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Re: Sulpiride + Parnate combo » SLS

Posted by ixus on June 18, 2005, at 8:13:12

In reply to Re: Sulpiride + Parnate combo, posted by SLS on June 18, 2005, at 7:34:48

Hi Scott,
> Sulpiride sometimes works better to treat depression at dosages of 50-100mg according to a Dr. D. Bakish that I spoke to before trying it.
>

This may be true, I plan to lower the dose as soon as it kicks in completely. However there are different reports about the dose and in some cases 100-300 mg is used. I read a raport where mean 180mg had been used.
I use this for primary anxiety and tensions.
>

That seemed a little low to me. I was thinking more like 100-200mg. However, 50-100mg of sulpiride equates to roughly 25-50mg of amisulpiride, a drug reported to exert antidepressant effects in this dosage range. Amisulpiride has been studied for use in dysthymia, the results of which have been positive. I think adding low-dose sulpiride or low-dose amisulpiride is worth a trial in combination with Parnate. I have not decided which of the two antipsychotics is a more powerful antidepressant.
>
I would be cautious saying that either amisulpride or sulpiride possesses strong antidepressant effect.
There are many articles about amisulpride about that, however this is a new drug and is marketed very extensively.

>Amisulpiride has a much greater affinity for D2 receptors; greater than that of dopamine. Sulpiride is weaker than dopamine. I think it might come down to ratios of affinities of drug to pre/post-synaptic receptors. Both seem to work, though. Sulpiride monotherapy caused me to feel better for about two hours after taking my first dose of 50mg, and nothing thereafter. I still have some of it floating around, so maybe I'll repeat the trial while adding it to the drugs I'm now taking, which include Parnate and desipramine.
>

50mg is a very low dose.
A few years ago I tried amisulpride 25-100mg combined with fluoxetine. It did not help, but I can not compare it, because now I am on Parnate.

> I experienced a brief (about 10 days), but significant improvement in depression and social anxiety when I added Zyprexa 5mg to Parnate 80mg. If anxiety is a feature of the core depressive illness, it should disappear when the depression resolves. You might not need to treat the anxiety separately.
>
Actually it is VERY difficult to say whethere anxiety or depression is primary. I tried to treat depression and anxiety with typical antidepressants without much success. Parnate relieves depression but anxiety remains.

> It looks as if Ixis has found a wonderful treatment that works well for him. A lower dosage of sulpiride might not address adequately his anxiety.
>
We'll see. I will definitely go for a lower dose,

/ixus


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