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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Vince on January 19, 2001, at 23:49:46
Hi everyone, this is the first time I've posted here.
I have read a lot of posts about amisulpride and adrafinil. I would like to give it a try but I'm afraid that it would be like my experience with Dexedrine. My doctor tried to add Dexedrine along with an SSRI that hadn't been working. It was great for a while. I had motivation, interest, etc. But only for about a week, then the good effects wore off and I felt worse than when I started taking it. When I went off the dex I slept for about 2 or 3 days. So I worry about stimulants or anything that affects dopamine. Even buspar had that same kind of effect. After a couple of weeks I really started to feel a depersonalization, kind of a 10 million miles from home - isolated - alone in the universe with only my depressed thoughts sort of a feeling.
I'm just wondering if these meds (Amisulpride and adrafinil) would be different. I'm looking for anyone who has had experience with Dexedrine and either of these other meds so that they can make a comparison? Or is there anyone out there who has had a bad experience with Amisulpride or adrafinil?
Just a brief history might be helpful. There seems to be a lot of very knowledgeable people here. I have had depression for a long, long time. Over the years I've tried almost all MAOI's, TCA's, SSRI's, Atypicals. It seems to be getting worse over the last couple of years. I'm seeing some really hellish lows. I seem to cycle every few days from "the very depths of hell" to "man I feel a lot better. I really think I'm going to get better this time" but I never ever feel like I'm not depressed. Even though my mood varies a little I don't know if it could be classified as any type of bipolar. But I just don't know if stimulants like Amisulpride and adrafinil would be good for whatever type of depression that I do have.
Can anybody give me any suggestions or point me in the right direction. I'm kind of afraid to just experiment because I'm not sure that I can tolerate another bad reaction to meds.
Thanks, Vince
Posted by JohnL on January 20, 2001, at 3:36:56
In reply to New here - questions about Amisulpride / adrafinil, posted by Vince on January 19, 2001, at 23:49:46
Hi Vince,
Though Amisulpride and Adrafinil have stimulative characteristics, they are not stimulants like Dexedrine. They are different in just about every way I can think of. For example, no addiction, no withdrawal, no dependence, and they take time to work. Unlike stimulants, both Amisulpride and Adrafinil take days to weeks to have any effect. You can feel a regular stimulant coming on an hour after dosing. A&A are longer term meds.I especially like these meds for people like you and me who have tried all sorts of things. These meds seem to cover the bases that were missed with everything else, and their mechanisms are distinctly unique and different than anything else. They are especially good for the type of depression characterized by blahness, anhedonia, lack of motivation, lack of interest, social withdrawal.
I've tried both separately and they both have merits on their own. But for some reason they work so much better together. Some likely things to expect with this combination: renewed interest, renewed motivation, more energy (but not like Dexedrine), somewhat increased mental cognition (in contrast to the dumb-drug TCAs you tried), social comfort, more talkative, more confident, MAYBE a slight dulling of sexual desire (I experience this somewhat, though it's not nearly as bad as the SSRIs), and not-so-good sleep. I'm still experimenting to find a good sleep med. Yet all of these things come on slowly and gradually. Though a slight boost might be felt as early as day 1, most of the benefits really start to accrue around 3 weeks or so, and continue to improve with each passing week.
To make a long story short, neither of these drugs are at all similar to Dexedrine, or to anything else you've tried. They are quite unique. While there are dozens of drugs that have common mechanisms (TCAs & SSRIs = reuptake inhibitors), Amisulpride stands alone. There is nothing else like it. With Adrafinil, there are other alpha-1 agonists, but not that focus specifically on brain receptors involved with mood, attention, interest, and cognition. Most alpha-1 agonists are used for blood pressure treatment. Adrafinil's alpha-1 agonism focuses on psychological aspects, not blood pressure. So it too stands alone. There is nothing else like it. Modafinil is supposedly similar, and they look almost identical in molecular structure, but in reality they are two dramatically different drugs. I've tried them both. I like Adrafinil, I didn't like Modafinil at all. But like I've said before, there is something special and unique about the combination of Adrafinil+Amisulpride. They have been referred to as "kinder gentler stimulants", and in my own experience they have nothing in common with Dexedrine, Ritalin, or Adderall.
