Posted by SLS on August 4, 2009, at 6:12:36
In reply to Re: Sorry to be dramatic but considering suicude, posted by g_g_g_unit on August 4, 2009, at 4:09:12
> > Abilify and low-dose amisulpride are used to treat depression through a pro-dopaminergic mechanism. Abilify is a D2 and D3 receptor partial agonist. Amisulpride is a preferential DA autoreceptor antagonist. Both drugs are effective in treating the negative symptoms of schizophrenia - the deficit syndrome. This syndrome includes all the symptoms you describe. Both drugs are now also used to treat depression.
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> so it's realistic to believe that Abilify could assist with anhedonia that might not derive from schizophrenia? aren't its DA-agonist properties restricted to lower doses? are there less potential s/e's at lower doses?Doctors who are now prescribing Abilify are using lower dosages than what would be appropriate for schizophrenia. It probably works best when added to other drugs. However, even at high dosages, Abilify retains its postsynaptic agonist properties. With amisulpride and sulpiride, lower dosages produce the antidepressant effect, as they tend to bind to presynaptic autoreceptors selectively. It is at higher concentrations that these drugs begin to block postsynaptic receptors; the net effect being that of an antipsychotic. I would try Abilify first, mainly because it does not raise prolactin the way amisulpride and especially sulpiride do. Also, Abilify should have less potential to produce EPS involuntary movements, although it probably causes more akathisia.
For me, the akathisia type restlessness when starting Abilify was mild and disappeared within a few days. My initial dosage was 20mg. I tried lowering it to 10mg, but it seemed that 20mg was more effective. Most people report having more energy and motivation while taking Abilify. I think it also helped with anhedonia, but only mildly so. Recently, most people using it for depression are using dosages of 2-5mg. I don't know whether or not the higher dosages are necessary for more severe depressions or perhaps for bipolar depressions. Because of my experience with Abilify, I would encourage someone who is not getting any benefit at the lower dosages to continue to titrate higher, so long as they are tolerating it. A friend of mine with unipolar depression cannot go higher than 2.5mg without getting cognitive side effects. However, she is responding very well at this dosage.
- Scott
poster:SLS
thread:910034
URL: http://www.dr-bob.org/babble/20090801/msgs/910178.html