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Dr. Bob is Robert Hsiung, MD,
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Posted by ed_uk2010 on January 9, 2015, at 10:19:35
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals, posted by Lamdage22 on January 9, 2015, at 9:31:24
>But what about TD though??
TD can happen with amisulpride, but it's not as common as with typicals such as haloperidol.
The EPS risk with amisulpride appears rather similar to risperidone.... being highly dependent on dose. The same may apply to TD risk, which is probably higher with risperidone than with olanzapine or (especially) quetiapine. The standard typical haloperidol produces a high incidence of TD at all doses and a very high incidence of EPS except at extremely small doses. I don't think amisulpride is nearly as bad as haloperidol, except perhaps at highly excessive doses. The risk of TD is much higher in the elderly than in young or middle aged adults, it also develops more quickly and is less likely to be reversible.
With amisulpride, those with obsessive-compulsive disorder appear more susceptible to EPS and possibly TD than those with psychotic disorders.
http://www.ncbi.nlm.nih.gov/pubmed/14992963
Posted by Lamdage22 on January 9, 2015, at 10:53:33
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals » Lamdage22, posted by ed_uk2010 on January 9, 2015, at 10:19:35
So what do you think?
Zyprexa or Amisulpride?
Either looking like a moron (twitching tongue and/or jumpy legs) or having diabetes type two, perhaps
I dont know which one id choose. Possibly diabetes.
Is the diabetes risk with Zyprexa higher or lower than the risk of TD with Amisulpride?
I think i should base my decision on that.
Posted by Lamdage22 on January 9, 2015, at 10:53:59
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals, posted by Lamdage22 on January 9, 2015, at 10:53:33
I dont want to look like a moron for the rest of my life.
Posted by Lamdage22 on January 9, 2015, at 10:56:54
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals » Lamdage22, posted by ed_uk2010 on January 9, 2015, at 10:19:35
Maybe the answer is to take both at a low dosage thus steering clear of trouble?
Posted by ed_uk2010 on January 9, 2015, at 13:51:10
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals, posted by Lamdage22 on January 9, 2015, at 10:53:33
>Is the diabetes risk with Zyprexa higher or lower than the risk of TD with Amisulpride?
I expect the diabetes risk with Zyprexa is considerably higher, except in the elderly. Of course, your Zyprexa/Seroquel combination can also cause TD.
Posted by Lamdage22 on January 10, 2015, at 4:47:10
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals » Lamdage22, posted by ed_uk2010 on January 9, 2015, at 13:51:10
Well i will talk to my Dr about it.
He wants to abandon Serouqel because he thinks that Zyprexa is NOT pro diabetic.
I will tell him im only up for replacing the Zyprexa.
Will see how it goes. I dont want to tell him that he is wrong.
Posted by ed_uk2010 on January 10, 2015, at 5:24:19
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals, posted by Lamdage22 on January 10, 2015, at 4:47:10
>He wants to abandon Serouqel because he thinks that Zyprexa is NOT pro diabetic.
How strange. Metabolic disturbance is well recognised with Zyprexa, more so that any other atypical apart from clozapine - which has a similar metabolic profile.
Posted by Lamdage22 on January 10, 2015, at 8:10:46
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals » Lamdage22, posted by ed_uk2010 on January 10, 2015, at 5:24:19
I bet amisulpride is better with weight than Zyprexa.
How is it with sex?
Posted by ed_uk2010 on January 11, 2015, at 12:38:25
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals, posted by Lamdage22 on January 10, 2015, at 8:10:46
> I bet amisulpride is better with weight than Zyprexa.
It is.
> How is it with sex?Similar to risperidone (and paliperidone depot) ie. it causes a problem to some people due to elevated prolactin.
..............
Aripiprazole (Abilify) does not elevate prolactin and causes less weight gain (in general) than Zyprexa. It may not be as effective overall as Zyprexa or amisulpride. Have you tried it?
Posted by Lamdage22 on January 11, 2015, at 14:50:17
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals » Lamdage22, posted by ed_uk2010 on January 11, 2015, at 12:38:25
Yeah i did. Akathisia hell.
But theres a new one coming out. Brexpiprazole?
Supposedly similar to Abilify with lower incidence of Akathisia.
Well see.
Posted by Christ_empowered on January 11, 2015, at 14:53:46
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals, posted by Lamdage22 on January 11, 2015, at 14:50:17
could you try abilify again? Maybe with a benzo or some other kinda sedative during start up?
I take 30mgs/day. That dose is less activating or whatever. Keeps me calm and minimizes all the crazy quite nicely. When I get really agitated, I take 200mgs neurontin+2mgs risperidone and I'm good to go.
I just think Abilify is more tolerable and probnably safer than a lot of other AP drugs out there.
Posted by Lamdage22 on January 12, 2015, at 6:31:48
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals, posted by Christ_empowered on January 11, 2015, at 14:53:46
No christ empowered, cant try again. It was really hell.
