve, always wanted to meet up with friends etc so there was some point where I stopped getting pleasure from things; I think it was when I was about 13, I went from loving sports to being quite indifferent to them, just going through the motions.

    I've had episodes of mild depression since I was about 16 though it never lasts for more than a few days. I've had periods of bad insomnia, I'm haven't slept well now for several weeks. I only came across the term anhedonia a few weeks ago and I think this is what is causing me alot of anxiety as it seems very hard to treat. I get some relief from alcohol where I can enjoy conversations more and not find it difficult to listen to people, as often I find it hard work to show an emotional response. I'm not completely devoid of personality, a few women have said I'm funny (probably in the way that Karl Pilkington is if you've ever listened to the Ricky Gervais podcasts).

    I've contacted two private hospitals to see a psychiatrist; one gave me a number to an answerphone and they don't ever ring you back. The other needs a referral from a GP and they want to charge £150 an hour and I think that's too expensive. I'm having trouble even getting a doctor's appointment at the moment as they're always busy and I'm wary of asking work for more doctor time as I've had several visits over the last few months for what I thought was thyroid trouble though it might be adrenal insufficiency which the NHS don't seem to ever acknowledge.

    So has anyone had any luck self medicating or seeing an NHS/private psychiatrist, I really don't know what to do at the moment as my work is really suffering, I find it hard not just to sit and stare into space, my concentration is awful? I've heard adrafinil works well but the brand here at qhi.co.uk doesn't seem to be made any more and I can't find anywhere else to buy it.

    Any recommendations, thanks for your help.

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    See a doc if you can. Try some things. Probably SSRI first. Then maybe an NRI or an SNRI. Then a MAOI if all else fails. Adrafinil might improve focus, motivation, and productivity. But for long term treatment of depression? Questionable.

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    If it weren't for your insomnia I would have recommended stimulant therapy. I've had chronic fatigue, anhedonia and an severe attention deficient since I was young. The NHS didn't want to know about it and just sent me to a cogntive behavioural therapy course. At least that's what they called it, in reality I briefly saw a nurse once a week who had been given a few weeks training on a drastically stripped down version of cogntive behavioural therapy that amounted to a condescending talk on positive thinking. I eventually saw a private psychiatrist who prescribed 30mg Adderall XR and 20mg dextroamphetamine daily. It cured my problems and the regimen hasn't lost efficacy during these last four years so I'm very happy with the results. However, these drugs are imported in tiny quantities from America and are obscenely expensive in England (as is the private psychiatrist's fee). My monthly bill for the medication and the psychiatrist is nearly £700, which is worth it to me but I doubt many others would think the same. You could take up a cocaine habit for what I'm paying.

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    Try and get referred to see a consultant psychiatrist. Either private or via the NHS. I self medicated for many years, was on every SSRI going. The SSRI'S made things worse. To cut a long story short I self medicated to the point of obsession. Developed various addictions to opiates, benzos. Whilst also maintaining a solid 4 or 5 years of work with the aid of capped street Amphet D/L with opiates and vitamins. When my sources ran out, I was barking, climbing the walls. I don't think its wise to self medicate simply because it needs to be sustainable. Even legal substance you get off the internet is just not sustainable. From what I remember some of the substances at QHI.co.uk worked for motivating me in some way, but again was never able to keep it up. I personally did not have the self discipline to stay on steady doses more than a few weeks without thinking something else could work better.

    Its very easy to get disheartened by the nhs service. Its hit and miss, but you have to be persistent with docs and psychiatrists. I got diagnosed with adult ADD. Got started on medication, Remeron, methylphenidate, Pregabalin. This combo serves me well. I don't need to worry if my sources are ever going to run out. It also gave me peace of mind to work on other areas of my life. You should be able to be referred for CBT, counseling etc in addition to starting medication (if necessary)

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    Thanks for the replies guys, you've given me alot of hope! Psyche what would be involved in stimulant therapy, I feel the insomnia has only occured recently from stress and would be resolved if I received the right treatment, how long did it take you to find the right meds? photonamp how long did it take you to find out that Remeron, methylphenidate, Pregabalin were the meds you needed?

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    Stimulant therapy is when a patient is prescribed therapeutic doses of a stimulant (such as racemic amphetamine, dextroamphetamine, methlyphenidate etc.) for some purpose (typically to alleviate fatigue and depression, improve focus and cognitive ability or to treat narcolepsy).

    I had tried many different drugs as a young man in an attempt to self-medicate although when I took the initiative to seek out a private psychologist I was already aware of the available options and had tried/abused them in either illicit or pharmaceutical form and so had a good idea of what would be best for myself. I suggested the extended release dl-amphetamine (Adderall) in the morning with an accompaniment of dextroamphetamine tablets in the afternoon to extend the effects until the evening. The psychiatrist agreed that this was a reasonable course of treatment for my symptoms. I had to hunt him out initially and travel down to Harley Street in London for the initial diagnoses and consultation but he is happy to do telephone/skype meetings once a month and mail my medication to me up here in Newcastle.

