![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by CraigF on May 10, 2001, at 14:55:34
I would like to try Amisulpride, as based upon what I've read here, but my new doctor is reluctant to prescribe something that she hasn't heard of. Seeing as I would be procuring it from overseas anyway, would I need a prescription?
Also, I'm currently at 40 mgs Celexa...can/should they be mixed? Thanks
Posted by AndrewB on May 10, 2001, at 23:12:59
In reply to Score some Amisulpride?AndrewB?Cam?, posted by CraigF on May 10, 2001, at 14:55:34
> I would like to try Amisulpride, as based upon what I've read here, but my new doctor is reluctant to prescribe something that she hasn't heard of. Seeing as I would be procuring it from overseas anyway, would I need a prescription?
>
> Also, I'm currently at 40 mgs Celexa...can/should they be mixed? ThanksCraig,
Amisulpride can be ordered from xxx. They are very reliable and the medicine is reasonably priced. No prescription is required.
I have an info. piece on amisulpride if you would like something to show to your doctor. There has been a lot of studies done on it for treatment of depression and dysthymia. My email address is andrewb@seanet.com.Amisulpride can be mixed with Celexa. Amisulpride is not metabolized by liver enzymes. I don't know whether the combination would be better than either alone, I just don't know if they tend to support or detract from one another. JohnL however had good results mixing a little Prozac with amisulpride.
AndrewB
Posted by SalArmy4me on May 10, 2001, at 23:42:13
In reply to Score some Amisulpride?AndrewB?Cam?, posted by CraigF on May 10, 2001, at 14:55:34
You can get it in Mexico if you're close enough to make a trip down there.
> I would like to try Amisulpride, as based upon what I've read here, but my new doctor is reluctant to prescribe something that she hasn't heard of. Seeing as I would be procuring it from overseas anyway, would I need a prescription?
>
> Also, I'm currently at 40 mgs Celexa...can/should they be mixed? Thanks
Posted by JohnL on May 11, 2001, at 4:09:33
In reply to Re: Score some Amisulpride?AndrewB?Cam?, posted by AndrewB on May 10, 2001, at 23:12:59
Dittos on everything Andrew said. Celexa+Amisulpride sounds like an excellent choice to me. In the unfortunate event that it is not helpful (the odds are in your favor it will be helpful), then keep Zyprexa and Risperdal in mind. The reason I say that is because even though I found Amisulpride to be the best thing to come along in a long time, when I switched to Zyprexa as a sleep aid I was pleasantly surprised to find it worked even better than Amisulpride.
John> > I would like to try Amisulpride, as based upon what I've read here, but my new doctor is reluctant to prescribe something that she hasn't heard of. Seeing as I would be procuring it from overseas anyway, would I need a prescription?
> >
> > Also, I'm currently at 40 mgs Celexa...can/should they be mixed? Thanks
>
> Craig,
>
> Amisulpride can be ordered from http://www.farmaciacerati.it/drug.html, the website for the Italian pharmacy Farmacia Cerati. They are very reliable and the medicine is reasonably priced. No prescription is required.
> I have an info. piece on amisulpride if you would like something to show to your doctor. There has been a lot of studies done on it for treatment of depression and dysthymia. My email address is andrewb@seanet.com.
>
> Amisulpride can be mixed with Celexa. Amisulpride is not metabolized by liver enzymes. I don't know whether the combination would be better than either alone, I just don't know if they tend to support or detract from one another. JohnL however had good results mixing a little Prozac with amisulpride.
>
> AndrewB
Posted by CraigF on May 11, 2001, at 6:51:59
In reply to Re: Score some Amisulpride?AndrewB?Cam?, posted by JohnL on May 11, 2001, at 4:09:33
JohnL:
Can I assume you're talking about treatment of depression, or stricly as an AP (I guess that question goes for everybody)
I don't want the weight gain that comes along with Zyprexa. Serequel made me to sleepy, and I still have nightmares about what Risperidone did to me.
I would ultimately like to replace Celexa, for a number of reasons, but I would probably start with a mix and wean off Celexa.
I don't believe those other Atypical APs are very effective for depression/anxiety as a primary therapy.
Posted by JohnL on May 12, 2001, at 5:39:48
In reply to Re: Score some Amisulpride?AndrewB?Cam? » JohnL, posted by CraigF on May 11, 2001, at 6:51:59
Yes, I was referring to APs for treating all forms of depression. I do not believe however that any of them alone offer complete cures as primary therapy, in agreement with what you said, but that as part of a cocktail with an SSRI they can be miraculous. With me for example Amisulpride was ok, Zyprexa was so-so, Prozac was so-so. But when I mixed Zyprexa plus Prozac, whoa, what a difference. Total cure. Or total remission, however one wants to look at it. In any case, total abolishment of dysthymic symptoms. Without an AP in the mix, total results were not achieved.
