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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by chinaboy on January 27, 2014, at 20:43:26
I talked with the psychiatrist today about his previous prescription(Paxil +Abilify) being ineffective, and he changed the prescription into Zoloft 200mg+Mirtrapine30mg+Wellbutrin 300mg. So expensive, so many meds.I kinda feel I'm over-medicated.
Do you guys think I should take so much med? What are the benefits /risks of taking them?
PS:My conditions are anhedonia(lack of motivation+inability to feel pleasure), social anxiety,and OCD.
Posted by chinaboy on January 27, 2014, at 21:02:35
In reply to Am I over-medicated?, posted by chinaboy on January 27, 2014, at 20:43:26
My Pdoc just phoned me and asked me to add Amisulpride 50mg in addition to above meds. Here I have a question: Should I take it everyday or every other day? My Pdoc didn't know about this and told me to ask this question through internet:(
Posted by jono_in_adelaide on January 28, 2014, at 0:05:45
In reply to add Amisulpride 50mg, posted by chinaboy on January 27, 2014, at 21:02:35
I'd take the cocktail for a month and see if it starts to get you better before you decide whether its appropriate or not - if it works, stick with it, if it doesnt work, change to somthing else.
So what if you're on 4 different pills, if it gets you better, thats all that matters, psychiatry isnt like centrum, where all you need is one tablet once a day
Posted by phidippus on January 28, 2014, at 15:38:43
In reply to Am I over-medicated?, posted by chinaboy on January 27, 2014, at 20:43:26
The Zoloft and the Mirtazapine are prescribed to treat your depression and OCD and are a reasonable combo. The Wellbutrin works differently than the other two meds and should be working to treat your anhedonia.
I don't think you're taking too many meds. The benefits to your depression and anxiety should make them worth taking. Side effects would be the biggest risk to taking them.
Eric
Posted by bleauberry on January 28, 2014, at 16:31:08
In reply to Am I over-medicated?, posted by chinaboy on January 27, 2014, at 20:43:26
I feel that one is over medicated when there are excessive side effects, or the desired effect is not achieved, or if there are lab signs the liver enzymes are showing warning signs. Other than that, I don't think the actual count of how many meds is taken is all that important. The point is to experience considerable improvement of quality of life. Whatever that takes. imo
I've been on amisulpride several times at various doses and I must say I feel it is one of the best meds available in all of psychiatry. It alone without the other meds could actually cover all your symptoms. I'm not predicting it would, just expressing confidence that it does have that kind of potential.
The cocktail you were prescribed I feel makes sense. High dose zoloft is probably primarily for the OCD and social anxiety. I'm not sure why on the remeron except maybe as a possible potentiator and sleep aid. Wellbutrin for anhedonia. Makes sense. The problem is that in the real world any of these could backfire and do the opposite of what was intended or not achieve the desired results. Mileage varies. Hopefully give it some time and see how it progresses.
Your cocktail was 3 meds and now 4. That's not bad. Many of us have been on 5 to 10 at any given time. That's when I start to see warning flags of overmedicated...tons of meds but still feel like crap.
OCD with anhedonia theoretically seems like a tough one to me. That's because the usual approach to taming down the OCD is to beef up the serotonin which dampens down dopamine which worsens anhedonia. To add more dopamine or norepinephrine to make up for that could trigger OCD again. And no matter what, the anhedonia might go untouched the whole time. I had that symptom for so many years and it's torture. Most of it is gone now.
Amisulpride can be unfriendly to your sex life so keep an eye on that.
Going forward after things have stabilized you may be able to lower doses of the other meds.
If you go to higher doses of amisulpride, it will begin to behave more like a regular antipsychotic and emotional numbing would not be a surprise. imo So that would not be good for the anhedonia. But, like I said, mileage varies and we really can't predict anything, so anything is possible.
And over time, the whole goal should be to have enough recovery in life that we can begin to whittle down on the meds gently over time and maybe someday not even need as much help any more.
I send you best wishes. I really hope your struggles improve very soon. I just wanted to share with you my thoughts on amisulpride.
