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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Jamal Spelling on January 16, 2008, at 11:40:52
And do you need to take the AP together with an SSRI to observe this effect?
Posted by Phoenix1 on January 16, 2008, at 13:23:29
In reply to Which APs, at low dosages, treat anhedonia?, posted by Jamal Spelling on January 16, 2008, at 11:40:52
> And do you need to take the AP together with an SSRI to observe this effect?
Amisulpride seems to have lots of supportive literature. I can't find it, but I think there is a paper that specifically looks at amilsulpride for anhedonia. Not sure if the drug is available in the US though. (I'm assuming you are in the US?) Then there are low dose Zyprexa/Normal dose SSRI combos that have shown efficacy.
Phoenix1
Posted by Jamal Spelling on January 16, 2008, at 13:41:49
In reply to Re: Which APs, at low dosages, treat anhedonia? » Jamal Spelling, posted by Phoenix1 on January 16, 2008, at 13:23:29
Does anyone have any thoughts on low dose flupentixol? It's a typical thioxanthene AP.
Does anyone know the difference between sulpiride and amisulpride? They are both benzamide APs, apparently very similar. It seems many have used amisulpride, but what about sulpiride? Can it, too, be used to counteract anhedonia, possibly alongside and SSRI?
Posted by Phoenix1 on January 16, 2008, at 22:17:49
In reply to Re: Thanks! » Phoenix1, posted by Jamal Spelling on January 16, 2008, at 13:41:49
> Does anyone have any thoughts on low dose flupentixol? It's a typical thioxanthene AP.
>
> Does anyone know the difference between sulpiride and amisulpride? They are both benzamide APs, apparently very similar. It seems many have used amisulpride, but what about sulpiride? Can it, too, be used to counteract anhedonia, possibly alongside and SSRI?Hi Jamal,
Take a look at this:
http://www.dr-bob.org/cgi-bin/pb/mget.pl?post=/babble/20041123/msgs/420491.html
And these:
http://www.ncbi.nlm.nih.gov/pubmed/15738862
http://www.biopsychiatry.com/amisulpride.htm
http://www.biopsychiatry.com/amisulpridedop.htm (NOTE: Specifically talks about dopaminergic deficiency with is associated with anhedonia.)And this:
http://www.biopsychiatry.com/sulpiride.htm
So I have no idea if amisulpride is superior to sulpride. Most of the literature on depression is on amisulpride, not sulpride. Both appear to be affective, fairly safe augmenters or primary drugs for minor anhedonia. I'm pretty sure they can be used with an SSRI, although there is no literature that I can find to support this. Seems amisulpride is used as the primary agent and has been shown to have similar efficacy to SSRI's in some studies. Although look at this:
http://www.dr-bob.org/cgi-bin/pb/mget.pl?post=/babble/20020416/msgs/103469.html#103469
Maybe a bad idea to combine? Just try amisulpride trial? Do a search on low dose flupentixol. I think there's some lit on it as an AD but don't have time to look it up for.
I hope this is more helpful than confusing, but I fear it may be the latter. Happy to talk to you any time on these topics. Fascinating to me!
Phoenix1
Posted by Jamal Spelling on January 17, 2008, at 7:31:13
In reply to Re: Thanks! » Jamal Spelling, posted by Phoenix1 on January 16, 2008, at 22:17:49
> > Does anyone have any thoughts on low dose flupentixol? It's a typical thioxanthene AP.
> >
> > Does anyone know the difference between sulpiride and amisulpride? They are both benzamide APs, apparently very similar. It seems many have used amisulpride, but what about sulpiride? Can it, too, be used to counteract anhedonia, possibly alongside and SSRI?
>
> Hi Jamal,
>
> Take a look at this:
>
> http://www.dr-bob.org/cgi-bin/pb/mget.pl?post=/babble/20041123/msgs/420491.html
>
> And these:
>
> http://www.ncbi.nlm.nih.gov/pubmed/15738862
> http://www.biopsychiatry.com/amisulpride.htm
> http://www.biopsychiatry.com/amisulpridedop.htm (NOTE: Specifically talks about dopaminergic deficiency with is associated with anhedonia.)