I understand your concerns of Zyprexa weight gain. Mine seems to have leveled off. I gained 10 pounds almost instantly, but then it slowed down, and now I think I'm losing some of that weight.
Like you I did not like Risperdal. But it works well sometimes if the other APs don't. Amisulpride is a wonderful option.
> JohnL:
>
> Can I assume you're talking about treatment of depression, or stricly as an AP (I guess that question goes for everybody)
>
> I don't want the weight gain that comes along with Zyprexa. Serequel made me to sleepy, and I still have nightmares about what Risperidone did to me.
>
> I would ultimately like to replace Celexa, for a number of reasons, but I would probably start with a mix and wean off Celexa.
>
> I don't believe those other Atypical APs are very effective for depression/anxiety as a primary therapy.
Posted by IanSFO on May 17, 2001, at 20:27:56
In reply to Re: Score some Amisulpride?AndrewB?Cam?, posted by JohnL on May 11, 2001, at 4:09:33
Did you see evidence of increased prolactin levels when you were taking amisulpride? Did you get your prolactin measured?
What about anyone else who tried it? Did anyone use bromocriptine, pergolide, pramipexole or other medication to counteract prolactin increase? And did it work, did it actually keep the level low?
Thanks. IanSF
> Dittos on everything Andrew said. Celexa+Amisulpride sounds like an excellent choice to me. In the unfortunate event that it is not helpful (the odds are in your favor it will be helpful), then keep Zyprexa and Risperdal in mind. The reason I say that is because even though I found Amisulpride to be the best thing to come along in a long time, when I switched to Zyprexa as a sleep aid I was pleasantly surprised to find it worked even better than Amisulpride.
> John
>
> > > I would like to try Amisulpride, as based upon what I've read here, but my new doctor is reluctant to prescribe something that she hasn't heard of. Seeing as I would be procuring it from overseas anyway, would I need a prescription?
> > >
> > > Also, I'm currently at 40 mgs Celexa...can/should they be mixed? Thanks
> >
> > Craig,
> >
> > Amisulpride can be ordered from http://www.farmaciacerati.it/drug.html, the website for the Italian pharmacy Farmacia Cerati. They are very reliable and the medicine is reasonably priced. No prescription is required.
> > I have an info. piece on amisulpride if you would like something to show to your doctor. There has been a lot of studies done on it for treatment of depression and dysthymia. My email address is andrewb@seanet.com.
> >
> > Amisulpride can be mixed with Celexa. Amisulpride is not metabolized by liver enzymes. I don't know whether the combination would be better than either alone, I just don't know if they tend to support or detract from one another. JohnL however had good results mixing a little Prozac with amisulpride.
> >
> > AndrewB
Posted by CraigF on May 17, 2001, at 22:45:01
In reply to Re: Score some Amisulpride?JohnL, posted by IanSFO on May 17, 2001, at 20:27:56
I can't think of any women that have tried amisulpride that I can direct you to.
Andrew seems the biggest proponent, perhaps he knows someone who can answer the prolactin questions.
Also, perhaps he knows why it was never approved in the US...I'd be interested in knowing myself.
Posted by IanSFO on May 18, 2001, at 0:43:03
In reply to Amisulpride Reactions?JohnL, Andrew?, posted by CraigF on May 17, 2001, at 22:45:01
> I can't think of any women that have tried amisulpride that I can direct you to.
>
I'm not sure why you mentioned directing me to women. I'm male. Ian is the Scottish form of John.
Posted by JohnL on May 18, 2001, at 3:45:38
In reply to Re: Score some Amisulpride?JohnL, posted by IanSFO on May 17, 2001, at 20:27:56
I did not have prolactin level checked and I did not have any indication of increased prolactin. I think that concern is mostly an issue with higher doses, not the low doses used for dysthymia.
If someone wanted to add a dopamine agonist, I think Mirapex might be the best of the bunch. I have no personal experience with it though. I've based this opinion primarily on feedback from others here at this site. I did try Bromocriptine once and did not like it.
John> Did you see evidence of increased prolactin levels when you were taking amisulpride? Did you get your prolactin measured?
>
> What about anyone else who tried it? Did anyone use bromocriptine, pergolide, pramipexole or other medication to counteract prolactin increase? And did it work, did it actually keep the level low?