    As for what would be best for yourself, it's really down to your individual brain chemistry and how it reacts with the different treatment options available. Most doctors/psychiatrists seem to start out with a neurotransmitter reuptake inhibitor such as methylphenidate (Ritalin). Presumably this is because it is seen as milder than the amphetamine based drugs which modulate the transport proteins to work in reverse with a net result of more neurotransmitter in the synaptic cleft. Ironically Ritalin made me feel cracked out and anti-social while Adderall makes me feel like myself only with improved abilities and energy levels. It just goes to show how unique peoples brain chemistries can be.
    There are also some newer medications that I haven't tried such as Focalin (the dextro isomer of "Ritalin") and Modafinil. Vyvanse is also becoming increasingly popular as it is a less abusable form of dextroamphetamine that was designed to activate in the gut, although I've heard a lot of anecdotal evidence of this prodrug suddenly no longer working, producing increased side effects after awhile and leaving the user with a high tolerance to dextroamphetamine.

    Methylphenidate (Ritalin) is available on the NHS (you may have to "fight" for it though and the waiting lists for psychiatrists is staggering, at least in the north-east). The amphetamine based choices are only available through private psychiatrists (although I believe the NHS uses dextroamphetamine to treat narcolepsy) and they cost far more than most people would be willing to pay. Adderall is £10 per capsule (regardless of dose) and dextroamphetamine is £1 per 5mg tablet.

    Good luck. Hope things work out for you.

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    Quote Originally Posted by evanski View Post
    See a doc if you can. Try some things. Probably SSRI first. Then maybe an NRI or an SNRI. Then a MAOI if all else fails. Adrafinil might improve focus, motivation, and productivity. But for long term treatment of depression? Questionable.
    PLEASE don't ever try any SSRI/SNRIs. I have to say this becauseI just recovered from a 3 month protracted withdrawal from HELL just from 9 months of 10mg daily Lexapro.

    The first couple of months, suicide constantly crossed my mind. Homicidal thoughts, too, though much less common.


    3 months of near total anhedonia is the same as 3 months of DESPAIR.


    I really don't think even the small (?) chance of experiencing this type of negative reaction to SSRIs / SNRIs is worth even trying them. Visit paxilprogress.org or Google 'international antidepressent withdrawal forum' before you decide to try any SSRI please!



    I'm such a naysayer.

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    Well, SSRI's are helpful with many people but they're very hard to come off of. I've been on Paxil for like 10 years now and it was one of the only ones that helped me sleep as well but now, despite that fact that I don't need it, I'm not coming off of it. I'd try some DLPA in the morning as well as some Picamilon (150mgs) for stimulant effects and 50 got anxiety (later in the day). Also, and this is first and foremost - solid nutrition and vigorous exercise daily will help more than any med imo.

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    My basic argument, though, is this: The potential for a withdrawal as horrific and long-lasting (2 weeks to 2+ years) withdrawal is not worth whatever benefit SSRIs may offer. It's a gamble that I don't think is worth taking. I count myself lucky mine only lasted 3 months.

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    do some doctors really prescribe people amphetamines for fatigue?if so, that surprises me as stimulants, although they helped at the start, worsened my overall energy levels..

    to the OP i have also suffered from anhedonia and insomnia along with depression for many years..low energy levels and motivation as well.i have self medicated with opiates, stims, benzos, they all help in certain ways but hurt in other ways..its a constant juggling act, very hard to find a good fit...

    i tried welbutrin hoping it would give me motivation and lessen my anhedonia and it did great for about maybe 2-3 weeks then the good effects went away but the bad(sweats, agitation) stayed..

    anhedonia is a bitch..

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    Quote Originally Posted by psyche View Post
    Methylphenidate (Ritalin) is available on the NHS (you may have to "fight" for it though and the waiting lists for psychiatrists is staggering, at least in the north-east). The amphetamine based choices are only available through private psychiatrists (although I believe the NHS uses dextroamphetamine to treat narcolepsy) and they cost far more than most people would be willing to pay. Adderall is £10 per capsule (regardless of dose) and dextroamphetamine is £1 per 5mg tablet.
    Dexamfetamine is available on the NHS for ADHD; it's the third-line treatment after methylphenidate and atomoxetine. You might have problems convincing a specialist to prescribe it, since some are not even aware that it's available, but they're expected to follow the NHS prescribing guidelines for adult ADHD. If you are spending £700 a month it'd be worth trying; I'm paying £7.60 a month for 196 5mg tablets. I don't know if you're aware of the AADD-UK website, but I believe some people on their forum were diagnosed by an NHS specialist in Newcastle, so you might find some contact details on there.

