![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Dwight on January 24, 2001, at 0:02:47
It's obvious that both you guys really like these meds. But you also talk about them as if you have some proof that they work for everybody else with low motivation, social anxiety symptoms. Who else besides you guys? I have the drugs in my cabinet, and I tried them. I didn't notice much. Maybe I'll try them again. You guys are so damn inspiring about it. But how do you know it works for other people?
Posted by JohnL on January 24, 2001, at 2:47:37
In reply to Adrafinal and Amisulpride---John and Andrew, posted by Dwight on January 24, 2001, at 0:02:47
> It's obvious that both you guys really like these meds. But you also talk about them as if you have some proof that they work for everybody else with low motivation, social anxiety symptoms. Who else besides you guys? I have the drugs in my cabinet, and I tried them. I didn't notice much. Maybe I'll try them again. You guys are so damn inspiring about it. But how do you know it works for other people?
You make a good point. I must apologize, I don't mean to sound like a salesman for these drugs, though I probably do at times. :-)
Based on clinical trials, the odds for success are about 70%. Personally I get the impression the odds for success are probably closer to 80% or higher. That's because unlike reuptake inhibitors, Adraf or Amis can provide benefits even to normal people. That is based on literature from non-peer-reviewed literature and comments from others. Nothing scientific, just a general impression.
I usually think these drugs have the highest potential for success in certain situations. That is, when several reuptake inhibitors have already been tried, maybe mood stabilizers, and this or that.
I am disappointed these drugs didn't help you. Obviously when one of us finds a drug that really works, we want it to work for everyone. I remember WayneR who used to be a regular here found miraculous cure with Naltrexone. Some of us jumped on the bandwagon and tried it, but most of us found little benefit. I'm sure that must have been distressing to Wayne. I experience the same feelings when my favorite drugs are not useful to someone else. If you wanted to take a second look, I would say that if you are experiencing absolutely no benefit within two weeks to three weeks, then they probably aren't right for you. That would likely mean that your dopamine function and your NE function is just fine, and that whatever chemistry is causing your symptoms lies elsewhere. Due to the low incidence of side effects, the low cost, and ease of purchasing, I would say they are worth a second look-see.
John
Posted by Sigolene on January 24, 2001, at 7:35:57
In reply to Re: Adrafinal and Amisulpride---John and Andrew, posted by JohnL on January 24, 2001, at 2:47:37
I also tried amisulpride for what you say: anhedonia, social phobia.... and i had no success with it. You are not alone.
I'm still trying to find the good med for me. I'm thinking about retrying moclobemide (European AD) with which i had good success in the past. Everyone is different, amisulpride is probably a good drug for some people, but not for me.
Sigolène.
Posted by Bradley on January 24, 2001, at 9:15:56
In reply to Re: Adrafinal and Amisulpride---John and Andrew, posted by JohnL on January 24, 2001, at 2:47:37
I was quite opptomistic that amisulpride and adrafinil would be helpfull but they were not. I'm giving Mirapex a try now. It's only been a couple days and allthough the nausea is uncomfortable, I believe it is improveing my depression allready. That has been my history with the numerous med trials I have undertaken, I have responded emmediately with only 2 . All the others I kept on them for at least 6 weeks with no improvement. The two that have helped me are Parnate and Librium. Unfortunatly the quit working after 3 months. I have retried Parnate after being off of it for 7 or 8 months and it has worked again then quit after 3 months. Hope Mirapex is the one that will be a long term treatment for me, but is sure is hard to be very opptomistic after so many drug failures.
Posted by Dwight on January 24, 2001, at 16:53:58
In reply to Adrafinil,Amisulpride not much help. Mirapex now, posted by Bradley on January 24, 2001, at 9:15:56
As I said before I have some AMis in my med cabinet. I ordered it long time ago, and when I initially tried I think I took 50mg doses for a several days, and didn't notice much. The company I ordered it from gave me a very small supply. I don't have much more left. But last night I took 150mg dose and noticed a very subtle change in how I felt--a soft, light feeling is the best way I can describe it. it was sort of pleasant, and today I took 150mg--noticed a feeling of more energy, and some aggravation. Anyway my question is what dose do you recommend and how often? Plus I'll need to get some more of this because I only have five pills left. What's the fastest way to get a good supply?