>
> Thanks. IanSF
>
>
> > Dittos on everything Andrew said. Celexa+Amisulpride sounds like an excellent choice to me. In the unfortunate event that it is not helpful (the odds are in your favor it will be helpful), then keep Zyprexa and Risperdal in mind. The reason I say that is because even though I found Amisulpride to be the best thing to come along in a long time, when I switched to Zyprexa as a sleep aid I was pleasantly surprised to find it worked even better than Amisulpride.
> > John
> >
> > > > I would like to try Amisulpride, as based upon what I've read here, but my new doctor is reluctant to prescribe something that she hasn't heard of. Seeing as I would be procuring it from overseas anyway, would I need a prescription?
> > > >
> > > > Also, I'm currently at 40 mgs Celexa...can/should they be mixed? Thanks
> > >
> > > Craig,
> > >
> > > Amisulpride can be ordered from http://www.farmaciacerati.it/drug.html, the website for the Italian pharmacy Farmacia Cerati. They are very reliable and the medicine is reasonably priced. No prescription is required.
> > > I have an info. piece on amisulpride if you would like something to show to your doctor. There has been a lot of studies done on it for treatment of depression and dysthymia. My email address is andrewb@seanet.com.
> > >
> > > Amisulpride can be mixed with Celexa. Amisulpride is not metabolized by liver enzymes. I don't know whether the combination would be better than either alone, I just don't know if they tend to support or detract from one another. JohnL however had good results mixing a little Prozac with amisulpride.
> > >
> > > AndrewB
Posted by CraigF on May 19, 2001, at 18:32:49
In reply to Re: Score some Amisulpride?Ian, posted by JohnL on May 18, 2001, at 3:45:38
I have two follow-up questions regarding Amisulpride:
Has anyone tried it with St. John's Wort (I have to get off the Celexa)and...
What doses should I aim for/order online:
-as an adjunct to SSRI/SJW?
-as the primary antidepressant?Thanks guys,
Craig
Posted by AndrewB on May 20, 2001, at 16:32:57
In reply to What dose? JohnL, AndrewB, posted by CraigF on May 19, 2001, at 18:32:49
Hi out there!I've been taking amisulpride for close to 2 years with good results for dysthymia, concentration problems and social anxiety (sociability). It doesn't work for everybody, but of the dozens of responses I have received on it, it seems to work in slightly over 50% of the treatment resistant patients who have tried it. By treatment resistant I mean those who have tried SSRIs and sometimes numerous other ADs without good results. Sometimes the results are miraculous.
Amisulpride isn't right for everyone, but if I had a atypical depression that included symptoms such dysthymia, anhedonia, apathy, negative ruminations, low self esteem, poor concentration, fatigue or social anxiety - it is a good drug to start with in general. It has been extensively studied and been shown very effective for dysthymia. It has a very low incidence of side effects in males. It also can be combined safely, apparently, with all other ADs and, furthermore, will not cause drug to drug interactions. I am aware of no exceptions to this.
All this being said, I am not a proponent of amisulpride, per se. I wouldn’t want anybody to pin there hopes on one medicine. I however am a proponent of atypical depressives, dysthymics, and those with social anxiety, who have tried traditional strategies, to look outside the box and to consider various options which basically improve the function of select parts of the dopaminergic system. This is based on my interpretation of the evidenceout there. That is, parts of the dopaminergic system can be central, and indeed may be the final loci, of depression, motivation, and social anxiety.
This does not mean taking a dopaminergic, i.e. wellbutrin, will solve your problem. The system is complicated with many feedback mechanisms. In healthy individualsthese feedback mechanisms allow the system to be kept in balance. but in people with mental problems the same feedback mechanisms can frustrate a doctor’s attempts to alter the long-term function of the dopaminergic system. This scenario has led the greater part of the medical community to conclude that dopaminergics don’t have a place in disorders of depression and anxiety.
However, at the risk of sounding like an expert in possession of rare knowledge, I believe that effective dopaminergic strategies do exist and are vastly underutilized. The reasons these strategies aren’t used more are multifold: some of the drugs are not available in the US (i.e. amisulpride), some drugs are relatively new (i.e. mirapex), and finally the dopaminergic strategy is likely to involve polypharmacy. Drugs involved in such polypharmacy may include dopaminergics or drugs that act indirectly on the dopaminergic system. For example, mirapex may be used as an add -on to an SSRI (SSRIS act indirectly on the dopaminergic system and this may explain there ultimate effectiveness). Selegiline and amphetamines, while sometimes anxiety producing alone, when combined with amisulpride can increase motivation without increasing anxiety. Mementine when combined amphetamine provide long term relief of depression while increasing motivation and self-esteem, obviating the oh -so-common poop-out of amphetamines.
