Posted by bleauberry on September 8, 2011, at 19:14:47
In reply to Question about Low Dose Amisulpride, posted by poser938 on September 6, 2011, at 1:33:40
We can talk about med mechanisms and theories and stuff but I think we need to keep in perspective that what we know is only a sliver of what we don't know. There is much more to these meds we aren't even aware of. That's why it's so hard to predict or figure out what did what.
I think the autoreceptors will adjust to the increased dopamine release but that it is somehow tied into the longer term "kicking in" thing. Or maybe they adjust and the good effect goes away. Or maybe amisulpride blocks them just a tiny bit, just enough to prevent excessive adjustment. I mean, it is preferential for certain receptors at certain doses, but it isn't perfect. It will hit other stuff to some degree. I'm just trying to point out that these meds don't do just what we think they do and nothing else, and even if they did, we don't really know what that means from one patient to another. It just aint that simple.
On the topic of anhedonia I just wanted to comment that while dopamine gets all the fanfare on that topic, the neurotransmitter I have found to be most strongly associated with my own battles of anhedonia is norepinephrine. A little bit dopamine, but mostly norepinephrine. I know it is tempting to point the finger at mirapex and immediately conclude dopamine....but as tried to say, it aint that simple. IMO. Sure, maybe we can fairly confidently point the finger at mirapix in your case, but that in no way points the finger conclusively at dopamine. There is too much other stuff involved with that med.
Anyway, my best anti-anhedonia strategies involved norepinephrine, not dopamine. Amisulpride was pretty good, but milnacipran was better. Super low doses of either is the key for me. If the dose is too high you will know because the flatness gets worse.
I do agree with your theory to attempt a reverse strategy...with amisulpride. But if your dose is too high it won't be any different than taking any other antipsychotic. For me I found 12.5 pretty potent, not quite enough, but 25mg was just a bit too much. In literature they usually talk in terms of 50mg to 100mg which in my opinion is past the point of being specific for the pre-receptors and is instead hitting all receptors. That is based on my own experience and observing comments of others at this board who have tried amisulpride.
I recall one of the most bizarre stories was someone who popped in about a year ago....long bad history like all of us....and came in just to say hi and how well he was doing....all his previous med failures became history when he started taking just a tiny crumb of amisulpride. Another person took a tiny crumb every other day instead of every day. That's the way it usually works best for me too though I never got the complete remission they did. My best dose is in the 18mg-23mg range. It is that finnicky.