# depression and motivation



## workman (Mar 5, 2004)

What is a good drug for depression where lack of motivation is the main symptom. Like struggling to go to class, work, do assignments, getting sidetracked from doing assignments, ect.
What would be good for this. Wellbutrin? What about the NE re-uptake inhibitor whatever it is called, it is for ADHD does it work for depression? I know these probably won't help for anxiety, but right now I need something to help with motivation more than anything. All the SSRI's and SSRI+ drugs just make it worse. Any suggestions? No stimulant drugs either because they won't get prescribed.


----------



## Noca (Jun 24, 2005)

Try ritalin if you need motivation, but be prepared to see you apetite go out the window.


----------



## workman (Mar 5, 2004)

stimulant = not going to be prescribed.


----------



## Caedmon (Dec 14, 2003)

The closest thing to a stimulant you'd likely get is Wellbutrin or Provigil (Provigil's a C4). Strattera is the SNRI you're probably thinking of - that could work. There is desipramine, which is a TCA. Cymbalta maybe. Fish oil isn't a prescription drug, but many studies show that PUFAs act on dopamine. As a last resort, Parnate which is an MAOI.

You could ask about a Dx of ADD, which is a more likely way of getting onto a stimulant.

http://amenclinics.com/ac/tests/subtype_test1.php

I'm doing the Wellbutrin + caffeine thing right now. Actually with the Topamax I can chomp down on these delicious chocolate-covered coffee beans all day and it doesn't make me anxious, it just wakes me up and makes me happy. (Those things are _great_!!)


----------



## workman (Mar 5, 2004)

Ok, I got these results:
ADD Combined Type - Not Probable 
ADD Inattentive Type - Highly Probable
Cingulate System Hyperactivity - Highly Probable
Limbic System Hyperactivity - Highly Probable 
Basal Ganglia Hyperactivity - Highly Probable 
Temporal Lobe System-Probable

ADD Inattentive seems a lot like me and may explain some of my other social problems besides SA. I'm going to a school pdoc, though, so I still don't think I would get a stimulant. 
The onset of these symptoms often become apparent later in child-hood or early adolescence. The brighter the individual, the later symptoms seem to become a problem. The symptoms must be present for at least six months and not be related to a depressive episode or the onset of marijuana usage. Using marijuana can often make a person seem as though they have ADD without hyperactivity. It is important to screen for pot usage in teen-agers or adults. 

Girls with ADD are frequently missed because they are more likely to have the non-hyperactive form. 

The severity of the disorder is rated as mild, moderate or severe. Even though these children have many of the same symptoms of the people with AD/HD, they are not hyperactive and may appear hypoactive. Additional symptoms for this subtype include: excessive daydreaming, frequent complaints of being bored, appearing apathetic or unmotivated, appearing frequently sluggish or slow moving or appearing spacey or internally preoccupied -- the classic "couch potato." 

Most people with this form of ADD are never diagnosed. They do not exhibit enough symptoms that "grate" on the environment to cause others to seek help for them. Yet, they often experience severe disability from the disorder. Instead of help, they get labeled as willful, uninterested, or defiant. 

As with the ADD combined type, brain studies in patients with ADD, inattentive subtype reveal a decrease in brain activity in the frontal lobes of the brain in response to an intellectual challenge. Again, it seems that the harder these people try to concentrate, the worse it gets. ADD, inattentive subtype is often very responsive to stimulant medications, such as Ritalin (methylphenidate), Dexedrine (dextroamphetamine), Cylert (magnesium pemoline), Desoxyn (methamphetamine), and Adderal (a combination of amphetamine salts). These medications "turn on" the frontal lobes and prevent brain shutdown, allowing a person to have more access to this part of their brain.


----------



## workman (Mar 5, 2004)

Does topamax help with concentration? Isn't it more likely to make you forgetful? Which would work better for motivation, wellbutrin or Strattera. How does the wellbutrin work for you with motivation? Are there any other dx's that can cause lack of motivation?


----------



## Caedmon (Dec 14, 2003)

workman said:


> Does topamax help with concentration?


Oh, Lord no!

I don't know what's better for motivation. I'm finding Wellbutrin helps with motivation, although not enough (yet). But nothing has ever really done that. I might need to push the dose higher.

Depression and ADD would be common psych causes of being unmotivated, I mean beyond general life circumstances. Prodromal schizophrenia. Hypothyroidism. Cannabis use. SSRIs can induce apathy. That's all I can think of for now.