Answers to specific questions:
*Amisulpride is not available in the U.S. now but will be available here in about two years. The reason for the delay may possibly be explained by the French drug maker’s (Sanofi-Synthelabo) lack of history (lack of in-house capabilities)in getting drugs approved for the market. My doctor has been following the US apporoval process and believes amisulpride offers unique therapuetic opportunities.
*Mirapex can be used where amisulpride has failed. There is some indication that mirapex will work for many of those that amisulpride doesn’t help and visa versa.
*Prolactin levels can be expected to increase with use of amisulpride. The amount they increase will vary by individual. My levels are slightly increased. For males, this usually does not result in any side effects. But sexual side effects in males can occur due to this. Possible remedies are to slighlty decrease the dosage or to add-on bromocriptine. BTW. prolactin levels increases are commom with the use of many Ads.
For women it is another story. Their prolactin level increases are generally more pronounced and about 50% of women will experience loss of menses, disrupted menses or breast swelling because of this. One case study showed that use of bromocriptine (which lowers prolactin) would remove these side effects without diminishing the effect of sulpiride (a drug very much analogous to amisulpride). Women who benefit from amisulpride but have these side effects should seriously consider taking bromocriptine as an add-on. With Geodon now available, women probabl yshould consider it as there first option low dose anti-psychotic rather than amisulpride.
Many women have tried amisulpride, Karen B. being one. She has written many posts describing her mostly positive experience with it but also she describes her loss of menses.
Doses of amisulpride probably are the same whether one is taking another AD such as an SSRI or taking it alone. 50mg., once a day is the standard dose. Occasionally 25mg. or 75mg. may be better. 100 mg. would be rarely be better.
You can try St. John’s Wort. I tried it without benefit. JohnL liked the combo of St. Johns and Amisulpride. Make sure your SJW dose is high enough though (900mg to 1500mg?).
Best wishes,
AndrewB
Posted by Leighwit on May 21, 2001, at 15:04:10
In reply to Re: amisulpride answers, posted by AndrewB on May 20, 2001, at 16:32:57
Hi Andrew,
Thanks for a great post; one full of useful info in a sociable & compassionate tone (which of course, is no surprise coming from you.)
I think I'll ask my Pdoc about ordering amisulpride to add to Wellbutrin. (She ordered Reboxetine for me, so this shouldn't be a problem).
I was using a small dose of Celexa (10-20 mg.) to minimize the side effects of Wellbutrin as well as to improve its AD performance. It was working very well for me. I took it to alleviate the irritablity side effect; the fact that it also improved the performance of Wellbutrin was an unexpected surprise, and icing on the cake. It's amazing to me, that something taken alone (I took Celexa alone at max dose in the past) can be virtually worthless, yet the same drug when used to augment another, can produce a big gain.
Unfortunately, I experienced severe weight gain from the Celexa (Celexa isn't considered high risk for weight gain, but my endocrinologist is certain Celexa was the culprit in my case, and finally, my Pdoc concurred). I discontinued it three weeks ago, and have finally stopped what was a continuous weight gain. My Pdoc said that whether or not a metabolism can recover from adverse changes brought on by some of these drugs is currently unknown, but being studied.
Someone else here suggested Remeron w/Wellbutrin. Guess I'll give both amisulpride and Remeron more serious attention & consideration before my appt. next week. Have you personally used amisulpride as an adjunct to another drug? As I recall (but my memory stinks these days) you had positive experiences with Reboxetine,yes?
Laurie/Leighwit
>
> Hi out there!
>
> I've been taking amisulpride for close to 2 years with good results for dysthymia, concentration problems and social anxiety (sociability). It doesn't work for everybody, but of the dozens of responses I have received on it, it seems to work in slightly over 50% of the treatment resistant patients who have tried it. By treatment resistant I mean those who have tried SSRIs and sometimes numerous other ADs without good results. Sometimes the results are miraculous.
>
> Amisulpride isn't right for everyone, but if I had a atypical depression that included symptoms such dysthymia, anhedonia, apathy, negative ruminations, low self esteem, poor concentration, fatigue or social anxiety - it is a good drug to start with in general. It has been extensively studied and been shown very effective for dysthymia. It has a very low incidence of side effects in males. It also can be combined safely, apparently, with all other ADs and, furthermore, will not cause drug to drug interactions. I am aware of no exceptions to this.
