Psycho-Babble Medication Thread 1109599

Shown: posts 1 to 17 of 17. This is the beginning of the thread.

 

What are the overall best antipsychotics...?

Posted by Skeletor on April 13, 2020, at 10:02:46

What are the overall best (atypical) antipsychotics for Depression, Anxiety, Agitation, OCD, Bipolar...?

"Best" as in being effective with fewer side effects. Which ones were the best for you? Which ones did you take? What condition(s) did you treat? What side effects did you get? How did the antipsychotics compare to "conventional" antidepressants?

Can antipsychotics be an alternative to "conventional" antidepressants? What are the risks? What are the benefits? Do they make you a tomato with time? Psychiatrists prescribe them more often in recent times, it seems.

 

Re: What are the overall best antipsychotics...?

Posted by Lamdage22 on April 13, 2020, at 22:16:19

In reply to What are the overall best antipsychotics...?, posted by Skeletor on April 13, 2020, at 10:02:46

The only Antipsychotic for me to ever improve mood was Abilify. However it produced akathisia. I haven't tried the new "abilifyish" meds like Vraylar and the other one, but I imagine that they are good for mood, too. Never tried Sulpride or Amisulpride. They are supposed to be good for mood.

My favorite Antipsychotic is Zyprexa, but there is no direct effect on mood. Only indirectly, delusions are usually poison for mood. However if you don't have any, I doubt it would help your mood.

 

Re: What are the overall best antipsychotics...?

Posted by undopaminergic on April 14, 2020, at 8:08:21

In reply to What are the overall best antipsychotics...?, posted by Skeletor on April 13, 2020, at 10:02:46

> What are the overall best (atypical) antipsychotics for Depression, Anxiety, Agitation, OCD, Bipolar...?
>

Low-dose flupenthixol, amisulpride, and sulpride, are effective in their own right for depression. Flupenthixol is typically regarded as typical (pun partly intended), but some have called it partially atypical. Newer drugs that may help for the same indication are aripiprazole and cariprazine.

As anti-manics, you would choose one of the more anti-histaminergic drugs, eg. olanzapine, risperidone, quetiapine. Likewise for anxiety.

> "Best" as in being effective with fewer side effects. Which ones were the best for you? Which ones did you take? What condition(s) did you treat? What side effects did you get? How did the antipsychotics compare to "conventional" antidepressants?
>

As anti-psychotics, the most potent I've tried is actually the anti-depressant trimipramine, followed by clozapine.

I've been fortunate in that I haven't had any weight gain from the clozapine.

Flupenthixol at higher doses (4+ mg or so) produced anorgasmia.

> Can antipsychotics be an alternative to "conventional" antidepressants?

See above. Certainly sulpiride outperformed most of the antidepressants I've taken, such as SSRIs and bupropion. Indeed, it transiently outperformed stimulants! Alas, after tolerance set in, there were no effects at all.

> What are the risks? What are the benefits? Do they make you a tomato with time? Psychiatrists prescribe them more often in recent times, it seems.
>

They are quite overprescribed in my opinion. The worst risk is tardive dyskinesia that persists after drug cessation.

-undopaminergic

 

Re: What are the overall best antipsychotics...?

Posted by Lamdage22 on April 14, 2020, at 10:55:35

In reply to Re: What are the overall best antipsychotics...?, posted by undopaminergic on April 14, 2020, at 8:08:21

Is there any drawback to taking Sulpiride, Amisulpiride or Fluanxol at low doses as a schizo? Could it actually have a pro-psychotic effect? Thanks.

 

Re: What are the overall best antipsychotics...?

Posted by undopaminergic on April 14, 2020, at 11:33:15

In reply to Re: What are the overall best antipsychotics...?, posted by Lamdage22 on April 14, 2020, at 10:55:35

> Is there any drawback to taking Sulpiride, Amisulpiride or Fluanxol at low doses as a schizo? Could it actually have a pro-psychotic effect? Thanks.
>

With sulpiride/amisulpride, I guess hypothetically, because it involves dopaminergic action. I don't know about the mechanism of Fluanxol's anti-depressive action.

I don't think you need to worry, because you can just stop taking it if you notice signs of increasing psychosis.

-undopaminergic

 

Re: What are the overall best antipsychotics...?

Posted by Lamdage22 on April 14, 2020, at 12:49:58

In reply to Re: What are the overall best antipsychotics...?, posted by undopaminergic on April 14, 2020, at 11:33:15

> I don't know about the mechanism of Fluanxol's anti-depressive action.

I recall it is similar to Sulpiride and Amisulpiride. I would piss my doctor off by asking though. He thinks meds are good like they are. Only Seroquel is facultative long term. That's his opinion. I chose him because of his trust in the FDA... and now I don't think I'd try anything when it is not yet on the german market.

The only other AP I can think of for depression is Seroquel, but I doubt that it is a heavy lifter in my regimen. What do you guys think about Seroquel for depression?

 

Re: What are the overall best antipsychotics...? Lamdage22

Posted by Skeletor on April 14, 2020, at 17:31:27

In reply to Re: What are the overall best antipsychotics...?, posted by Lamdage22 on April 14, 2020, at 12:49:58

> What do you guys think about Seroquel for depression?

Powerful antihistamine. Good for sleep.

 

Re: What are the overall best antipsychotics...?