> I talked with the psychiatrist today about his previous prescription(Paxil +Abilify) being ineffective, and he changed the prescription into Zoloft 200mg+Mirtrapine30mg+Wellbutrin 300mg. So expensive, so many meds.I kinda feel I'm over-medicated.
>
> Do you guys think I should take so much med? What are the benefits /risks of taking them?
>
> PS:My conditions are anhedonia(lack of motivation+inability to feel pleasure), social anxiety,and OCD.
>
Posted by chinaboy on January 29, 2014, at 3:09:07
In reply to Re: Am I over-medicated?, posted by bleauberry on January 28, 2014, at 16:31:08
>
> I've been on amisulpride several times at various doses and I must say I feel it is one of the best meds available in all of psychiatry. It alone without the other meds could actually cover all your symptoms. I'm not predicting it would, just expressing confidence that it does have that kind of potential.
>
>
> Amisulpride can be unfriendly to your sex life so keep an eye on that.
>
> If you go to higher doses of amisulpride, it will begin to behave more like a regular antipsychotic and emotional numbing would not be a surprise. imo So that would not be good for the anhedonia. But, like I said, mileage varies and we really can't predict anything, so anything is possible.
>
>
>
Thank you for your thoughts and kind words! But how often do you take Amisulpride? Everyday or every other day? At what dose? Do you take it alone or with other meds?
I tried it some time ago. It brought me so much motivation and I could get things done, which was rare in my case.But overtime, its effect was gone and tolerance was built.What should I do then?
Posted by bleauberry on January 29, 2014, at 13:55:10
In reply to How often should I take Amisulpride? » bleauberry, posted by chinaboy on January 29, 2014, at 3:09:07
Amisulpride is dosed once daily with or without food, with or without other meds. It has very little interaction with other meds.
The issue of tolerance has popped up before. There was someone here a couple years ago who dealt with that by dosing it only once every other day. That dose was 25mg I believe. For him it prevented the tolerance, and for him getting one good day out of two was better than getting none out of two. So basically he got the benefits of amisulpride one day, then a day off back to the blahs, then amisulpride again. And so on.
Reducing the dose to 12.5 worked ok for me too, though it was really best for me somewhere in the middle between 12.5mg and 25mg. It is a sensitive med in terms of dosing and effects.
My own experience was that when that tolerance set in, I kept dosing anyway, and then weeks later the real longer term effects of the med took over, which were similar to the early effects except smoother and more subtle. They came on slowly so I didn't really notice until one day I realized a lot of improvement had happened.
> Thank you for your thoughts and kind words! But how often do you take Amisulpride? Everyday or every other day? At what dose? Do you take it alone or with other meds?
> I tried it some time ago. It brought me so much motivation and I could get things done, which was rare in my case.But overtime, its effect was gone and tolerance was built.What should I do then?
>
Posted by chinaboy on February 4, 2014, at 23:32:47
In reply to Re: How often should I take Amisulpride?, posted by bleauberry on January 29, 2014, at 13:55:10
Thank you for replying! I've taken Amisulpride for a few days, but couldn't feel anything positive, let alone the early stimulating effect. People say that they feel they are stimulated and mood brighted at the beginning, but I feel nothing good. Is this normal? Should I continue taking it?
Posted by chinaboy on February 5, 2014, at 22:47:00
In reply to I couldn't feel anything positive on Amisulpride » bleauberry, posted by chinaboy on February 4, 2014, at 23:32:47
Just contacted my pdoc. He insisted that I take 50mg 0f Ami because he wasn't sure my anhedonia was due to depression or negative symptoms of sch. He said that since the med combo caused 5-ht syndrome, Amisulpride alone is enough for me, and that 50mg 0f Ami is both anti- anhedonia and antipsychotic.
Posted by Andy_NL on February 6, 2014, at 12:56:24
In reply to Re: How often should I take Amisulpride?, posted by bleauberry on January 29, 2014, at 13:55:10
Hi to Every,
Bleauberry, only a couple of questions please:
In your case, the longer term effects of Amis dosed at 12-25 mg every day, lasts or, anyway, fade after a period?
Did you have sexual problems (or other Important side effects) during the daily use of small doses of Amis? After how much days/weeks?
Thank you very much indeed for your infos!
Andy
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