>
> All this being said, I am not a proponent of amisulpride, per se. I wouldn’t want anybody to pin there hopes on one medicine. I however am a proponent of atypical depressives, dysthymics, and those with social anxiety, who have tried traditional strategies, to look outside the box and to consider various options which basically improve the function of select parts of the dopaminergic system. This is based on my interpretation of the evidenceout there. That is, parts of the dopaminergic system can be central, and indeed may be the final loci, of depression, motivation, and social anxiety.
>
> This does not mean taking a dopaminergic, i.e. wellbutrin, will solve your problem. The system is complicated with many feedback mechanisms. In healthy individualsthese feedback mechanisms allow the system to be kept in balance. but in people with mental problems the same feedback mechanisms can frustrate a doctor’s attempts to alter the long-term function of the dopaminergic system. This scenario has led the greater part of the medical community to conclude that dopaminergics don’t have a place in disorders of depression and anxiety.
>
> However, at the risk of sounding like an expert in possession of rare knowledge, I believe that effective dopaminergic strategies do exist and are vastly underutilized. The reasons these strategies aren’t used more are multifold: some of the drugs are not available in the US (i.e. amisulpride), some drugs are relatively new (i.e. mirapex), and finally the dopaminergic strategy is likely to involve polypharmacy. Drugs involved in such polypharmacy may include dopaminergics or drugs that act indirectly on the dopaminergic system. For example, mirapex may be used as an add -on to an SSRI (SSRIS act indirectly on the dopaminergic system and this may explain there ultimate effectiveness). Selegiline and amphetamines, while sometimes anxiety producing alone, when combined with amisulpride can increase motivation without increasing anxiety. Mementine when combined amphetamine provide long term relief of depression while increasing motivation and self-esteem, obviating the oh -so-common poop-out of amphetamines.
>
> Answers to specific questions:
>
> *Amisulpride is not available in the U.S. now but will be available here in about two years. The reason for the delay may possibly be explained by the French drug maker’s (Sanofi-Synthelabo) lack of history (lack of in-house capabilities)in getting drugs approved for the market. My doctor has been following the US apporoval process and believes amisulpride offers unique therapuetic opportunities.
>
> *Mirapex can be used where amisulpride has failed. There is some indication that mirapex will work for many of those that amisulpride doesn’t help and visa versa.
>
> *Prolactin levels can be expected to increase with use of amisulpride. The amount they increase will vary by individual. My levels are slightly increased. For males, this usually does not result in any side effects. But sexual side effects in males can occur due to this. Possible remedies are to slighlty decrease the dosage or to add-on bromocriptine. BTW. prolactin levels increases are commom with the use of many Ads.
>
> For women it is another story. Their prolactin level increases are generally more pronounced and about 50% of women will experience loss of menses, disrupted menses or breast swelling because of this. One case study showed that use of bromocriptine (which lowers prolactin) would remove these side effects without diminishing the effect of sulpiride (a drug very much analogous to amisulpride). Women who benefit from amisulpride but have these side effects should seriously consider taking bromocriptine as an add-on. With Geodon now available, women probabl yshould consider it as there first option low dose anti-psychotic rather than amisulpride.
>
> Many women have tried amisulpride, Karen B. being one. She has written many posts describing her mostly positive experience with it but also she describes her loss of menses.
>
> Doses of amisulpride probably are the same whether one is taking another AD such as an SSRI or taking it alone. 50mg., once a day is the standard dose. Occasionally 25mg. or 75mg. may be better. 100 mg. would be rarely be better.
>
> You can try St. John’s Wort. I tried it without benefit. JohnL liked the combo of St. Johns and Amisulpride. Make sure your SJW dose is high enough though (900mg to 1500mg?).
>
> Best wishes,
>
> AndrewB
>
>
Posted by IanSFO on May 21, 2001, at 18:08:22
In reply to Re: amisulpride answers » AndrewB, posted by Leighwit on May 21, 2001, at 15:04:10
If you're concerned about weight gain, I'm surprised you're considering adding Remeron to Wellbutrin. Though not everybody taking Remeron gains weight, a lot of people do, primarily because it has the potential to make you ravenously hungry. Purportedly it has fewer side effects at higher doses than at lower ones, but I don't think that's 100% guaranteed. A friend of mine has added more than 30 pounds of weight in just a few months.
> Hi Andrew,
>
> Thanks for a great post; one full of useful info in a sociable & compassionate tone (which of course, is no surprise coming from you.)
