Posted by vince on March 10, 2001, at 4:48:09
In reply to Re: Amisulpride dosage, posted by AndrewB on January 26, 2001, at 8:21:54
> Dwight,
>
> If you want to give a trial of amisulpride at a higher dose, try 100mg. for at least two weeks. 150mg. is probably too high.
>
> Amisulpride can be ordered quickly and without an Rx from xxx
>
> Amisulpride is not for everyone. I keep all the posts and emails of people who respond and don't respond to amisulpride. Though I haven't counted up the results lately, it seems that around half of our treatment resistant population responds to it. It seems to be best suited for those with various symptoms of atypical depression like low mood, constant negative thoughts, social anxiety, anhedonia and fatigue. Often people who respond to amisulpride still feel unmotivated and therefore use it with an add-on like adrafinil, selegiline, or adderall. But it can’t be predicted which of these three add-ons will work for a particular person (I use selegiline and adderall with good results.).
>
> Normally people respond quickly, within a week, to amisulpride and other neuroleptics. But there seems to be exceptions to this. Dennis's recent post relates how he had an initial response to it, then a fading away of effectiveness until after 2 weeks, when its effect started again building up slowly over the month.
>
> I think that if a person has the symptoms like negative thoughts, low energy, low mood, anhedonia and social anxiety (indicative of dopaminergic dysfunction) AND they have already tried other medicines without success like SSRIs AND they have ruled out bipolar disorder or cyclothymia, they should give certain dopaminergics a try. Amisulpride is a good med. to start with because of its safety, lack of side effects and its good rate of response.
>
> Note though that some people don’t respond to amisulpride but respond to other neuroleptics such as Zyprexa, seroquel and sulpiride. A failure with one doesn’t guarantee another neuroleptic won’t help. Furthermore, studies and recent posts indicate that Mirapex (a dopamine D2/D3 agonist) may work for these symptoms whether alone or in combination with a neuroleptic or an SSRI. Doses as high as 1.5mg. to 2mg. taken three times a day seem most effective. It is also my speculation, given the effectiveness of Ziprasidone (still not on the market), that cycloserine or the combo of pindolol/buspirone may augment the effect of certain nueroleptics.
>
> In sum, if your symtomology strongly indicates dopaminergic dysfunction and you’ve tried the more conventional ADs, trying various dopaminergics, in combination or alone, may be well advised, but some patience is often required in finding the dopaminergic med that works for you.
>
> Best wishes, keep us updated on how it goes.
>
> AndrewB.
Hi Andrew - I pulled up an old post of yours because I've just tried amisulpride without much luck. I was kind of hopeful for a few days because it seemed to bring up a lot of old nastalgic kind of feelings from long, long ago before I became depressed, feelings that I hadn't experienced for quit a while. But then it seemed to poop out before that went anywhere. So I've kind of thinking about trying Mirapex or the new Ziprasidone, or maybe both in combination so that I get some seratonin and dopamine action. I'm not sure though because it seems that from what I've read here that Mirapex and Ziprasidone effect the D2 recepter in oposite directions. I'm not sure what that would do. Maybe I'ld become invisible like 'Hollow Man'. Well really though, the best information I have to go on are the posts like yours. I don't know diddly about pharmacology and I get lost easily in these descussions of blocking such and such recepter, or a strong agonist of another.I just wanted to see if you or anyone else here might have any ideas as to what is best to try. I could give you a very long list of things that I've tried that didn't help. some of them dopaminergic like wellbutrin, risperdol, amineptine before it was taken off the market, and now amisulpride. I wish I could find something that would help like dexadrine did but wouldn't poop out in such a short time. My pdoc had me on my bazillionth ssri and like the rest it wasn't working. So then he added in dex. I felt great for about four days and then hit the wall, bamm, ride over everybody off. I got off and slept for three days. I'm not sure what D receptor dex hits but if I could find something that would do the same but not cause things to down regulate so fast, that would be a lot of help. Sorry this is getting long. If you do have any ideas please feel free to share them.
Vince
poster:vince
thread:52374
URL: http://www.dr-bob.org/babble/20010310/msgs/56107.html