Posted by JohnL on November 15, 2000, at 3:59:57
In reply to ZYPREXA OR AMISULPIRIDE? to johnl,andrew or anyon, posted by rogdog on November 14, 2000, at 11:51:17
> I am just received a starter pack of zyprexa after a total let don with a trial of seroquel.. andrew, I read a previous post about your experience with zyprexa(i think it was you, or mabey it was John?)i cant remember. anyways, i was going to order some amisulpiride but my doctor wanted me to give zyprexa a "shot", I always here that it is augmented with something else, have you or anyone else out there had success with an antipsychotic alone? thanks for the input, rog
I haven't heard of someone taking Zyprexa as monotherapy for depression. Actually there was someone here a couple months ago that commented how well Zyprexa was working for her, but I don't remember her name or whether she was taking something else with it.
In clinical trials Amisulpride was used as monotherapy. In one study it was tested head to head against Fluoxetine treated patients. Results were similar in both groups. It has been compared head to head with other antipsychotics, and was shown to equally or more effective, except it had a more robust effect on negative symptoms and was associated with a low risk of side effects commonly associated with antipsychotics. I don't think it has been tested head to head against Zyprexa.
My personal preference is Amisulpride, for the simple reason that it is nearly free of side effects. It is somewhat activating. Zyprexa on the other hand has a much harsher side effect profile, with me anyway. The sedation, tiredness, weak legs, weight gain, and morning hangover were just too much for me.
I think if someone's depression is linked primarily to a hypo-dopamine chemistry, then Amisulpride would be the better choice. But if serotonin and norepinephrine are also involved, then Zyprexa might be a better choice, since it acts on serotonin and norepinephrine in a way similar to Remeron. Even better would be to take Amisulpride+Remeron, because that way you could actually adjust each side of the equation as needed. More/less dopamine effect? Adjust Amisulpride. More/less 5HT or NE effect? Adjust Remeron.
For my anhedonia symptoms nothing has ever come close to being as effective as Amisulpride+Adrafinil. Each alone is rather mild, yet with good effects. But the two together is greater than the sum of the two added, if that makes any sense.
Another interesting thing about Amisulpride and/or Adrafinil... They seem to work better and faster with each re-trial. I've stopped and started them several times. For the first solid trial I experienced good effects within a week, even the first day, but didn't feel total improvement until about a month. But it's almost as if these drugs permanently modify something in the brain, because with each re-trial I have experienced a very rapid re-response. Usually the first day. I stopped taking both drugs a few weeks ago. No withdrawals. My good mood lingered on. I was surprised, but pleased. But a couple days ago I really crashed hard one afternoon. I could feel it coming on like a freight train. So the next morning I took one dose of Adrafinil and a mere 25mg Amisulpride. Bingo. By the afternoon I felt almost completely cured again. I didn't even feel the need to take anything the next day. So at least temporarily while I'm in a re-thinking mode, I'm dosing every other day and doing fine. It's weird. It's almost as if these drugs permanently fixed something that now only requires small erratic amounts for maintenance. I never experienced this same phenomenon with any other drug you can think of. But for that matter, no other drug ever worked as well as these in the first place either. I was never able to give Zyprexa a fair trial of at least a month because the side effects were too harsh for me.
John
poster:JohnL
thread:48787
URL: http://www.dr-bob.org/babble/20001102/msgs/48841.html