>
> I think I'll ask my Pdoc about ordering amisulpride to add to Wellbutrin. (She ordered Reboxetine for me, so this shouldn't be a problem).
>
> I was using a small dose of Celexa (10-20 mg.) to minimize the side effects of Wellbutrin as well as to improve its AD performance. It was working very well for me. I took it to alleviate the irritablity side effect; the fact that it also improved the performance of Wellbutrin was an unexpected surprise, and icing on the cake. It's amazing to me, that something taken alone (I took Celexa alone at max dose in the past) can be virtually worthless, yet the same drug when used to augment another, can produce a big gain.
>
> Unfortunately, I experienced severe weight gain from the Celexa (Celexa isn't considered high risk for weight gain, but my endocrinologist is certain Celexa was the culprit in my case, and finally, my Pdoc concurred). I discontinued it three weeks ago, and have finally stopped what was a continuous weight gain. My Pdoc said that whether or not a metabolism can recover from adverse changes brought on by some of these drugs is currently unknown, but being studied.
>
> Someone else here suggested Remeron w/Wellbutrin. Guess I'll give both amisulpride and Remeron more serious attention & consideration before my appt. next week. Have you personally used amisulpride as an adjunct to another drug? As I recall (but my memory stinks these days) you had positive experiences with Reboxetine,yes?
>
> Laurie/Leighwit
>
> >
> > Hi out there!
> >
> > I've been taking amisulpride for close to 2 years with good results for dysthymia, concentration problems and social anxiety (sociability). It doesn't work for everybody, but of the dozens of responses I have received on it, it seems to work in slightly over 50% of the treatment resistant patients who have tried it. By treatment resistant I mean those who have tried SSRIs and sometimes numerous other ADs without good results. Sometimes the results are miraculous.
> >
> > Amisulpride isn't right for everyone, but if I had a atypical depression that included symptoms such dysthymia, anhedonia, apathy, negative ruminations, low self esteem, poor concentration, fatigue or social anxiety - it is a good drug to start with in general. It has been extensively studied and been shown very effective for dysthymia. It has a very low incidence of side effects in males. It also can be combined safely, apparently, with all other ADs and, furthermore, will not cause drug to drug interactions. I am aware of no exceptions to this.
> >
> > All this being said, I am not a proponent of amisulpride, per se. I wouldn’t want anybody to pin there hopes on one medicine. I however am a proponent of atypical depressives, dysthymics, and those with social anxiety, who have tried traditional strategies, to look outside the box and to consider various options which basically improve the function of select parts of the dopaminergic system. This is based on my interpretation of the evidenceout there. That is, parts of the dopaminergic system can be central, and indeed may be the final loci, of depression, motivation, and social anxiety.
> >
> > This does not mean taking a dopaminergic, i.e. wellbutrin, will solve your problem. The system is complicated with many feedback mechanisms. In healthy individualsthese feedback mechanisms allow the system to be kept in balance. but in people with mental problems the same feedback mechanisms can frustrate a doctor’s attempts to alter the long-term function of the dopaminergic system. This scenario has led the greater part of the medical community to conclude that dopaminergics don’t have a place in disorders of depression and anxiety.
> >
> > However, at the risk of sounding like an expert in possession of rare knowledge, I believe that effective dopaminergic strategies do exist and are vastly underutilized. The reasons these strategies aren’t used more are multifold: some of the drugs are not available in the US (i.e. amisulpride), some drugs are relatively new (i.e. mirapex), and finally the dopaminergic strategy is likely to involve polypharmacy. Drugs involved in such polypharmacy may include dopaminergics or drugs that act indirectly on the dopaminergic system. For example, mirapex may be used as an add -on to an SSRI (SSRIS act indirectly on the dopaminergic system and this may explain there ultimate effectiveness). Selegiline and amphetamines, while sometimes anxiety producing alone, when combined with amisulpride can increase motivation without increasing anxiety. Mementine when combined amphetamine provide long term relief of depression while increasing motivation and self-esteem, obviating the oh -so-common poop-out of amphetamines.
> >
> > Answers to specific questions:
> >
> > *Amisulpride is not available in the U.S. now but will be available here in about two years. The reason for the delay may possibly be explained by the French drug maker’s (Sanofi-Synthelabo) lack of history (lack of in-house capabilities)in getting drugs approved for the market. My doctor has been following the US apporoval process and believes amisulpride offers unique therapuetic opportunities.
> >
> > *Mirapex can be used where amisulpride has failed. There is some indication that mirapex will work for many of those that amisulpride doesn’t help and visa versa.