Im gonna try the amisulpride. Tomorrow. Starting with 50mg
Posted by ed_uk2010 on January 12, 2015, at 8:57:58
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals, posted by Lamdage22 on January 12, 2015, at 6:31:48
> No christ empowered, cant try again. It was really hell.
>
> Im gonna try the amisulpride. Tomorrow. Starting with 50mg.I think you'll find it very tolerable at that dose. You may not notice anything different. Even low doses tend to elevate prolactin, but that usually takes time.
How are you planning to reduce your other antipsychotics? When used alone, the usual dose of amisulpride is between 400mg and 800mg per day (split into two doses) for those with prominent hallucinations and/or delusions. Close to 400mg twice a day is often optimal for acutely psychotic patients, but may cause some extrapyramidal symptoms. Around 200mg twice a day is suitable for less severe psychotic symptoms. Less than 300mg per day is used for the relief of negative symptoms and depressive symptoms associated with psychosis, but is rarely sufficient when obvious hallucinations and delusions are a problem (or have been a problem prior to treatment with other drugs). 50mg per day is not antipsychotic, but may improve mood.
Posted by Lamdage22 on January 13, 2015, at 12:21:18
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals, posted by ed_uk2010 on January 12, 2015, at 8:57:58
Is there any way to decrease the prolactin? Alternative or meds?
Please no dopamine agonists as you sure know i cant take them.
Posted by Lamdage22 on January 13, 2015, at 12:33:18
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals, posted by Lamdage22 on January 13, 2015, at 12:21:18
I am not sure if i want a hormone that is made for breastfeeding in my body. Seriously.
Is there a chance that it DOESNT raise prolactin or is it a sure thing??
Posted by ed_uk2010 on January 14, 2015, at 0:32:53
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals, posted by Lamdage22 on January 13, 2015, at 12:33:18
> I am not sure if i want a hormone that is made for breastfeeding in my body. Seriously.
The hormone is always in your body (not just during breastfeeding). It is present both in men and in women. The level is raised by most antipsychotics however, especially risperidone, paliperidone and amisulpride.
>Is there a chance that it DOESNT raise prolactin or is it a sure thing??
Not always, but it usually raises it to some extent - the amount is very variable. It doesn't always cause any symptoms. You can also have a blood test to check the level.
Are you male or female?
Posted by ed_uk2010 on January 14, 2015, at 0:49:36
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals, posted by Lamdage22 on January 13, 2015, at 12:21:18
>Is there any way to decrease the prolactin? Alternative or meds?
The major medication used (in combination with other antipsychotics) is aripiprazole (Abilify). Naturally, you don't want to take that given your previous experience.
You shouldn't initially take anything. It may not be required. Treatment depends on several factors... whether you are male or female (to some extent), whether you have symptoms or not, and the blood prolactin level. There is a herbal remedy which has been looked at in trials: peony-glycyrrhiza decoction. The effective dose was 45g/day. The medicine may be available from Chinese medicine shops.
Posted by Lamdage22 on January 14, 2015, at 4:32:13
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals, posted by ed_uk2010 on January 14, 2015, at 0:49:36
Thanks, ed for the information..
So this PGD does NOT cause any psychotic symptoms usually?
It sounds cool.
Posted by ed_uk2010 on January 15, 2015, at 13:03:01
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals, posted by Lamdage22 on January 14, 2015, at 4:32:13
>So this PGD does NOT cause any psychotic symptoms usually?
Not that I'm aware of. I don't know how easy it is to buy though. You'd need to speak to a Chinese herbalist.
Posted by Lamdage22 on January 16, 2015, at 3:12:40
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals » Lamdage22, posted by ed_uk2010 on January 15, 2015, at 13:03:01
Interesting. My mood seems slightly lifted with the 50mgs
Posted by ed_uk2010 on January 17, 2015, at 14:01:19
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals, posted by Lamdage22 on January 16, 2015, at 3:12:40
> Interesting. My mood seems slightly lifted with the 50mgs
It may be. The main psychological effect of very low doses is mild mood elevation.
Posted by Lamdage22 on January 18, 2015, at 5:19:41
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals, posted by ed_uk2010 on January 17, 2015, at 14:01:19
I hope it sticks with the higher doses.
Posted by Lamdage22 on January 18, 2015, at 5:20:38
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals, posted by Lamdage22 on January 18, 2015, at 5:19:41
I have headaches sometimes since i take amisulpride.
Posted by ed_uk2010 on January 18, 2015, at 6:53:27
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals, posted by Lamdage22 on January 18, 2015, at 5:20:38
>I have headaches sometimes since i take amisulpride.
Have you reduced your other meds? Amisulpride isn't a common cause of headaches. Maybe give it time and take paracetamol.
Posted by Lamdage22 on January 18, 2015, at 9:10:28
In reply to Re: Mutiple mechanism with Zyprexa and some atypicals » Lamdage22, posted by ed_uk2010 on January 18, 2015, at 6:53:27
Should i measure my prolactin now as its not elevated by amisulpride yet to be able to compare?
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