Posted by bleauberry on August 14, 2011, at 8:36:15
In reply to AP mechanisms of effect: Amisulpiride, sulpiride, posted by floatingbridge on August 13, 2011, at 21:48:53
I can't really comment on mechanisms because from what I have seen they don't do a good job of predicting how well, or not well, a med will work with any particular person. There are too many other unknowns about these meds, as well as individual biochemistry, for me to put a whole lot of faith in the mechanisms we are aware of.
That said, there are only 2 APs I favor. Zyprexa or amisulpride. Sometimes abilify. Zyprexa is the king as far as I am concerned. The other me-too copycats don't come close. imo. Amisulpride is unique in that the mechanism can be adjusted depending on the size of the dose. Higher doses are more AP-like, while lower doses are more stimulant-like, and you can find a middle window that is mix of both. I found it calming yet somewhat energizing. Its antidepressant and dysthymia effects are well known. From my own personal experience with it, I would say it was a mild antidepressant, stronger on anhedonia than anything else, and somehow increased my appetite and weight a little bit which was good. That was unexpected because it doesn't have any mechanisms I am aware of that should do that (back to the mechanisms thing). Weight gain is not a common issue with it. Of course, I'm only talking a couple pounds.
Risperdal I think, with depression patients anyway, imo has its best potential at very low doses in combination with antidepressants that hit both serotonin and norepinephrine. It seems to combine well with paxil or milnacipran in overseas studies. I have never heard of it doing a good job all by itself. Which is in contrast to zyprexa or amisupride, where I have heard plenty of stories of them doing good all by themselves.
So anyway that's my 2 cents worth. Zyprexa or amisulpride,
It also needs to be revisited why an AP in the first place? I mean, if anxiety is the issue, there are a lot better things that don't even require a doctor or a prescription.
poster:bleauberry
thread:993693
URL: http://www.dr-bob.org/babble/20110809/msgs/993720.html