> >
> > *Prolactin levels can be expected to increase with use of amisulpride. The amount they increase will vary by individual. My levels are slightly increased. For males, this usually does not result in any side effects. But sexual side effects in males can occur due to this. Possible remedies are to slighlty decrease the dosage or to add-on bromocriptine. BTW. prolactin levels increases are commom with the use of many Ads.
> >
> > For women it is another story. Their prolactin level increases are generally more pronounced and about 50% of women will experience loss of menses, disrupted menses or breast swelling because of this. One case study showed that use of bromocriptine (which lowers prolactin) would remove these side effects without diminishing the effect of sulpiride (a drug very much analogous to amisulpride). Women who benefit from amisulpride but have these side effects should seriously consider taking bromocriptine as an add-on. With Geodon now available, women probabl yshould consider it as there first option low dose anti-psychotic rather than amisulpride.
> >
> > Many women have tried amisulpride, Karen B. being one. She has written many posts describing her mostly positive experience with it but also she describes her loss of menses.
> >
> > Doses of amisulpride probably are the same whether one is taking another AD such as an SSRI or taking it alone. 50mg., once a day is the standard dose. Occasionally 25mg. or 75mg. may be better. 100 mg. would be rarely be better.
> >
> > You can try St. John’s Wort. I tried it without benefit. JohnL liked the combo of St. Johns and Amisulpride. Make sure your SJW dose is high enough though (900mg to 1500mg?).
> >
> > Best wishes,
> >
> > AndrewB
> >
> >
Posted by Leighwit on May 22, 2001, at 13:46:24
In reply to Re: amisulpride answers, posted by IanSFO on May 21, 2001, at 18:08:22
Ian,
Thanks! I thought I'd heard the correlation before (between Remeron and weight gain) but I thought my recollection was wrong. The recommendation was in response to my post about quitting an AD because of weight gain side effects, and needing to replace it as an augmentation to Wellbutrin. I made many too assumptions about the response.
In my case, it's now off the list. Thanks again,
Laurie
> If you're concerned about weight gain, I'm surprised you're considering adding Remeron to Wellbutrin. Though not everybody taking Remeron gains weight, a lot of people do, primarily because it has the potential to make you ravenously hungry. Purportedly it has fewer side effects at higher doses than at lower ones, but I don't think that's 100% guaranteed. A friend of mine has added more than 30 pounds of weight in just a few months.
>
>
> > Hi Andrew,
> >
> > Thanks for a great post; one full of useful info in a sociable & compassionate tone (which of course, is no surprise coming from you.)
> >
> > I think I'll ask my Pdoc about ordering amisulpride to add to Wellbutrin. (She ordered Reboxetine for me, so this shouldn't be a problem).
> >
> > I was using a small dose of Celexa (10-20 mg.) to minimize the side effects of Wellbutrin as well as to improve its AD performance. It was working very well for me. I took it to alleviate the irritablity side effect; the fact that it also improved the performance of Wellbutrin was an unexpected surprise, and icing on the cake. It's amazing to me, that something taken alone (I took Celexa alone at max dose in the past) can be virtually worthless, yet the same drug when used to augment another, can produce a big gain.
> >
> > Unfortunately, I experienced severe weight gain from the Celexa (Celexa isn't considered high risk for weight gain, but my endocrinologist is certain Celexa was the culprit in my case, and finally, my Pdoc concurred). I discontinued it three weeks ago, and have finally stopped what was a continuous weight gain. My Pdoc said that whether or not a metabolism can recover from adverse changes brought on by some of these drugs is currently unknown, but being studied.
> >
> > Someone else here suggested Remeron w/Wellbutrin. Guess I'll give both amisulpride and Remeron more serious attention & consideration before my appt. next week. Have you personally used amisulpride as an adjunct to another drug? As I recall (but my memory stinks these days) you had positive experiences with Reboxetine,yes?
> >
> > Laurie/Leighwit
> >
> > >
> > > Hi out there!
> > >
> > > I've been taking amisulpride for close to 2 years with good results for dysthymia, concentration problems and social anxiety (sociability). It doesn't work for everybody, but of the dozens of responses I have received on it, it seems to work in slightly over 50% of the treatment resistant patients who have tried it. By treatment resistant I mean those who have tried SSRIs and sometimes numerous other ADs without good results. Sometimes the results are miraculous.
