In addition, our results suggest that ECT induces GM volume increase in core nodes of the reward circuitry, selectively associated with improvement in anticipatory anhedonia but not overall syndromal depression severity.
A combination of therapy and psychoactive drugs is usually the most effective treatment for both anhedonia and depression. Medications that alter the way the brain processes rewards are especially helpful with anhedonia. Some people also experience an improvement with lifestyle changes.
Anhedonia treatment will be a part of the overall treatment plan. Oftentimes, the ways that you treat depression are also used as anhedonia treatment. People with anhedonia may try medication, therapy, new experiences, practicing mindfulness, and making sure to get proper nutrition and sleep.
Electroconvulsive therapy (ECT) is known to be an effective option in the treatment of mood disorders, especially resistant depression.
Human studies indicate that ECT leads to dopamine system activation. Rudorfer et al. (69) reported an increased level of homovanillic acid (HVA), a measure of dopamine turn-over, in the cerebrospinal fluid (CRF) following ECT.
Conclusion. Altogether, our results showed that serum serotonin levels significantly increase following ECT in MDD patients.
If nothing else has helped, including ECT, and you are still severely depressed, you may be offered neurosurgery for mental disorder (NMD), deep brain stimulation (DBS) or vagus nerve stimulation (VNS).
ECT does not change a person's personality, nor is it designed to treat those with just primary “personality disorders.” ECT can cause transient short-term memory — or new learning — impairment during a course of ECT, which fully reverses usually within one to four weeks after an acute course is stopped.
ECT may flood the brain with neurotransmitters such as serotonin and dopamine, which are known to be involved in conditions like depression and schizophrenia.
Cons of ECT:
Confusion post-treatment. Typically not well tolerated in the elderly population. Memory loss (retrograde amnesia) which usually improves within a couple months of the procedure. Physical side effects related to tension (nausea, headache, jaw aches, and muscle aches.
If you've noticed a waning interest in things that once brought you joy, contact a doctor or a mental health professional. The good news is, once you start treatment, you should be able to start feeling pleasure and happiness again. Typically, anhedonia dissipates once the underlying condition is managed.
Healing takes time and resolve. And no two people heal at the same rate; some require much longer treatment periods before achieving success. The good news is that the brain does heal and damaged dopamine receptors can regenerate within 6 to 12 months.
Milestones such as 3, 6, and 12 months of sobriety are when symptoms like anhedonia noticeably improve. Like most symptoms of PAWs, anhedonia comes in waves. For some people episodes of anhedonia fade after a few hours or days. For others, they can last weeks.
Moreover, some antidepressants (e.g., SSRIs) have been shown to help treat emotional blunting in MDD, which phenotypically overlaps with anhedonia in some subjects (27). The results of the present study indicate that vortioxetine may also be an effective treatment of anhedonia in MDD.
Another interesting finding was that, after the ketamine infusion, individuals taking lithium experienced greater anti-anhedonic effects than those receiving valproate when the antidepressant effect was controlled for.
Based on the available evidence, most antidepressants demonstrated beneficial effects on measures of anhedonia as well as the other depressive symptoms. Only escitalopram/riluzole combination treatment was ineffective in treating symptoms of anhedonia in MDD.
ECT has been referred to as a “reset button for the brain,” which not only directly improves depressive symptoms, but also allows current medications to work more effectively.
Despite many scientific and governmental authorities having concluded that ECT does not cause brain damage, there is significant evidence that ECT has indeed caused brain damage in some patients, both historically and recently, and evidence that it always causes some form or degree of brain damage.
The following strategies should not be used routinely: augmentation of an antidepressant with a benzodiazepine for more than 2 weeks as there is a risk of dependence. augmentation of an antidepressant with buspirone*, carbamazepine*, lamotrigine* or valproate* as there is insufficient evidence for their use.
The concern of some psychiatrists is that while ECT may help with depressive symptoms, it could worsen anxiety symptoms, including obsessional thoughts or panic attacks.
But some people experience more long-lasting or permanent memory loss, including losing personal memories or forgetting information they need to continue in their career or make sense of their personal relationships. Some people also find they have difficulty remembering new information from after they've had ECT.
Risk Assessment of Electroconvulsive Therapy in Clinical Routine: A 3-Year Analysis of Life-Threatening Events in More Than 3,000 Treatment Sessions. Background: Extensive research has reported that electroconvulsive therapy (ECT) can be highly effective in approximately 80% of patients suffering from depression.
People who have had ECT before and responded well are good candidates for ECT. Other first-line indications for the procedure include people who are catatonic or suffering from a form of depression known as psychotic depression (depression associated with delusions and hallucinations).
There is considerable variability in the trajectories, but most commonly there is progressive symptomatic improvement within the first week and complete remission within 3 to 4 weeks.
Success rates / patient responses – One study found that ECT was slightly more effective than TMS but that patients prefered TMS over ECT. Side effects – ECT patients report more significant side effects. TMS patients report minor and short-lived side effects.