    To the OP: If you described those symptoms to an NHS GP or private psychiatrist I think the outcome would be the same; they'd be highly likely to prescribe an SSRI (citalopram or escitalopram, probably) and refer you to a therapist for CBT. If you didn't respond to citalopram, they would usually try another SSRI or venlafaxine. The GP might then prescribe a TCA or mirtazapine before considering a referral to an NHS psychiatrist. Get an appointment with another GP at the practice if your current GP is useless or doesn't listen. If you want to self medicate, I'd suggest trying nicotine patches or gum first, which should improve your concentration. There's several threads about nicotine gum/patches in the archive which are worth reading.

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    In the UK my gp couldnt prescribe ritalin as it was only licensed for kids (he did hes best to find a way to prescribe it as i had it prescribed in belguim) now im waiting for a appointment for a nhs psychiatrist that specialises in ADHD but from what ive read the nhs doesnt beleive in adult adhd, hopefully i can get something out of it.

    Are dex and adderall (its available under the nhs but needs to be ordered and nearly impossible to get here) licensed for adults? Seems like offlabel prescribing is pretty much impossible within the nhs.

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    Quote Originally Posted by psyche View Post
    Stimulant therapy is when a patient is prescribed therapeutic doses of a stimulant (such as racemic amphetamine, dextroamphetamine, methlyphenidate etc.) for some purpose (typically to alleviate fatigue and depression, improve focus and cognitive ability or to treat narcolepsy).

    I had tried many different drugs as a young man in an attempt to self-medicate although when I took the initiative to seek out a private psychologist I was already aware of the available options and had tried/abused them in either illicit or pharmaceutical form and so had a good idea of what would be best for myself. I suggested the extended release dl-amphetamine (Adderall) in the morning with an accompaniment of dextroamphetamine tablets in the afternoon to extend the effects until the evening. The psychiatrist agreed that this was a reasonable course of treatment for my symptoms. I had to hunt him out initially and travel down to Harley Street in London for the initial diagnoses and consultation but he is happy to do telephone/skype meetings once a month and mail my medication to me up here in Newcastle.

    As for what would be best for yourself, it's really down to your individual brain chemistry and how it reacts with the different treatment options available. Most doctors/psychiatrists seem to start out with a neurotransmitter reuptake inhibitor such as methylphenidate (Ritalin). Presumably this is because it is seen as milder than the amphetamine based drugs which modulate the transport proteins to work in reverse with a net result of more neurotransmitter in the synaptic cleft. Ironically Ritalin made me feel cracked out and anti-social while Adderall makes me feel like myself only with improved abilities and energy levels. It just goes to show how unique peoples brain chemistries can be.
    There are also some newer medications that I haven't tried such as Focalin (the dextro isomer of "Ritalin") and Modafinil. Vyvanse is also becoming increasingly popular as it is a less abusable form of dextroamphetamine that was designed to activate in the gut, although I've heard a lot of anecdotal evidence of this prodrug suddenly no longer working, producing increased side effects after awhile and leaving the user with a high tolerance to dextroamphetamine.

    Methylphenidate (Ritalin) is available on the NHS (you may have to "fight" for it though and the waiting lists for psychiatrists is staggering, at least in the north-east). The amphetamine based choices are only available through private psychiatrists (although I believe the NHS uses dextroamphetamine to treat narcolepsy) and they cost far more than most people would be willing to pay. Adderall is £10 per capsule (regardless of dose) and dextroamphetamine is £1 per 5mg tablet.

    Good luck. Hope things work out for you.
    Wtf? arent adderall and dexedrine insured in the nhs?
    This is retarded lol better stay with rc's.

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    Quote Originally Posted by Mercury View Post
    Dexamfetamine is available on the NHS for ADHD
    I've sent you a private message with a few questions if you wouldn't mind answering them. Cheers, buddy.


    Quote Originally Posted by alias45 View Post
    Wtf? arent adderall and dexedrine insured in the nhs?
    This is retarded lol better stay with rc's.
    The NHS does not use Adderall. Although what the poster 'Mercury' has said in this thread means there have been cases of the NHS prescribing dextroamphetmine tablets for ADHD.
    I've been on a waiting list to see a specialist that works for the NHS for nearly a year now (apparently there is only one in the entire north of england) and what 'Mercury' said has given me some extra ammo when I eventually get to see them and fight for a prescription.
    I've tried research chemicals but none of them are good candidates for ADHD treatment in my opinion. They aren't anything like amphetamine in terms of its utility and side effect profile. Ethylphenidate is a close match for Ritalin but the peripheral side effects were intolerable.