> > >
> > > Amisulpride isn't right for everyone, but if I had a atypical depression that included symptoms such dysthymia, anhedonia, apathy, negative ruminations, low self esteem, poor concentration, fatigue or social anxiety - it is a good drug to start with in general. It has been extensively studied and been shown very effective for dysthymia. It has a very low incidence of side effects in males. It also can be combined safely, apparently, with all other ADs and, furthermore, will not cause drug to drug interactions. I am aware of no exceptions to this.
> > >
> > > All this being said, I am not a proponent of amisulpride, per se. I wouldn’t want anybody to pin there hopes on one medicine. I however am a proponent of atypical depressives, dysthymics, and those with social anxiety, who have tried traditional strategies, to look outside the box and to consider various options which basically improve the function of select parts of the dopaminergic system. This is based on my interpretation of the evidenceout there. That is, parts of the dopaminergic system can be central, and indeed may be the final loci, of depression, motivation, and social anxiety.
> > >
> > > This does not mean taking a dopaminergic, i.e. wellbutrin, will solve your problem. The system is complicated with many feedback mechanisms. In healthy individualsthese feedback mechanisms allow the system to be kept in balance. but in people with mental problems the same feedback mechanisms can frustrate a doctor’s attempts to alter the long-term function of the dopaminergic system. This scenario has led the greater part of the medical community to conclude that dopaminergics don’t have a place in disorders of depression and anxiety.
> > >
> > > However, at the risk of sounding like an expert in possession of rare knowledge, I believe that effective dopaminergic strategies do exist and are vastly underutilized. The reasons these strategies aren’t used more are multifold: some of the drugs are not available in the US (i.e. amisulpride), some drugs are relatively new (i.e. mirapex), and finally the dopaminergic strategy is likely to involve polypharmacy. Drugs involved in such polypharmacy may include dopaminergics or drugs that act indirectly on the dopaminergic system. For example, mirapex may be used as an add -on to an SSRI (SSRIS act indirectly on the dopaminergic system and this may explain there ultimate effectiveness). Selegiline and amphetamines, while sometimes anxiety producing alone, when combined with amisulpride can increase motivation without increasing anxiety. Mementine when combined amphetamine provide long term relief of depression while increasing motivation and self-esteem, obviating the oh -so-common poop-out of amphetamines.
> > >
> > > Answers to specific questions:
> > >
> > > *Amisulpride is not available in the U.S. now but will be available here in about two years. The reason for the delay may possibly be explained by the French drug maker’s (Sanofi-Synthelabo) lack of history (lack of in-house capabilities)in getting drugs approved for the market. My doctor has been following the US apporoval process and believes amisulpride offers unique therapuetic opportunities.
> > >
> > > *Mirapex can be used where amisulpride has failed. There is some indication that mirapex will work for many of those that amisulpride doesn’t help and visa versa.
> > >
> > > *Prolactin levels can be expected to increase with use of amisulpride. The amount they increase will vary by individual. My levels are slightly increased. For males, this usually does not result in any side effects. But sexual side effects in males can occur due to this. Possible remedies are to slighlty decrease the dosage or to add-on bromocriptine. BTW. prolactin levels increases are commom with the use of many Ads.
> > >
> > > For women it is another story. Their prolactin level increases are generally more pronounced and about 50% of women will experience loss of menses, disrupted menses or breast swelling because of this. One case study showed that use of bromocriptine (which lowers prolactin) would remove these side effects without diminishing the effect of sulpiride (a drug very much analogous to amisulpride). Women who benefit from amisulpride but have these side effects should seriously consider taking bromocriptine as an add-on. With Geodon now available, women probabl yshould consider it as there first option low dose anti-psychotic rather than amisulpride.
> > >
> > > Many women have tried amisulpride, Karen B. being one. She has written many posts describing her mostly positive experience with it but also she describes her loss of menses.
> > >
> > > Doses of amisulpride probably are the same whether one is taking another AD such as an SSRI or taking it alone. 50mg., once a day is the standard dose. Occasionally 25mg. or 75mg. may be better. 100 mg. would be rarely be better.
> > >
> > > You can try St. John’s Wort. I tried it without benefit. JohnL liked the combo of St. Johns and Amisulpride. Make sure your SJW dose is high enough though (900mg to 1500mg?).
> > >
> > > Best wishes,
> > >
> > > AndrewB
> > >
> > >
Posted by Cecilia on June 11, 2001, at 3:34:15
In reply to Score some Amisulpride?AndrewB?Cam?, posted by CraigF on May 10, 2001, at 14:55:34
For Andrew`s survey-I tried Amisulpride-definitely have most of the symptoms you mentioned (chronic depression, social anxiety, low self esteem, negative ruminations etc.)--no benefit noticed.
This is the end of the thread.
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