>
> And this:
>
> http://www.biopsychiatry.com/sulpiride.htm
>
> So I have no idea if amisulpride is superior to sulpride. Most of the literature on depression is on amisulpride, not sulpride. Both appear to be affective, fairly safe augmenters or primary drugs for minor anhedonia. I'm pretty sure they can be used with an SSRI, although there is no literature that I can find to support this. Seems amisulpride is used as the primary agent and has been shown to have similar efficacy to SSRI's in some studies. Although look at this:
>
> http://www.dr-bob.org/cgi-bin/pb/mget.pl?post=/babble/20020416/msgs/103469.html#103469
>
> Maybe a bad idea to combine? Just try amisulpride trial? Do a search on low dose flupentixol. I think there's some lit on it as an AD but don't have time to look it up for.
>
> I hope this is more helpful than confusing, but I fear it may be the latter. Happy to talk to you any time on these topics. Fascinating to me!
>
> Phoenix1
>Thanks for your detailed and informative response.
Years ago, I was on a combination of Zoloft and low dose (< 1mg/day) flupentixol, with reasonable results. Not sure if it did much for my mood, but sure helped me feel alive and calm. I enjoyed listening to music for example; now I just feel dead. Everything feels boring.
Side-effects of the flupentixol were:
- non-permanent hair loss (no kidding). My hair fell out substantially while using it; this problem ended when I stopped the flupentixol;
- weight gain, of the order 10kgs, in the sense that, when I stopped the flupentixol, I lost about 10kgs in just a few months. Still don't know how that worked, because my diet didn't really change.
- I needed more sleep, although I was perfectly alert while awake. So I didn't find it sedating as such, I just needed more sleep. And boy, was it good sleep!I actually have a theory, which I cannot prove of course, that long-term use of Zoloft may have permanently affected my ability to experience pleasure.
Posted by Phoenix1 on January 17, 2008, at 8:43:25
In reply to Re: Thanks!, posted by Jamal Spelling on January 17, 2008, at 7:31:13
> > > Does anyone have any thoughts on low dose flupentixol? It's a typical thioxanthene AP.
> > >
> > > Does anyone know the difference between sulpiride and amisulpride? They are both benzamide APs, apparently very similar. It seems many have used amisulpride, but what about sulpiride? Can it, too, be used to counteract anhedonia, possibly alongside and SSRI?
> >
> > Hi Jamal,
> >
> > Take a look at this:
> >
> > http://www.dr-bob.org/cgi-bin/pb/mget.pl?post=/babble/20041123/msgs/420491.html
> >
> > And these:
> >
> > http://www.ncbi.nlm.nih.gov/pubmed/15738862
> > http://www.biopsychiatry.com/amisulpride.htm
> > http://www.biopsychiatry.com/amisulpridedop.htm (NOTE: Specifically talks about dopaminergic deficiency with is associated with anhedonia.)
> >
> > And this:
> >
> > http://www.biopsychiatry.com/sulpiride.htm
> >
> > So I have no idea if amisulpride is superior to sulpride. Most of the literature on depression is on amisulpride, not sulpride. Both appear to be affective, fairly safe augmenters or primary drugs for minor anhedonia. I'm pretty sure they can be used with an SSRI, although there is no literature that I can find to support this. Seems amisulpride is used as the primary agent and has been shown to have similar efficacy to SSRI's in some studies. Although look at this:
> >
> > http://www.dr-bob.org/cgi-bin/pb/mget.pl?post=/babble/20020416/msgs/103469.html#103469
> >
> > Maybe a bad idea to combine? Just try amisulpride trial? Do a search on low dose flupentixol. I think there's some lit on it as an AD but don't have time to look it up for.
> >
> > I hope this is more helpful than confusing, but I fear it may be the latter. Happy to talk to you any time on these topics. Fascinating to me!
> >
> > Phoenix1
> >
>
> Thanks for your detailed and informative response.
