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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by sigolene on November 8, 2008, at 5:33:51
I've been on solian (amisulpride) for 3 months, low dose, for negative symptoms, with good success for the first time (done many other trials before). But I have bad stomach side effects, and I have to stop solian.
I would like to know which neroleptic is the nearest from solian, that I could try, for negative symptoms. Maybe abilify ?
Posted by SLS on November 8, 2008, at 7:00:10
In reply to amisulpride/ solian, posted by sigolene on November 8, 2008, at 5:33:51
Hi Sigoléne.
> I've been on solian (amisulpride) for 3 months, low dose, for negative symptoms, with good success for the first time (done many other trials before). But I have bad stomach side effects, and I have to stop solian.
> I would like to know which neroleptic is the nearest from solian, that I could try, for negative symptoms. Maybe abilify ?Abilify is a good choice, maybe the best of the newer antipsychotics. Perhaps Geodon.
Have you tried Dogmatil / sulpiride? It is very close in activity to amisulpride, but does not bind as tightly to DA receptors. It might give you all of the benefits of amisulpride without the gastro-intestinal side effects.
If it were me, I would probably try Abilify first. It has a lower risk of producing long-term EPS than other antipsychotics.
- Scott
Posted by Jeroen on November 8, 2008, at 7:51:14
In reply to Re: amisulpride/ solian, posted by SLS on November 8, 2008, at 7:00:10
hi, i tryed sulpiride, lesser side effects then solian, worth a try first, if that not helping try abilify
Posted by bleauberry on November 8, 2008, at 21:13:08
In reply to amisulpride/ solian, posted by sigolene on November 8, 2008, at 5:33:51
Sulpride is very similar, but is also just different enough that it may not have the same bad effects.
While others have mentioned Abilify, I kind of disagree with that. I think the closest thing among the atypicals would be low dose risperdal. I believe it has pretty strong presysnaptic blockade at low doses similar to risperdal, though it also has some serotonin stuff that amisulpride doesn't. Amisulpride is unique in its selectivity for dopamine and nothing else. Zyprexa might also provide some benefit, though not as directly as amisulpride, since zyprexa does a bunch of other stuff too that would cloud the picture. Abilify, I dunno. It is not only a dopamine blocker, but also a dopamine agonist, and a serotonin agonist/antagonist, and well, it is a complicated one. I don't see that as being very similar to amisulpride.
I wish your doctor could get a better handle on exactly what the gut problems are so you could address those directly without interrupting a treatment that is working for you. The gut is a lot easier to treat than the mind.
I mean, basics. Do you take a daily high dose of 35billion to 50billion units of a probiotic with 7 or more strains in it? That alone can do wonders. How about digestive enzymes to help your gut work better? How about a gluten sensitivity test to see if maybe you just need to avoid gluten products? (wheat, barley) Excellent substitutes made from rice, corn, and other flours. Another very common gut allergen is cow dairy products.
It sounds to me like amisulpride is not the cause of any problems, but rather the trigger that is highlighting some problems that were already there but not yet noticed. It just exaggerated them to a point of noticing. Maybe?
Anyway, try treating the gut first. Only after a month of doing that aggressively with no progress would I consider switching meds.
I can't remember the name. Triflurophenazine? Something like that. I would have to try to look it up. It is an older antipsychotic. I read in a Dr Stahl pharmacology book years ago that drug is the closest thing to amisulpride. Other than that, in order, I would go for sulpride, risperdal, zyprexa, all in very low doses as you would do with amisulpride.
Posted by sigolene on November 9, 2008, at 12:24:24
In reply to Re: amisulpride/ solian, posted by bleauberry on November 8, 2008, at 21:13:08
I've already stopped solian, and taken 2 days of abilify 5mg. But I feel really bad and depressed. It was the same with risperdal, I tried many months before. The idea that solian is worsening a preexisting digestion problem seems to me interesting, but difficult to know how to find the problem. I've already tried to supress different king of food, without success. Could someone tell me the exact difference between amisulpride and sulpiride ?
Thank you everyone for your answers, and sorry if my english is not perfect...
Posted by Jeroen on November 9, 2008, at 12:43:40
In reply to Re: amisulpride/ solian, posted by sigolene on November 9, 2008, at 12:24:24
hi there is sure a different in amisulpiride and sulpiride, i know because i taken them both
theres is a story on dr bob about a woman that took amisulpiride and did nothing
she then started sulpiride and it worked like a miracle to her
so you see, you got to try them bothsulpiride made a small difference in myself but not worth enough
Posted by Jeroen on November 9, 2008, at 14:11:57
In reply to Re: amisulpride/ solian, posted by sigolene on November 9, 2008, at 12:24:24
hi, i feel bad and depressed too, but the solutions ive got are like a brain mind game
Posted by bleauberry on November 9, 2008, at 18:30:45
In reply to Re: amisulpride/ solian, posted by sigolene on November 9, 2008, at 12:24:24
What exactly are the digestive problems? What do you mean by "digestive problems"? What are the symptoms? In detail, what are the problems you are experiencing?
