Posted by undopaminergic on March 20, 2008, at 20:09:14
In reply to Question re Amisulpride - and Sulpiride, posted by Basia on March 20, 2008, at 6:39:02
> I was on Sulpiride for ten years and also tried Amisulpiride for a month or two as they thought an atypical would be less dangerous and freer of side effects.Amisulpiride did not work.
> Apart from schizoaffective disorder, I also have a diagnosis of HPPD. I have noticed that atypicals can worsen this and have been on Clozapine, Olanzapine , Loxapine, Haloperidol, Stelazine and others with limited success. Sulpiride has been the only one that has got rid of my HPPD and psychosis completely. However, it is too dangerous for me to stay on it as my prolactin was sky high and I stopped menstruating and developed thinning bones at the tender age of 30 - I am now 34. I did notice that the anti-depressant action of Sulpiride stopped after a year but I went up to 800mg, which enabled me to work and socialise very effectively for all those years. I was then put on Lamotrigine for suicidal depression and this saved my life.
>
> I am now on Seroquel and dealing with harsh side effects and a return of HPPD. I am wondering whether atypicals' effect on a wider range of receptors may be to blame. I have heard that Risperidone can worsen HPPD.
>
> Any ideas?It makes sense, because sulpiride and amisulpride (and possibly some other benzamides) affect the narrowest range of receptors - or in other words, are the most selective - of the dopamine antagonists used clinically. They also cross the blood-brain-barrier (BBB) with difficulty relative to most other antipsychotics (except perhaps risperidone), which means that at doses that produce the desired degree of dopamine-antagonism in the CNS, they produce a more effective peripheral DA-blockade in comparison with agents that cross the BBB more freely. One of the consequences is the blockade of DA-receptors in the pituitary, resulting in disinhibition of prolactin secretion. Through a chain of events, the prolactin produces diminished gonadal activity (hypogonadism) and thus a deficit of sex hormones. In theory, it should be possible to correct the deficiency with hormone supplements, and there are other options as well for preventing and/or reversing bone loss.
poster:undopaminergic
thread:816111
URL: http://www.dr-bob.org/babble/20080316/msgs/819098.html