----------



## popeet (Dec 8, 2005)

*multiple layers of confusion*

inattentive type

complimented by a somewhat pissed off and competitive personality i suppose.

ah me. i cannot express the level to which i have been add and depressed and unmotivated and completely into at least 12 different things at once, since i was born, with no motivation to pursue them past the a certain point.

i'll take that test though the results seem a bit broad and sweeping. 

wellbutrin gave me the worst trip of my life. it made my friend have a grand mal seizure (it does that to some). it helps people to focus to an extent, but not us.

coffee beans = yes  good thing i worked in a coffee place. no end to the beans and pure chocolate i could access there.

ritalin and anafranil (clomipramine-- atypical tricyclic used for ocd) worked wonders for me. except i ground my molars, had yawn-orgasms, gagged at inappropriate times, wrote in a tiny serial killer scrawl and then somehow i lost my ritalin supply (not related to bizarre behaviors above). and then it went downhill from there.

then maximum dose zoloft worked for motivation and focus to a degree, but eh, i was left somewhat hyperaggressive and paranoid.

oh yeah, strattera, good idea.... i'm going to get some strattera today (hehe, i have a very compliant doc) though she (my doc) said it made her dead sleepy and my boss (also on it) said it made her vomit.

luvox is most certainly not helping me right now. i'm supposed to be (a) doing pre-admissions interviews, (b) getting a new job and (c) securing an internship. i am doing (d) none of the above. instead i've found myself beading necklaces (lol) because it's a nice simple repetitive task. i can't even decide whether i'm going to be a slacker or not. just the thought of those above things is making me tired.

i probably don't need to tell you that i pretty much flunked school my entire young life. i got straight A's most semesters in (non-art) college though (post-meds). i'm sick of going through this massive sense of confusion and discombobulation.

so i'm looking for what you're looking for. i'll let you know how the strattera works on me.


----------



## popeet (Dec 8, 2005)

*cademon's amen test*

sorry for bashing that test. it was interesting.

i took it and it said inattentive type was "not probable"
it said i possibly have combined type. hah. what it was trying to gently say is that i will most likely end up in prison. 

it also said that cingulate hyperactivity was not probable, which i find strange since i have ocd and repetitive thoughts (treated by luvox). and the anterior cingulate is responsible for depressive ruminations or (along with the caudate nucleus in the basal ganglia) the feeling that "something is wrong" when nothing is wrong, which i have.

it said instead, that i have basal (anxiety) and limbic (emotional lability/hypersensitivity like in BPD) hyperactivity. which means that TCA's for crazy feelins and benzos (or, yeech, BuSpar) for you-know-what. Lol it says BuSpar promises to take away my aggressiveness. no it didn't! <punches BuSpar>.

huh. test says maybe i don't have add after all. maybe i just have a low tolerance for life itself. amen to that.


----------



## workman (Mar 5, 2004)

Well, I called the counseling center, and to get tested for add you have to take a test which is like an hour and a half long, then see a counselor to see if they think you are right for the diagnosis. Then yiou have to pay $150 for several hours of evaluations to see if you have it. If I went through all that I would want a stimulant, and the pdoc there already said benzos are addictive, so I doubt she would prescribe a stimulant.


----------



## popeet (Dec 8, 2005)

this incenses me. we spend so much money on evaluations only to not be treated with the most effective medications. i say, get the testing but ask for a sliding scale fee or reduced fee. will they be giving you an entire battery (like MMPI, etc)? 

in any case, i could treat your ADD by you coming to my basement, giving you the same tests (family has the catalogs) getting on my (easily purchased) EEG neurofeedback machine (modified for first person shooters ). hell let's do a little methamphetamine and learn Chinese while we're at it. : /

i don't need to start this here but this is not about your welfare. we do alcohol, tobacco, sugar and coffee and can't stop. those sh*tbags.

just to have the experience of a medication that works, i personally would keep searching for a good ol fashioned hollywood wife style doctor who will keep you tanked with beautiful people pills. the spoiled rich brats i've met have no problems getting these things. 

i think you have the right to become dissatisfied with them or experience the addiction to them ON YOUR OWN. i am of the thinking that pharms and pharm dispensing strategies=$$$. and i used to think meds carried you further away from actual change but i'm suffering and i think that's garbage. actual change happens chemically.

yes. i've been through this and i don't see docs (or RNPs) no more. i'd keep searching and i wish you luck.


----------



## workman (Mar 5, 2004)

so does it seem worth it? $150 for maybe might have it. Then, if I do, the pdoc probably won't even prescribe a stimulant. I could then go somewhere else, but then that would be more money, and they would probably want to do thier own intake evaluation.


----------



## vanilla (Dec 14, 2008)

Hi Workman,
Was wondering if you could tell me how you managed to get an anaysis done... Gosh, those Inattentive symptoms are ditto what i have.Crazy daydreaming.And it happens even more before exams. So, how did you get this analysis-did you go to Dr Amen and do his package for 3000 usd or is there a cheaper way to do it?...coz I live in the southeast..nowhere near the Amen clinics,(nearest would be in Virginia). You've mentioned you paid 150 for tests...so that means they din't do spect imaging did they? Did they analyse you without the Spect imaging???Did your health insurance go up after this analysis? I need to sort myself out..please help...
thanks,


----------

