Posted by karaS on November 1, 2004, at 23:05:57
In reply to Re: no more Cymbalta for now » karaS, posted by zeugma on November 1, 2004, at 18:31:37
> > > > Most likely I'll just sit here thinking about this and changing my mind a million times before I do anything.
> > 2 more thoughts before I talk to my doctor again:
> > reboxetine and Amisulpride. The word on reboxetine as an AD isn't that great, is it? Hopefully, I'm wrong about that. Amisulpride and Sulpiride - are they related? I believe I read that one or both of them are the only medications specifically for my DA receptor problem. I would take it in AD dosage. I know that they are APs but what makes a medication an AP? If they're taken at AD dosage, do they still carry a risk of TD/movement disorder?
> >
> I wish I could recommend Strattera. The drug unquestionably has an AD effect. But the sedation/fatigue effect that I eventually got from it seems far from uncommon. Reboxetine has a bad reputation here, and most say desipramine is a superior AD. But in theory reboxetine should be a good AD.Yes, in theory reboxetine should be good - desipramine without as much of the anticholinergic effects. But in reality if it doesn't pan out, who cares about the theory. I just wish that dispramine didn't give me so much tachycardia.
> AP's are drugs that block the negative and positive symptoms of psychosis- delusions, paranoia, as well as apathy and withdrawal. The negative symptoms of schizophrenia and depression are similar, which is why many AP's have AD effects, at least at lower doses. AP's block the D2 receptor, which is thought to underlie the efficacy against the positive symptoms- delusions and such- while they also block 5HT-2 receptors which is thought to improve the positive symptoms. I think amisulpiride is a cleaner version of sulpiride.So you think that there's still movement disorder risk to using amisulpride at AD dosage level?
> Something you might want to consider is Abilify. It is a partial agonist of D2 receptors. In theory, if your D2 receptors are overly sensitive, then Abilify will desensitize them, much like buspirone is thought to desensitize the 5HT-1A receptor. I have also read claims that Abilify is the only AP besides clozapine that does not carry the risk of tardive dyskinesia. I would say Seroquel would be the least likely of the others to induce TD.My pdoc recommened Abilfy to add on to something else for my potential "soft bipolar'" condiiton - if in fact i have that. If so, might be able to kill two birds with one stone.
Thanks, as always for the info. I assume it's still to early to ask you how the 50 Ritalin LA is going?
K
poster:karaS
thread:406397
URL: http://www.dr-bob.org/babble/20041029/msgs/410412.html