Posted by SLS on January 24, 2001, at 18:15:24
In reply to Adrafinil,Amisulpride not much help. Mirapex now, posted by Bradley on January 24, 2001, at 9:15:56
>
> I was quite opptomistic that amisulpride and adrafinil would be helpfull but they were not. I'm giving Mirapex a try now. It's only been a couple days and allthough the nausea is uncomfortable, I believe it is improveing my depression allready. That has been my history with the numerous med trials I have undertaken, I have responded emmediately with only 2 . All the others I kept on them for at least 6 weeks with no improvement. The two that have helped me are Parnate and Librium. Unfortunatly the quit working after 3 months. I have retried Parnate after being off of it for 7 or 8 months and it has worked again then quit after 3 months. Hope Mirapex is the one that will be a long term treatment for me, but is sure is hard to be very opptomistic after so many drug failures.
Hi Bradley.Why don't you try adding Mirapex to Parnate? Sounds like it might be worth a shot. You may want to use Parnate or Nardil as the core of your regimen around which you can augment with stimulants and/or dopaminergics like Mirapex. You can also try adding low dosages of lithium or Lamictal, or even tricyclics. I hope Mirapex by itself does the trick. Life would be so much easier!
- Scott
Posted by AndrewB on January 26, 2001, at 8:21:54
In reply to Re: Amisulpride dosage, posted by Dwight on January 24, 2001, at 16:53:58
Dwight,
If you want to give a trial of amisulpride at a higher dose, try 100mg. for at least two weeks. 150mg. is probably too high.
Amisulpride can be ordered quickly and without an Rx from xxx
Amisulpride is not for everyone. I keep all the posts and emails of people who respond and don't respond to amisulpride. Though I haven't counted up the results lately, it seems that around half of our treatment resistant population responds to it. It seems to be best suited for those with various symptoms of atypical depression like low mood, constant negative thoughts, social anxiety, anhedonia and fatigue. Often people who respond to amisulpride still feel unmotivated and therefore use it with an add-on like adrafinil, selegiline, or adderall. But it can’t be predicted which of these three add-ons will work for a particular person (I use selegiline and adderall with good results.).
Normally people respond quickly, within a week, to amisulpride and other neuroleptics. But there seems to be exceptions to this. Dennis's recent post relates how he had an initial response to it, then a fading away of effectiveness until after 2 weeks, when its effect started again building up slowly over the month.
I think that if a person has the symptoms like negative thoughts, low energy, low mood, anhedonia and social anxiety (indicative of dopaminergic dysfunction) AND they have already tried other medicines without success like SSRIs AND they have ruled out bipolar disorder or cyclothymia, they should give certain dopaminergics a try. Amisulpride is a good med. to start with because of its safety, lack of side effects and its good rate of response.
Note though that some people don’t respond to amisulpride but respond to other neuroleptics such as Zyprexa, seroquel and sulpiride. A failure with one doesn’t guarantee another neuroleptic won’t help. Furthermore, studies and recent posts indicate that Mirapex (a dopamine D2/D3 agonist) may work for these symptoms whether alone or in combination with a neuroleptic or an SSRI. Doses as high as 1.5mg. to 2mg. taken three times a day seem most effective. It is also my speculation, given the effectiveness of Ziprasidone (still not on the market), that cycloserine or the combo of pindolol/buspirone may augment the effect of certain nueroleptics.
In sum, if your symtomology strongly indicates dopaminergic dysfunction and you’ve tried the more conventional ADs, trying various dopaminergics, in combination or alone, may be well advised, but some patience is often required in finding the dopaminergic med that works for you.
Best wishes, keep us updated on how it goes.
AndrewB.
Posted by SLS on January 26, 2001, at 15:49:36
In reply to Re: Amisulpride dosage, posted by AndrewB on January 26, 2001, at 8:21:54
Time for you to go to school.
Sincerely,
Scott
> Dwight,
>
> If you want to give a trial of amisulpride at a higher dose, try 100mg. for at least two weeks. 150mg. is probably too high.
