Posted by Katz on February 2, 2001, at 13:12:54
In reply to Re:Amisulpride Update #2, posted by AndrewB on February 2, 2001, at 0:08:45
Hi AndrewB!!!
Thankyou! I value your suggestions. Being that you are, our resident pharmacologist/chemist, I was about to seek you out, but alas, you have found me.
I was somewhat disillusioned to hear about the amisulpride/sedation situation. I'm hanging in there though and hoping for the best. I will keep in mind your dosage suggestions and titrate down instead of up as I had intended to do. For the next few days I will stay at 25mg as you also suggested. In the meantime, I will begin to research Merapex. It's comforting to know what my next step will be should the amisulpride not work out. There is something about the "feel" of the amisulpride that gives me an innate sense that I'm on the right track. I think if anything (aside from methylphenidate) is going to work for me, it will be one of the antipsychotics. I have no idea why I am saying that, it is based on nothing more than a "feeling". It is certainly not based on any educated guess or even anicdotal evidence.
Now, getting back to what's happening with my amisulpride trial: tired and exhausted last night I could not get to sleep. Refusing to put up with the insommnia, I decided to take something for it. My choices of meds where: valium, melatonin or bromocriptine. I decided against the bromocriptine because of its dopamine action. I didn't want to complicate the amisulpride issue and besides, I had taken the bromocripine before for anti-aging, growth hormone releasing action and although at 2.5 mg, it put be quickly to sleep, it also caused a rapid onset of depression. I quit the bromocriptine within a week of the initial trial. (I wonder, Andrew, if this might provide a further clue to what is going on inside my head?) I decided against the melatonin. It knocks me out cold but leaves me feeling drugged and zombie-like when I awake. I went with the valium (generic) and took 5 mg. I was asleep within 20 min. It put me into a dead sleep that I did not awake from until 10 AM (I'm usually up at 8). Had I not been awaken by the phone, I would have been sleeping several more hours. I awoke feeling drugged and sleepy. I quickly took 25 mg amisulpride + 300 mg andrafinil. The drugged and sleepy feeling quickly disappeared. I am now feeling awake and alert. Not motivated and not energized, just awake and alert. There is another issue that might give you another clue into what is going on. My sleep is very deep. I don't seem to experience very much REM. I very rarely dream! When I was on the reboxetine, sleep became a "night out at the movies". The reboxetine was discontinued after a month because it lost it's initial energizing effects and I was beginning to experience periods of fleeting depression which would last anywhere from 30 min. to an hour. Any postive effects from the reboxetine had disappeared and I was left with only the negative ones. I may have given up on this trial too soon.
So, that's the situation as it now stands. I am trying to do a daily update on my day to day amisulpride trial in hopes that it may be of benefit to someone else. I hope you will keep a check on these posts and keep me advised as to what you believe my next steps should be.
Thanks again,
Kathy
>Katz,
>
> First of all I would like to suggest that you not get your expectations up too high about any one med. You never know what is going to work. The best avenue to success is patience and willingness to try various med. (combo.s). But chances are, with time, you will find the right med.
>
> Sedation is one the most common sided effects among non-responders to amisulpride. Usually, but not always, it does not go away.
>
> I suggest you try amisulpride at your current dosage for a total of 5 days.
>
> Since we know too high doses of amisulpride cause sedation, if the sedation persists, after five days switch to taking 12.5mg.s of amisulpride at night. Give this trial 5 days. If you are still sedated or unresponsive it is time to try something else.
>
> It is possible that the sedation in this case is caused by supersensitive and very responsive postsynaptic dopamine D2/D3 receptors. The receptors may be so sensitive they are attracting amisulpride, even at low doses to attach to them. When this happens the amisulpride will block these receptors and can cause sedation and tension.
>
> This scenario, if applicable, gives us a clue as to what may work for you. Specifically you may benefit from stimulation of those D2/D3 receptors. Mirapex is very effective at doing this, so I would make it my first choice for a trial if amisulpride doesn’t work.
>
> Mirapex is available in the US or without an Rx abroad.
>
> Please keep us informed on how it is going and try to keep the faith that a med. that will help you is out there.
>
> AndrewB
poster:Katz
thread:52347
URL: http://www.dr-bob.org/babble/20010131/msgs/53173.html