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Re: Fluanxol vs. Amisulpride? » ed_uk

Posted by TomG on February 26, 2006, at 16:05:58

In reply to Re: Fluanxol vs. Amisulpride? » TomG, posted by ed_uk on February 26, 2006, at 11:07:07

> Perhaps you could consider fluoxetine + aripiprazole in the absense of olanzapine?

The reason I wanted to combine the two was because of this article:

http://www.cpa-apc.org/publications/archives/CJP/2004/february/lettersCombo.asp

Its all theory of course but I thought the administration of Abilify in an enviroment where the Zyprexa was already supressing dopamine might make Abilify function even more so as a partial agonist at dopamine receptors.


> Be cautious with the dose if you do decide to try a psychostimulant. High doses can induce a paranoid psychosis as you already know!

I don't even know where to begin or what would be best to start with.

> Remeron can be useful for negative symptoms provided that you don't get sedated on it - as some people do. It seems like you didn't get sedated when you tried it previously though so it would make sense to try it again. If the dose is too low, drowsiness tends to be a problem. If the dose is too high, Remeron can be agitating. Did you gain weight on Remeron when you tried it before?

I didn't gain weight, and I don't remember the dose that I was on. I do remember that I slept well on it and was not sedated the next day though.


What I think I'm going to do before I get into all this augmentation of the Symbyax is ditch it and try Amisulpride first. I can always come back to the Symbyax. Amisulpride just seems like such a clean targeted drug and if it works it will probably be a stand alone drug.

What are your thoughts about my lithium response? When I first tried it three years ago I took it by itself at 600mgs for two weeks then moved up to 900mgs and in about three days got a response that only lasted five days. Raising the dose caused this weird agitation.

Three years pass and I try it again and I'm able to reach 1350mgs with no agitation and no problems. This version was the ER Lithium Carb and the other was not so that might have made a difference. This was combined like I said with 1200mgs Neurontin and 50mgs Zoloft. When the Zoloft was added I was in a daze for the whole month before I went back to see my doc. He removed the Zoloft and started 20mgs Geodon and there was a quick robust response. I had some mild hypotension so I called my doctor and he said not to worry and told me to taper the Neurontin and lithium down to nothing.

So a great month goes by and I was only on the 20mgs Geodon. At my next appointment he keeps me at that dose and sends me on my way. Two weeks go by and the Geodon slowly lost its effect over the course of a couple of days. Then you know what happens from there. I tried playing with the dose and only got up to 40mgs with no improvement had terrible insomnia etc. It also out of no where started causing terrible anxiety and panic attacks, so it was discontinued with the help of lorazepam. If I have to try it again I think I'll start it at a higher dose and work through the anxiety and insomnia should it present.

What I'm more interested is your thoughts on the effects of the lithium somehow contributing to the response of the low 20mg dose. My doctor was convinced that it was the Geodon doing all the work, and he removed the other two drugs because so. Actually three drugs if you count the Zoloft.

I just become very suspicious when I look at my history of response to drugs and they involve lithium and a combination of lithium and other drugs however neither trial provided sustained relief.

Should Solian turn out to be a disappointment I think I'm going to try the combination of lithium, Geodon, Neurontin, and possibly Zoloft again. Its a shame the doc so abrubtly removed the drugs that could have been helping or augmenting others. Oh well. We'll see..


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poster:TomG thread:612982
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