>
> Years ago, I was on a combination of Zoloft and low dose (< 1mg/day) flupentixol, with reasonable results. Not sure if it did much for my mood, but sure helped me feel alive and calm. I enjoyed listening to music for example; now I just feel dead. Everything feels boring.
>
> Side-effects of the flupentixol were:
> - non-permanent hair loss (no kidding). My hair fell out substantially while using it; this problem ended when I stopped the flupentixol;
> - weight gain, of the order 10kgs, in the sense that, when I stopped the flupentixol, I lost about 10kgs in just a few months. Still don't know how that worked, because my diet didn't really change.
> - I needed more sleep, although I was perfectly alert while awake. So I didn't find it sedating as such, I just needed more sleep. And boy, was it good sleep!
>
> I actually have a theory, which I cannot prove of course, that long-term use of Zoloft may have permanently affected my ability to experience pleasure.Hi Jamal,
Glad you found the links interesting. I have a strong healthy fear of SSRIs after trying most of them with no positive results. I believe that one of them may have semi-permanently worsened my anxiety. Just an opinion, as many people see to do well on SSRIs and have no problems discontinuing. Maybe some of us do have permanent side effects though.
Anyways, the amisulpride thing is really interesting. It appears to be very different from the classic APs but also significantly different from the atypical AP's. I'm not sure if you could replicate it's antidepressant effects by using any other AP. I'd love to give it a try if Nardil weren't working so well. Something to keep in the back of my head in case I need a new AD for some reason. Not many choices left after what I've tried.
Phoenix1
Phoenix1
Posted by bleauberry on January 17, 2008, at 20:39:21
In reply to Which APs, at low dosages, treat anhedonia?, posted by Jamal Spelling on January 16, 2008, at 11:40:52
I found prozac plus zyprexa was pretty good at anhedonia. Actually looking back, I was into talk radio, listening to music, planting fruit trees in my yard, building a shed and house stuff, bike riding, walking to the beach, stopping the car to take a short hike on a trail, winning awards at work...even when I thought I still had some anhedonia. I was obviously a million miles better than I thought I was. Zyprexa alone didn't do that. Prozac alone didn't do that. Together they did. Maybe other ssri/ap combos would be good too, I don't know. The other common one I have heard about is celexa/risperdal.
As monotherapy for anhedonia, the best qualified I am aware of is amisulpride. It is availabe by overseas mailorder. I never had any problem getting it, other than the 2 to 3 week wait for it to arrive in the mailbox.
Posted by kingcolon on January 25, 2008, at 3:01:20
In reply to Re: Which APs, at low dosages, treat anhedonia?, posted by bleauberry on January 17, 2008, at 20:39:21
> I found prozac plus zyprexa was pretty good at anhedonia. Actually looking back, I was into talk radio, listening to music, planting fruit trees in my yard, building a shed and house stuff, bike riding, walking to the beach, stopping the car to take a short hike on a trail, winning awards at work...even when I thought I still had some anhedonia. I was obviously a million miles better than I thought I was. Zyprexa alone didn't do that. Prozac alone didn't do that. Together they did. Maybe other ssri/ap combos would be good too, I don't know. The other common one I have heard about is celexa/risperdal.
>
> As monotherapy for anhedonia, the best qualified I am aware of is amisulpride. It is availabe by overseas mailorder. I never had any problem getting it, other than the 2 to 3 week wait for it to arrive in the mailbox.Given the risks of TD, EPS with the AP's, I am avoiding them for my depression, which includes anhedonia. There are plenty of other dopaminergic agents to try: Mirapex, Requip, Wellbutrin, ?Trivistal, even the stimulants (Adderal,Dex, Ritalin,?Provigil). I did fairly well with Requip but had to discontinue it due to palpitations. I'm one of the few fortunate ones to have been able to use Subutex (buprenorphine), which I've been on now for 6 months with about the best anti-anhedonic response I've had to any med. I also use phosphytidylserine, acetyl carnitine, and Rhodiola which have dopamine boosting properties.
This is the end of the thread.
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