Posted by iforgotmypassword on October 9, 2009, at 13:58:14
I am wondering if anyone here has done this before: combined a dopamine agonist with an AP. It seems unlikely there are a lot of people, as the indications of APs are usually intended for illnesses associated with psychosis (schizophrenia and bipolar) and while off-label use is common, it is hard to find many med articles on off-label uses.
I was wondering what would happen to the akathisia and EPS suffered with aripiprazole (Abilify), if a dopamine agonist (say pramipexole (Mirapex)) was being used as an augmenter. Aripiprazole does a have a window where at least a sliver of dopamine receptors are still not occupied, and pramipexole seems to have an even greater affinity for D3 and D2 receptors than dopamine itself. Presumably the effect would be strictly post-synaptic in how it works, since most autoreceptors would be occupied with aripiprazole.
It seems (to me, I could definitely be wrong) that aripiprazole may be the strongest 5-HT1a partial agonist on the market, particularly given its bioavailability and extremely long half life. I have a very strong suspicion that 5-HT1a partial agonism may be what causes (or at least is a part of) aripiprazole's anti-anhedonic effects. In fact, if you search anti-anhedonic on google, the main other drug mentioned is FLIBANSERIN, little else.
So my goal is to figure out how to get the benefits of aripiprazole, but also be able to tolerate its antidopaminergic effects. If I really want to give this a go, what dosages should i be considering?
I should note that I got terrible akathisia from a 20mg dose of ziprasidone. I wonder if pramipexole may protect against or even reverse any upregulation of D2L receptors I may already have, and maybe have important therapeutic dopaminergic effect, when it is augmenting an AP.
(Sorry, I am having trouble today, so I imagine there is a lot of mistyping and grammar errors in this.)
poster:iforgotmypassword
thread:920273
URL: http://www.dr-bob.org/babble/20091001/msgs/920273.html