    Due to the information in 'Mercury's post I must apologize to OP for saying I thought dextroamphetmine was only prescribed for nacrolepsy. This was a result of countless general practitioners ignorantly giving me misinformation. I'd advise you to attempt to get a referral to a "specialist" from a GP for ADHD (if one says no then just keep trying different ones). I'd suggest doing this ASAP since the waiting list will probably be enormous. If the NHS route doesn't pan out or you have money to burn then you can go private and walk out a consultation with pretty much any meds you ask for.
    Last edited by psyche; September 3rd, 2012 at 10:34 PM. Reason: added a reply to alias45

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    Found out about Schizoid Personality Disorder and it seems like I have quite a few of the traits. Treatment is supposedly low doses of risperidone or olanzapine and wellbutrin according to wikipedia. Has anyone had success treating this, not sure whether to try one of those drugs or the stimulant therapy, seems like SPD doesn't respond well to treatment.

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    "apparently there is only one in the entire north of england"

    I bet thats the one my gp wanted to send my too, but as its outside the "state or council"? she had to ask wheter i could see him insured and she wasnt sure wheter they would do that, after that id be on the waiting list.

    From what ive read i shouldnt hope much of this lol, the medical care here in the UK is absolutely horrible, im used to good care in belguim the nhs is just insane.

    Amphetamine is pretty much the only thing that works for anhedonia in shizo or shizoid like conditions, i use stims for my shizo related anhedonia.

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    sj11-i too share many traits of schizoid pd...i have tried many different drugs and i thought welbutrin would help and it did make me a little more social and motivated but also more anxious..GHB helped me much more when it came to eliminating schizoid traits than any other drug or med out there..

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    I tried a nicotine patch, I found the taste really horrible as I have never smoked and I felt quite dizzy. It did make me feel the most positive I have for ages (probably since the last time I was drunk) for about 30 minutes so I expect I would respond to some kind of stimulant.
    Last edited by sj11; September 19th, 2012 at 08:06 PM. Reason: adding something I forgot

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    Quote Originally Posted by photonamp View Post
    Try and get referred to see a consultant psychiatrist. Either private or via the NHS. I self medicated for many years, was on every SSRI going. The SSRI'S made things worse. To cut a long story short I self medicated to the point of obsession. Developed various addictions to opiates, benzos. Whilst also maintaining a solid 4 or 5 years of work with the aid of capped street Amphet D/L with opiates and vitamins. When my sources ran out, I was barking, climbing the walls. I don't think its wise to self medicate simply because it needs to be sustainable. Even legal substance you get off the internet is just not sustainable. From what I remember some of the substances at QHI.co.uk worked for motivating me in some way, but again was never able to keep it up. I personally did not have the self discipline to stay on steady doses more than a few weeks without thinking something else could work better.

    Its very easy to get disheartened by the nhs service. Its hit and miss, but you have to be persistent with docs and psychiatrists. I got diagnosed with adult ADD. Got started on medication, Remeron, methylphenidate, Pregabalin. This combo serves me well. I don't need to worry if my sources are ever going to run out. It also gave me peace of mind to work on other areas of my life. You should be able to be referred for CBT, counseling etc in addition to starting medication (if necessary)
    I never got anything from SSRI's either, except delayed ejaculation.

    That bit in bold is great, I think anyone looking for happy in a pill will always be disappointed, using them as a way to allow you to make your life work is the key.

    Quote Originally Posted by Belfort View Post
    i tried welbutrin hoping it would give me motivation and lessen my anhedonia and it did great for about maybe 2-3 weeks then the good effects went away but the bad(sweats, agitation) stayed..
    Same for me on Welbutrin, after a couple of weeks it made me nasty, very detached, and even though I was logically aware I was being this way, I could not seem to control it.

    I stopped right away.

    A friend of mine however who has ADD and used Adderall in the past says that 150mg Wellbutrin per day is probably the best med he has used.

    Quote Originally Posted by Mercury View Post
    Dexamfetamine is available on the NHS for ADHD; it's the third-line treatment after methylphenidate and atomoxetine. You might have problems convincing a specialist to prescribe it, since some are not even aware that it's available, but they're expected to follow the NHS prescribing guidelines for adult ADHD. If you are spending £700 a month it'd be worth trying; I'm paying £7.60 a month for 196 5mg tablets. I don't know if you're aware of the AADD-UK website, but I believe some people on their forum were diagnosed by an NHS specialist in Newcastle, so you might find some contact details on there.
    Did you try methylphenidate and atomoxetine first I assume?

    Have you ever used Adderall?

    I did try dexamphetamine and it really calmed my mind, in myself I felt probably the most 'normal' ever, I even fell asleep while waiting for people on two occasions, but not lethargy, just peaceful.

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    Did you get dexamphetamine and Wellbutrin on the NHS?

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