>
> Amisulpride can be ordered quickly and without an Rx from xxx
>
> Amisulpride is not for everyone. I keep all the posts and emails of people who respond and don't respond to amisulpride. Though I haven't counted up the results lately, it seems that around half of our treatment resistant population responds to it. It seems to be best suited for those with various symptoms of atypical depression like low mood, constant negative thoughts, social anxiety, anhedonia and fatigue. Often people who respond to amisulpride still feel unmotivated and therefore use it with an add-on like adrafinil, selegiline, or adderall. But it can’t be predicted which of these three add-ons will work for a particular person (I use selegiline and adderall with good results.).
>
> Normally people respond quickly, within a week, to amisulpride and other neuroleptics. But there seems to be exceptions to this. Dennis's recent post relates how he had an initial response to it, then a fading away of effectiveness until after 2 weeks, when its effect started again building up slowly over the month.
>
> I think that if a person has the symptoms like negative thoughts, low energy, low mood, anhedonia and social anxiety (indicative of dopaminergic dysfunction) AND they have already tried other medicines without success like SSRIs AND they have ruled out bipolar disorder or cyclothymia, they should give certain dopaminergics a try. Amisulpride is a good med. to start with because of its safety, lack of side effects and its good rate of response.
>
> Note though that some people don’t respond to amisulpride but respond to other neuroleptics such as Zyprexa, seroquel and sulpiride. A failure with one doesn’t guarantee another neuroleptic won’t help. Furthermore, studies and recent posts indicate that Mirapex (a dopamine D2/D3 agonist) may work for these symptoms whether alone or in combination with a neuroleptic or an SSRI. Doses as high as 1.5mg. to 2mg. taken three times a day seem most effective. It is also my speculation, given the effectiveness of Ziprasidone (still not on the market), that cycloserine or the combo of pindolol/buspirone may augment the effect of certain nueroleptics.
>
> In sum, if your symtomology strongly indicates dopaminergic dysfunction and you’ve tried the more conventional ADs, trying various dopaminergics, in combination or alone, may be well advised, but some patience is often required in finding the dopaminergic med that works for you.
>
> Best wishes, keep us updated on how it goes.
>
> AndrewB.
Posted by vince on March 10, 2001, at 4:48:09
In reply to Re: Amisulpride dosage, posted by AndrewB on January 26, 2001, at 8:21:54
> Dwight,
>
> If you want to give a trial of amisulpride at a higher dose, try 100mg. for at least two weeks. 150mg. is probably too high.
>
> Amisulpride can be ordered quickly and without an Rx from xxx
>
> Amisulpride is not for everyone. I keep all the posts and emails of people who respond and don't respond to amisulpride. Though I haven't counted up the results lately, it seems that around half of our treatment resistant population responds to it. It seems to be best suited for those with various symptoms of atypical depression like low mood, constant negative thoughts, social anxiety, anhedonia and fatigue. Often people who respond to amisulpride still feel unmotivated and therefore use it with an add-on like adrafinil, selegiline, or adderall. But it can’t be predicted which of these three add-ons will work for a particular person (I use selegiline and adderall with good results.).
>
> Normally people respond quickly, within a week, to amisulpride and other neuroleptics. But there seems to be exceptions to this. Dennis's recent post relates how he had an initial response to it, then a fading away of effectiveness until after 2 weeks, when its effect started again building up slowly over the month.
>
> I think that if a person has the symptoms like negative thoughts, low energy, low mood, anhedonia and social anxiety (indicative of dopaminergic dysfunction) AND they have already tried other medicines without success like SSRIs AND they have ruled out bipolar disorder or cyclothymia, they should give certain dopaminergics a try. Amisulpride is a good med. to start with because of its safety, lack of side effects and its good rate of response.
>
> Note though that some people don’t respond to amisulpride but respond to other neuroleptics such as Zyprexa, seroquel and sulpiride. A failure with one doesn’t guarantee another neuroleptic won’t help. Furthermore, studies and recent posts indicate that Mirapex (a dopamine D2/D3 agonist) may work for these symptoms whether alone or in combination with a neuroleptic or an SSRI. Doses as high as 1.5mg. to 2mg. taken three times a day seem most effective. It is also my speculation, given the effectiveness of Ziprasidone (still not on the market), that cycloserine or the combo of pindolol/buspirone may augment the effect of certain nueroleptics.
