Tell us a bit about yourself and how you came to be involved with GALENOS and this review in particular?
I am a health care provider with a background in Clinical Medicine and MSc International Public Health. It was during the writing of my many course assignments that I checked with my mental health circles on the kind of research and research organizations that were available, when I came across MQ Mental Health Research who were recruiting for different roles including Experiential Advisors.
What is anhedonia?
Loss of enjoyment in activities that one used to enjoy before. It is common in people living with depression.
Why did GALENOS decide to look into this and what role did the lived experience advisory board play in this?
From my understanding, GALENOS were reviewing existing information in a Living Systematic review on clinical studies to establish pro-dopaminergic pathways on anhedonia. This would pave way for drugs that specifically target anhedonia. The Global Lived Experience Advisory Board (GLEAB) shared their opinion on the priority that should be given on the several studies that were targeting the outcome of this study, they were also involved in sharing their opinion on the final written report.
What did you find, i.e. what role does dopamine play in anhedonia?
Dopamine as a neurotransmitter is responsible for the feeling of pleasure and motivation, and that low levels of dopamine increase the feeling of anhedonia and depression, hence pro-dopaminergic drugs which mimic dopamine in the brain are used in the treatment of depression but their mechanism in anhedonia is yet to be established (anhedonia being a key symptom of depression but not the only one).
What are the implications for research?
There were several angles from the discussions we had including people with psychiatric and other comorbidities, the possibility that it is the dopaminergic pathway that is being treated already and there are no two different pathways between anhedonia and depression.
What were your recommendations in this research and how did you come up with them?
My recommendations focused on establishing a clear, evidence-based link between pro-dopaminergic drugs and anhedonia before moving into more detailed mechanistic research. Strengthening this foundational relationship would make clinical outcomes more predictable and help bridge gaps between animal and human studies. I also recommended that future research profile adverse effects alongside effectiveness, and examine how these drugs interact with other depressive symptoms, to improve reliability and reduce confounding factors. Ensuring equity was another priority, with an emphasis on engaging diverse populations so that trial outcomes more closely reflect real-world experiences. As someone who has managed anhedonia, I highlighted the importance of interventions that provide measurable positive and negative outcomes without worsening co-occurring symptoms.
These recommendations were shaped through the prioritization exercise, which required ordering studies by relevance and impact. My personal experience, academic training, and the methods emphasized through the Cochrane Training guided me to focus on evidence quality, feasibility, patient relevance, and translation into practice. These perspectives formed the basis for the recommendations I put forward.
Why is a structure like GALENOS important when looking at evidence?
For this review, the fact that it was an LSR, it allows real time findings which are applicable even in the present and show the present state, also working with a wide range of people including those with lived experiences increases the reliability of the studies.
What role did lived experience play in this study?
First, my chances of working with GALENOS were improved due to the fact that I had a lived experience, in the real world this would have been a reason to be left out or dealt with cautiously, for the person involved, there is a chance for equity while for the study it is more realistic and deals with humans in the current living world as opposed to only tons and tons of other work done in the past
