Posted by bleauberry on December 30, 2008, at 19:20:30
In reply to Amisulpride for dysthymia: duration of teatment, posted by David P on December 28, 2008, at 20:58:41
No one knows duration of treatment. The usual concensus is to stay on a med after it has started working for 6 months, and then slowly taper off it to see how you do. If you have had relapsing dysthymia for a long time, consensus is to stay on a med for perhaps the rest of your life.
Our receptors and genes can adapt to whatever manipulation we do on them. Maybe that is part of ssri poopout? Maybe that is part of stimulant tolerance? Benzo poopout? In that same vein, amisulpride is stimulating an artificial flow of dopamine. Will your dopamine receptors eventually adjust so that stimulation doesn't work any more? Don't know.
Here is one thing to consider though. If your dopamine stimulation was low to begin with, and now amisulpride has raised it to where normal should be, then it would not seem tolerance or poopout should happen. If your dopamine stimulation was normal to begin with, and now it is artificially high, then maybe poopout could happen. If that is the case, then time off from the drug could prevent that.
But, just as you experienced almost instant improvement with amisulpride, you could also experience deterioration just as fast. I mean, take away that dopamine stimulation and you could be really down. Maybe.
If you are concerned, maybe try going down to 25mg? Stay there for a while and see?
As you mentioned, I think amisulpride is a fantastic medicine and it is a shame it isn't FDA approved. That is all politics and economics. Too bad those things get in the way of improving medical treatments. I have always felt that if a drug has been used around the world for at least two decades, it has a solid track record, there are hundreds of studies on it, multiple positive placebo controlled studies, well, there is no need for the whole FDA thing. Just approve it and put it in the pharmacy. All the work and proof and time-testing has already been done, yeah?
poster:bleauberry
thread:871216
URL: http://www.dr-bob.org/babble/20081223/msgs/871488.html