John
Posted by AndrewB on January 20, 2001, at 9:07:29
In reply to New here - questions about Amisulpride / adrafinil, posted by Vince on January 19, 2001, at 23:49:46
Vince,
I very much believe that adrafinil, amisulpride, and related drugs like mirapex and selegiline have great utility and are underutilized in atypical depression. I myself have been completely treated of my dysthymia, fatigue and social anxiety with the combo of amisulpride, selegiline and (occasionally) adderall.
There is a time a place for everthing though. Have you fully explored mood stabilizers. Just from your brief message it seems that your first priority maybe should be to find an effective mood stabilizer.
AndrewB
Posted by Vince on January 20, 2001, at 18:05:07
In reply to Re: New here - questions about Amisulpride / adrafinil, posted by JohnL on January 20, 2001, at 3:36:56
JohnL,
I was glad to see your response to my post. I was really hoping for some advice and encouragement. I will probably give these a try one at a time and then both together if I don't have a bad response to either of them.
Can you give me an idea of the dosing schedule when these meds are used separately and when used together? Do you have to build up to a maintenance level slowly? One more question, did you experience any weight loss on either Amisulpride or adrafinil?
Vince
Posted by Vince on January 21, 2001, at 1:25:39
In reply to Re: New here - questions about Amisulpride / adrafinil, posted by AndrewB on January 20, 2001, at 9:07:29
> Vince,
>
> I very much believe that adrafinil, amisulpride, and related drugs like mirapex and selegiline have great utility and are underutilized in atypical depression. I myself have been completely treated of my dysthymia, fatigue and social anxiety with the combo of amisulpride, selegiline and (occasionally) adderall.
>
> There is a time a place for everthing though. Have you fully explored mood stabilizers. Just from your brief message it seems that your first priority maybe should be to find an effective mood stabilizer.
>
> AndrewBAndrewB
Thank you for responding to my post. I have tried two different anti-convulsants. The last that I tried was lamictal in combination with high dose Effexor. I tried another in combination with an SSRI but I can't remember what it was, I would have to ask my doctor to check the records. I do remember that I did not respond to either mood stabilizer. The side effects in both cases included breaks in my train of thought, kind of like the train would jump the track, so to speak. I would be thinking about something and all of the sudden I would be wondering, “where in the hell was I, what was I just thinking.” Right now I am trying Neurontin. I've only been on that for about a week. Not sure what to think of it yet.
Base on what you and JohnL have said, I'll probably try adrafinil and amisulpride, seperatly first then together if they both work out. I'm not sure if I will continue the neurontin during my little experiment.
Vince
Posted by JohnL on January 21, 2001, at 5:12:02
In reply to Re: New here - questions about Amisulpride / adrafinil » JohnL, posted by Vince on January 20, 2001, at 18:05:07
> JohnL,
>
> I was glad to see your response to my post. I was really hoping for some advice and encouragement. I will probably give these a try one at a time and then both together if I don't have a bad response to either of them.
>
> Can you give me an idea of the dosing schedule when these meds are used separately and when used together? Do you have to build up to a maintenance level slowly? One more question, did you experience any weight loss on either Amisulpride or adrafinil?
>
> VinceHi Vince,
Starting dose of Adrafinil is one tab per day (300mg). Though it's mild enough you could take one twice a day without any problem. Max dose is 4 per day, though higher doses have been used to treat narcolepsy. Amisulpride minimum dose is 50mg. I take 33mg. You could take anywhere from 25mg to 75mg, though 50mg is usually a starting point. Max is 1200mg to 1800mg...but that's for psychosis. For depression related symptoms the range is 50mg to 300mg, but seems to almost always end up being 100mg or less.It will take a couple weeks to receive delivery and get started. After that, if you have any questions, please let me know. Would be glad to help. Keep in mind that even if you do experience an initial boost from these meds, their effects take a couple weeks to kick in. Benefits continue to improve over weeks and months. If you don't feel anything in the first week, the drugs still might work. If you do feel something within the first week, that's a solid clue that it will work out nicely given more time.
Prior to these drugs I had been on Zyprexa and had gained almost 20 pounds in a very short time. With Adrafinil and Amisulpride I have lost all that weight and am now back at my baseline. I'm not losing or gaining. Just holding steady at my normal weight.
