Treatments

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There is no clear consensus on what is the safest, most effective treatment for anhedonia. 

Compared to the research done on other mental health issues, there has been little research done on treating anhedonia. Most studies of antidepressants focus on treating melancholic depression (depression with strong negative emotion), not anhedonic depression.

But a few drugs are starting to show promise. Drugs that have been shown in studies to improve anhedonia are listed here. This page will be updated as more research is done.

If you want to volunteer for a scientific study, you can find a list of active studies at clinicaltrials.gov. Type “anhedonia” under condition/disease.

Atypical Antidepressants 

  • Agomelatine — the side effect profile of agomelatine is better than most commonly prescribed antidepressants

  • Wellbutrin — particularly good at treating sexual anhedonia

  • Pramipexole — although this has been shown to relieve anhedonia, there is some concern about the long-term safety of Pramipexole treatment

Psychedelics

  • Intravenous ketamine — this is a legally available treatment for depression in much of the world

  • Psilocybin — although this treatment is not yet legal in most of the world, there is a great volume of research that affirms that a high dose of psilocybin taken with a guide is a safe, non-addictive, highly effective antidepressant

Stimulants 

  • Methylphenidate

MAOIs

The cure rate of some of the older MAOIs, like Parnate and Nardil, is higher than many more recent antidepressants like Prozac. When SSRIs and SNRIs fail, often a MAOI will succeed at curing anhedonia and depression. Moclobemide has been shown in studies to help people with anhedonia.

Guidance for using MAOIs can be found at maoiexperts.org and psychotropical.com

Research needs to be done to see if anti-Parkinson MAOIs like rasagiline and selegiline—which increase patients’ dopamine—are able to treat anhedonia.

Note to drug developers: there is a huge demand for anhedonia treatments. Bringing a MAOI for anhedonia to market will make you rich.

Experimental Treatments

SSRIs & SNRIs

SSRIs generally don’t help with anhedonia. In fact, often SSRIs make anhedonia worse: around half of people who take SSRIs and SNRIs report that it increases anhedonia. Prozac, Lexapro, and Celexa are ineffective treatments for anhedonia.

There is, however, some evidence that Trintellix treats anhedonia in some patients. Fetzima is a bit better than the placebo at treating anhedonia.

Sources & Further Reading

1. Pharmacological interventions targeting anhedonia in patients with major depressive disorder: A systematic review. Cao B et al 2019 (link)

2. Pharmacological Treatments for Anhedonia. Klein M et al 2022 (link)

3. Long-term effects of psychedelic drugs: A systematic review. Aday J et al 2020 (link)

3. The Efficacy of Vortioxetine on Anhedonia in Patients With Major Depressive Disorder Cao B et al 2019 (link)

4. The efficacy of levomilnacipran ER across symptoms of major depressive disorder: a post hoc analysis of 5 randomized, double-blind, placebo-controlled trials McIntyre et al 2016 (link)

5. Sequential improvement of anxiety, depression and anhedonia with sertraline treatment in patients with major depression Boyer et al 2000 (link)