>
> In sum, if your symtomology strongly indicates dopaminergic dysfunction and you’ve tried the more conventional ADs, trying various dopaminergics, in combination or alone, may be well advised, but some patience is often required in finding the dopaminergic med that works for you.
>
> Best wishes, keep us updated on how it goes.
>
> AndrewB.
Hi Andrew - I pulled up an old post of yours because I've just tried amisulpride without much luck. I was kind of hopeful for a few days because it seemed to bring up a lot of old nastalgic kind of feelings from long, long ago before I became depressed, feelings that I hadn't experienced for quit a while. But then it seemed to poop out before that went anywhere. So I've kind of thinking about trying Mirapex or the new Ziprasidone, or maybe both in combination so that I get some seratonin and dopamine action. I'm not sure though because it seems that from what I've read here that Mirapex and Ziprasidone effect the D2 recepter in oposite directions. I'm not sure what that would do. Maybe I'ld become invisible like 'Hollow Man'. Well really though, the best information I have to go on are the posts like yours. I don't know diddly about pharmacology and I get lost easily in these descussions of blocking such and such recepter, or a strong agonist of another.I just wanted to see if you or anyone else here might have any ideas as to what is best to try. I could give you a very long list of things that I've tried that didn't help. some of them dopaminergic like wellbutrin, risperdol, amineptine before it was taken off the market, and now amisulpride. I wish I could find something that would help like dexadrine did but wouldn't poop out in such a short time. My pdoc had me on my bazillionth ssri and like the rest it wasn't working. So then he added in dex. I felt great for about four days and then hit the wall, bamm, ride over everybody off. I got off and slept for three days. I'm not sure what D receptor dex hits but if I could find something that would do the same but not cause things to down regulate so fast, that would be a lot of help. Sorry this is getting long. If you do have any ideas please feel free to share them.
Vince
Posted by AndrewB on March 11, 2001, at 22:03:54
In reply to Re: Amisulpride dosage » AndrewB, posted by vince on March 10, 2001, at 4:48:09
Vince,
It think a trial with Mirapex, then a trial ziprasidone is a good idea. If both seem to help you can try both in combo.Pharmacologically, Mirapex and low dose amisupride (or ziprasidone) don't counteract each other at the D2/D3 receptor. Both, when successfull, increase activity at the postsynaptic D2/D3 receptors. My personal experience was that Mirapex and amisulpride don't counteract one another. Another person's experience was that risperdal and Miarapex was an effective combo. Risperdal is more similar in its receptor action to ziprasidone than amisulpride.
There is the possibility that nonresponse to amisulpride may be a good indicator of response to Mirapex but we need more feedback from people like you to confirm if this is true or not.
I am also trialing something for prevention of poop out from amphetamines like dexedrine. If it works in the 30 day or so trial, I will pass the information onto others.
AndrewB
Posted by vince on March 11, 2001, at 23:44:09
In reply to Re: Amisulpride dosage, posted by AndrewB on March 11, 2001, at 22:03:54
> Vince,
>
>
> It think a trial with Mirapex, then a trial ziprasidone is a good idea. If both seem to help you can try both in combo.
>
> Pharmacologically, Mirapex and low dose amisupride (or ziprasidone) don't counteract each other at the D2/D3 receptor. Both, when successfull, increase activity at the postsynaptic D2/D3 receptors. My personal experience was that Mirapex and amisulpride don't counteract one another. Another person's experience was that risperdal and Miarapex was an effective combo. Risperdal is more similar in its receptor action to ziprasidone than amisulpride.
>
> There is the possibility that nonresponse to amisulpride may be a good indicator of response to Mirapex but we need more feedback from people like you to confirm if this is true or not.
>
> I am also trialing something for prevention of poop out from amphetamines like dexedrine. If it works in the 30 day or so trial, I will pass the information onto others.
>
>
> AndrewB
I really appreciate your feedback. Also, I would really be interested in learning how the amphetamine poop out trial goes.Vince
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.