John
Posted by JohnL on January 21, 2001, at 5:15:50
In reply to Re: New here - questions about Amisulpride / adrafinil » AndrewB, posted by Vince on January 21, 2001, at 1:25:39
> Base on what you and JohnL have said, I'll probably try adrafinil and amisulpride, seperatly first then together if they both work out. I'm not sure if I will continue the neurontin during my little experiment.......
>
> Vince
.......whether it's doctor prescribed, self prescribed, FDA cleared, nonFDA, or whatever, they are all little experiments. That's why they say doctors are 'practicing'. Practicing on us. :-)
Posted by Vince on January 21, 2001, at 11:04:27
In reply to Re: questions about Amisulpride/adrafinil Vince, posted by JohnL on January 21, 2001, at 5:12:02
>
> Hi Vince,
> Starting dose of Adrafinil is one tab per day (300mg). Though it's mild enough you could take one twice a day without any problem. Max dose is 4 per day, though higher doses have been used to treat narcolepsy. Amisulpride minimum dose is 50mg. I take 33mg. You could take anywhere from 25mg to 75mg, though 50mg is usually a starting point. Max is 1200mg to 1800mg...but that's for psychosis. For depression related symptoms the range is 50mg to 300mg, but seems to almost always end up being 100mg or less.
>
> It will take a couple weeks to receive delivery and get started. After that, if you have any questions, please let me know. Would be glad to help. Keep in mind that even if you do experience an initial boost from these meds, their effects take a couple weeks to kick in. Benefits continue to improve over weeks and months. If you don't feel anything in the first week, the drugs still might work. If you do feel something within the first week, that's a solid clue that it will work out nicely given more time.
>
> Prior to these drugs I had been on Zyprexa and had gained almost 20 pounds in a very short time. With Adrafinil and Amisulpride I have lost all that weight and am now back at my baseline. I'm not losing or gaining. Just holding steady at my normal weight.
> JohnI've given up hope on all the US AD's that have the blessing of the FDA. It seems that only the French are looking into anything new and approving a medication based on its efficacy, while the US companies are determined to continue to milk the SSRI cash cow.
I appreciate your help. It seems that you are very helpful on a lot of questions for a lot of people on this group.
Thanks,
Vince
Posted by Gracie2 on January 21, 2001, at 15:17:57
In reply to Re: questions about Amisulpride/adrafinil Vince, posted by Vince on January 21, 2001, at 11:04:27
John-
I believe I remember you saying that you
supplemented the A&A with prozac? I am not interested in trying prozac again (due to no visible effect besides weight gain) - do you think St. John's Wort could substitute for the prozac? Thanks-
Gracie
Posted by phillybob on January 21, 2001, at 22:27:09
In reply to Re: New here - questions about Amisulpride / adrafinil » AndrewB, posted by Vince on January 21, 2001, at 1:25:39
Vince, should you choose to exhaust the mood stabilizer route as Andrew had suggested, you might follow this link (and it's links):
http://www.dr-bob.org/babble/20010111/msgs/52193.html(p.s. from what I've read, I don't believe neurontin to be effective in a situation such as yours; lamictal and topamax seem to have more efficacy, at least anecdotally; perhaps, your trial of the former was unsuccessful due its effects being clouded by the augmentation with the high dose of Effexor? Perhaps it could work as monotherapy or in combination with topamax as the poster Lexie has done?)
Posted by Bryce on January 23, 2001, at 0:07:58
In reply to Questions about Amisulpride/adrafinil JohnL, posted by Gracie2 on January 21, 2001, at 15:17:57
>
> John-
> I believe I remember you saying that you
> supplemented the A&A with prozac? I am not interested in trying prozac again (due to no visible effect besides weight gain) - do you think St. John's Wort could substitute for the prozac? Thanks-
> GracieI don't think it would be wise to mix St. Johns with Adrafinil. It would be a completely unexplored option. Besides if what current research is saying about SJW is true (increased liver enzymes) who's to say it wouldn't enhance Adrafinils metabolism and negate any good effects it might have.
Posted by Gracie2 on January 23, 2001, at 16:27:05
In reply to Questions about Amisulpride/adrafinil JohnL, posted by Gracie2 on January 21, 2001, at 15:17:57
>
> John-
> I believe I remember you saying that you
> supplemented the A&A with prozac? I am not interested in trying prozac again (due to no visible effect besides weight gain) - do you think St. John's Wort could substitute for the prozac? Thanks-
> Gracie
This is the end of the thread.
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