Hi Mm80, my view is that psychiatrists prescribe drugs based on their interpretation of how they understand mood disorders. Explaining the mechanism of action of Strattera as an NRI may be simplistic, but in certain brain regions that have been
studied, that's how it appears to act. Strattera also increases the number of glutamate receptors (glutamate is an excitatory neurotransmitter) in certain neurons in animal models. Strattera likely has an effect on brain regions important to mood that haven't been studied, but the best guess is that the drug would work as a treatment for ADHD in humans because glutamate receptor functioning is thought to be impaired in the disorder. I've tried Modafinil, Dexedrine and Adderall with different success as adjuncts to other antidepressants (to boost my mood). I chose to ask for Modafinil, in part because it's reported to act as a DRI but also because Adderall was making me feel anxious even though I'd taken it for a long time. Modafinil seemed to boost my mood without causing the anxiety. Drugs that affect the dopamine system (i.e. those that improve neurotransmission in pathways associated with
reward) and have been studied in clinical trials to treat what they're designed to treat would probably have increased benefit to someone who suffers from anhedonia. It's sounds simplistic (that I would consider asking for a med. that acts as a DRI) since my aim is to combat anhedonia and facilitate reward, and it might be, but that's my take.