Posted by SFY on March 12, 2006, at 18:11:45
I have long-standing dysthymia/anhedonia: constant low mood, disinterest, little motivation, as well as a history of major depressive episodes. The lingering depression also manifests itself as chronic insomnia of the early morning awakening type. The major depression has been well-treated over the years with antidepressants but the dysthymia has proved harder to treat.
I also have Social Anxiety (but more of an avoidant variety than a seriously anxious one) with severe rejection sensitivity. Cognitive-behavioral therapy has helped over the years but then I seem to run up against the low motivation factor and reach a plateau. A course of Nardil did help but after a time I started suffering severe insomnia and went off it.
Right now, I am taking Nortryptiline which keeps my major depression at bay (or at least provides a floor for it) but does nothing for my dysthymia. My current thinking is to get my blood levels for Nortryptiline checked & see if they fall within the therapeutic window and to ask my pdoc to add some type of dopamine augmentation for the dysthymia. I've been looking at Mirapex and Requip but am wondering about the other options and which (if any) might be best for me.
(And if that doesn't do the trick then I'm looking at Emsam, and then Parnate, if I can get beyond the fears about exacerbating my insomnia.)
poster:SFY
thread:619465
URL: http://www.dr-bob.org/babble/20060310/msgs/619465.html