I didn't really mean that amisulpride is flaring up a pre-existing condition. Maybe no condition did exist prior. But, maybe it is there was. What I really meant was that in depression and anxiety, the body is already under tremendous stress. It's not as if our nervous system is under attack, but the immune system and hormones and such are just cruising along happily like nothing is wrong. No, it involves every molecule of your body and every system. We carry within us at all times harmful bacteria, yeast, fungi, etc. They are kept under control in small harmless numbers. But when we are weakened, they can overwhelm. The digestive system is an obvious point of attack. Perhaps either amisulpride itself helped to somehow feed their strength, or perhaps it somehow aggravated tissue linings, or it somehow weakened the good guys who keep the bad guys in control, or maybe amisulpride itself is actually the direct cause of problems and not anything else, or maybe it has nothing at all to do with amisulpride but is instead a completely separate weakness that just happened to coincidentally become evident while on amisulpride. In any of the above cases, all except the amisulpride-cause itself can be treated with simple things, high dose probiotics being the main line of defense and healing. Digestive enzymes also take a huge strain off an already weakened system. They can do a good portion of the digesting for you and give a weakened system time to heal rather than trying to keep up.
I'm just saying treat the gut first. If you haven't taken high dose multistrain probiotics, and you haven't taken digestive enzymes, then you haven't done the primary things that need to be done.
Based on what others have said and what I have heard rumors of over the years, sulpiride is different than amisulpride. Very similar, but also different enough to make a big difference one way or the other. Kind of like modafinil versus adrafinil. Look at the molecular diagrams of those two and they look practically identical. But they are very different. Modafinil is derived from adrafinil. They both basically do the same thing. But they are different enough. Same with sulpiride and amisulpride?
But as I said, don't be too hasty to point the finger at amisulpride. Stay well on it, and treat the gut instead. But that get's back to where I started...what exactly are the problems? That would help to figure this thing out.
> I've already stopped solian, and taken 2 days of abilify 5mg. But I feel really bad and depressed. It was the same with risperdal, I tried many months before. The idea that solian is worsening a preexisting digestion problem seems to me interesting, but difficult to know how to find the problem. I've already tried to supress different king of food, without success. Could someone tell me the exact difference between amisulpride and sulpiride ?
> Thank you everyone for your answers, and sorry if my english is not perfect...
Posted by sigolene on November 10, 2008, at 10:49:54
In reply to Re: amisulpride/ solian » sigolene, posted by bleauberry on November 9, 2008, at 18:30:45
well, the problem is, each time I eat, especially after lunch, my stomach become distended with air, and the only thing I can do is to lie down on a bed because I've got pain. Because everything is "blocked" in stomach and intestine. When I lie down, it relaxes, and air goes away.
All this, only with solian...
Posted by Jeroen on November 10, 2008, at 10:53:13
In reply to Re: amisulpride/ solian » bleauberry, posted by sigolene on November 10, 2008, at 10:49:54
switch 2 sulpiride
Posted by shasling on November 10, 2008, at 15:33:32
In reply to Re: amisulpride/ solian, posted by sigolene on November 9, 2008, at 12:24:24
> I've already stopped solian, and taken 2 days of abilify 5mg. But I feel really bad and depressed. It was the same with risperdal, I tried many months before. The idea that solian is worsening a preexisting digestion problem seems to me interesting, but difficult to know how to find the problem. I've already tried to supress different king of food, without success. Could someone tell me the exact difference between amisulpride and sulpiride ?
> Thank you everyone for your answers, and sorry if my english is not perfect...
Abilify is one of my favorite miracle meds, and I HATED it when I first started it; made me feel really, just, crazy. Titrate slowly if you wanna keep giving it a chance, aqnd that bad feeling diminishes. Good luck
Posted by bleauberry on November 10, 2008, at 17:47:07
In reply to Re: amisulpride/ solian » bleauberry, posted by sigolene on November 10, 2008, at 10:49:54
The only thing I am really good at is playing guitar. I am no expert on stomach issues, psychiatry, or anything else in life. I know more than most people, and probably more than a whole lot of doctors, but still, no expert. So the suggestions I pose below should be in that light.
First off, what has your doctor said about this? Did he suggest any tests to look for the bacteria that causes ulcers? Did he inquire about your bowel movements (loose, hard, constipated, varying widely from day to day)? Has he tested for common allergens such as gluten or dairy?
I know you said you did some food experiments yourself to try and rule out allergens. Maybe go back and do that again, this time vigilantly skip all things with gluten...wheat, barley, oats, barley malt. Do it for a week. All the foods you normally eat are available in non-wheat form. They are more expensive and some don't taste as good.
Do you have silver fillings in your teeth? Mercury is notorious for screwing up the gut and making it extremely sensitive to everything, foods, meds, everything. If yes, you gotta make your highest priority getting those removed and replaced with white fillings ASAP.
Simple things you can do...
Buy a probiotic supplement with 35 billion to 50 billion units, preferably with 7 or more strains in it. The dose is one a day, but for troubled systems you can take it with every meal. It loads your gut with all the good bacteria involved in digestion, crowding out bad bacteria and yeast, breaking down foods into vitamins, and keeping things moving smoothly. Also consider a supplement to speed up and loosen your bowel movements. Also try a good quality (probably the most expensive you can find) digestive enzyme supplement. It should have a wide variety of enzymes in it to break down proteins, fats, and carbs. It if is measured in milligrams, forget it, that is not a good brand. The good ones are measured in these other weird measurements you probably have not seen before.Having tried all these things for a few weeks, sulpiride is next in line as I see it.
But, I do not understand why your doctor is out of the loop on this one? I mean, he must know how hard it is to be successfull with a psychiatric patient? Well, there has been success. It would seem to me an extremely high priority to keep it that way, which means keeping amisulpride right where it is. But treat the other problems.
Posted by sigolene on November 11, 2008, at 5:15:30
In reply to Re: amisulpride/ solian, posted by bleauberry on November 10, 2008, at 17:47:07
OK thank you. I'll go back to my doctor and tell her about all what you suggest, and we'll see...I will keep you informed if I can find a solution.
This is the end of the thread.
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