Posted by Lamdage22 on April 15, 2020, at 0:49:03

In reply to Re: What are the overall best antipsychotics...? Lamdage22, posted by Skeletor on April 14, 2020, at 17:31:27

Im not really buying that it does much of anything for depression.

 

Re: What are the overall best antipsychotics...?

Posted by undopaminergic on April 15, 2020, at 2:41:49

In reply to Re: What are the overall best antipsychotics...?, posted by Lamdage22 on April 15, 2020, at 0:49:03

> Im not really buying that it does much of anything for depression.

I agree, except that the anti-histaminergic action can treat certain symptoms that are associated with some depressions, eg. insomnia and agitation.

-undopaminergic

 

Re: What are the overall best antipsychotics...? Lamdage22

Posted by Skeletor on April 15, 2020, at 15:56:42

In reply to Re: What are the overall best antipsychotics...?, posted by Lamdage22 on April 15, 2020, at 0:49:03

> Im not really buying that it does much of anything for depression.

Yeah, seems unlikely. If it at least had some powerful 5HT2 antagonism, but it even lacks that...

 

Re: What are the overall best antipsychotics...?

Posted by Lamdage22 on May 21, 2020, at 11:09:12

In reply to Re: What are the overall best antipsychotics...? Lamdage22, posted by Skeletor on April 15, 2020, at 15:56:42

If you ask me, D2 antagonistic Antipsychotics do nothing for depression unless they somehow raise Dopamine at a low dose. Sulpiride, Amisulpiride. Maybe others.

The abilifyish meds are different, because they sort of modulate Dopamine instead of killing it.

 

Re: What are the overall best antipsychotics...?

Posted by undopaminergic on May 21, 2020, at 12:15:00

In reply to Re: What are the overall best antipsychotics...?, posted by Lamdage22 on May 21, 2020, at 11:09:12

> If you ask me, D2 antagonistic Antipsychotics do nothing for depression unless they somehow raise Dopamine at a low dose. Sulpiride, Amisulpiride. Maybe others.
>

Sulpiride and amisulpride preferentially block presynaptic dopamine autoreceptors, increasing dopamine release.

Flupenthixol is antidepressive, but I don't know what its mechanism of action might be.

> The abilifyish meds are different, because they sort of modulate Dopamine instead of killing it.
>

Yes, they are partial agonists. They antagonise when endogenous dopamine is high, and stimulate when dopamine is low.

-undopaminergic

 

Re: What are the overall best antipsychotics...?

Posted by undopaminergic on May 21, 2020, at 12:17:33

In reply to Re: What are the overall best antipsychotics...?, posted by undopaminergic on May 21, 2020, at 12:15:00

> > If you ask me, D2 antagonistic Antipsychotics do nothing for depression unless they somehow raise Dopamine at a low dose. Sulpiride, Amisulpiride. Maybe others.
> >
>
> Sulpiride and amisulpride preferentially block presynaptic dopamine autoreceptors, increasing dopamine release.
>

The serotonin 5-HT2 receptor antagonism of many antipsychotics may be helpful in depression too. The antidepressant mirtazapine also has this action.

-undopaminergic

 

Re: What are the overall best antipsychotics...?

Posted by Lamdage22 on May 21, 2020, at 12:35:10

In reply to Re: What are the overall best antipsychotics...?, posted by undopaminergic on May 21, 2020, at 12:15:00

Also at higher dosages?

> Flupenthixol is antidepressive, but I don't know what its mechanism of action might be.

 

Re: What are the overall best antipsychotics...?

Posted by undopaminergic on May 22, 2020, at 0:22:20

In reply to Re: What are the overall best antipsychotics...?, posted by Lamdage22 on May 21, 2020, at 12:35:10

Yes, apparently, but it has extrapyramidal side effects at such doses. As always, there are individual differences both in terms of desired and adverse effects.

> Also at higher dosages?
>
> > Flupenthixol is antidepressive, but I don't know what its mechanism of action might be.
>

 

Re: What are the overall best antipsychotics...?

Posted by Lamdage22 on May 22, 2020, at 6:27:09

In reply to Re: What are the overall best antipsychotics...?, posted by undopaminergic on May 22, 2020, at 0:22:20

Yeah I think my meds are fine. I just need good Psychotherapy. I have made alot of progress these past two years. I feel like I am finally up for digging a little deeper!

 

Re: What are the overall best antipsychotics...?

Posted by undopaminergic on May 22, 2020, at 9:10:20

In reply to Re: What are the overall best antipsychotics...?, posted by Lamdage22 on May 22, 2020, at 6:27:09

> I just need good Psychotherapy. I have made alot of progress these past two years.
>

I've come a long way too, mostly through my own (solitary) efforts, both psycho- and pharmaco-therapeutic.

> I feel like I am finally up for digging a little deeper!

Me too, but for that (to go deeper), a bit more intense psychotherapy is required than what I'm getting (currently two 25-minute chat sessions a week plus non-realtime messaging). I find that it is easier for me to go into sensitive matters through on-line therapy, in the written word.

-undopaminergic


This is the end of the thread.


Show another thread

URL of post in thread:


Psycho-Babble Medication | Extras | FAQ


[dr. bob] Dr. Bob is Robert Hsiung, MD, bob@dr-bob.org

Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.