Psycho-Babble Medication Thread 1096249

Shown: posts 1 to 11 of 11. This is the beginning of the thread.

 

Primavanserin (Nuplazid) - A new antipsychotic?

Posted by SLS on December 7, 2017, at 15:24:55

Primavanserin (Nuplazid)

Primavanserin is a new selective inverse agonist of the serotonin 5-HT2a receptor. At this point, it is indicated for hallucinations and delusions associated with Parkinsons Disease.

Has anyone thought to use this drug as an antipsychotic? Perhaps in can be used as an augmenter.


- Scott

 

Re: Primavanserin (Nuplazid) - A new antipsychotic?

Posted by Christ_empowered on December 8, 2017, at 7:17:32

In reply to Primavanserin (Nuplazid) - A new antipsychotic?, posted by SLS on December 7, 2017, at 15:24:55

hi. this is interesting (to me...). wiki says they're doing studies w/ people diagnosed w/ Schizophrenia, w/ the new drug used alongside a tranquilizer. They're also looking into treatment of agitation and some forms of depression, also.

I don't know. the wiki page says one study used low dose risperidone w/ this drug and got good results. it also seems to reduce adverse effects from Haldol, so...that's incredible (to me...), all on its own.

there isn't any information on the adverse effects on the wiki page. as much as I'd love to jump for joy...remember: it wasn't until the 70s and 80s that the adverse effects from the 1st generation neuroleptics were taken seriously by psychiatrists, and then largely because of litigation and bad publicity.

ok. hopefully, someone else will do more thorough research on this new drug and post something.


 

Re: Primavanserin (Nuplazid) - A new antipsychotic?

Posted by Christ_empowered on December 8, 2017, at 7:21:15

In reply to Primavanserin (Nuplazid) - A new antipsychotic?, posted by SLS on December 7, 2017, at 15:24:55

A quick goodrx search shows that a 30 day supply is over $2,500. pricing for this drug makes the costs of the remaining on patent "atypicals" look like a bargain. --sigh--

Given the way Mental Health works in the US, I'm guessing that a lot of more affluent and well-insured people will try it, while the more severely sick will be stuck on Haldol and Prolixin injections. It is what it is...

 

Re: Primavanserin (Nuplazid) - A new antipsychotic? Christ_empowered

Posted by SLS on December 8, 2017, at 9:32:06

In reply to Re: Primavanserin (Nuplazid) - A new antipsychotic?, posted by Christ_empowered on December 8, 2017, at 7:21:15

> A quick goodrx search shows that a 30 day supply is over $2,500.

Dammit.

That's unconscionable.

Sick.

I thought of you when I first saw this drug become available. I was thinking it might make a good augmenter of Abilify that might allow you to reduce your dosage of Abilify and produce an antidepressant effect. Instead, you might consider remaining on Abilify and adding a low dosage of Risperdal. Although not an inverse agonist, Risperdal has the most potent antagonist activity at 5-HT2a receptors of all the available antipsychotics. You might be able to reduce your dosage of Abilify when Risperdal is added and perhaps glean a greater antidepressant effect.


- Scott

 

Re: Primavanserin (Nuplazid) - A new antipsychotic?

Posted by Christ_empowered on December 8, 2017, at 10:11:49

In reply to Re: Primavanserin (Nuplazid) - A new antipsychotic? Christ_empowered, posted by SLS on December 8, 2017, at 9:32:06

hi. me again. I am amazed at high price of this stuff.

Do you think adding buspar might do...something? I have some 2mgs risperidone tablets. Its PRN, for agitation. I haven't needed any in a while, thank goodness.

How much do you think I could try taking on a daily basis? And...how low do you think I could go w/ the Abilify?

I'm still @ 30 right now, because of the Wellbutrin start up. I seem to be handling it well, so I'm hoping to go back down to 20 soon.

Thanks for your help, SLS.

 

Re: Primavanserin (Nuplazid) - A new antipsychotic? Christ_empowered

Posted by SLS on December 8, 2017, at 11:04:59

In reply to Re: Primavanserin (Nuplazid) - A new antipsychotic?, posted by Christ_empowered on December 8, 2017, at 10:11:49

In what ways is Wellbutrin helping you?

What happens when you discontinue or reduce the dosage of Abilify?

If you have never tried buspirone, it is hard to justify excluding it from consideration. You never know. Abilify is actually a pretty potent 5-HT1a partial agonist, too.


- Scott

 

Re: Primavanserin (Nuplazid) - A new antipsychotic?

Posted by Christ_empowered on December 9, 2017, at 1:06:04

In reply to Re: Primavanserin (Nuplazid) - A new antipsychotic? Christ_empowered, posted by SLS on December 8, 2017, at 11:04:59

hi. Wellbutrin is somewhat stimulating, in a good way. its like...the few things I liked about Ritalin, without the jitters and agitation. something like that, anyway.

I just brought up buspirone because I'm not gung ho about 2 tranquilizers all the time. risperidone has been great for agitation and such, but...whoa. I could -not- take it daily, not at 2mgs or more, anyway.

the jump from 30 to 20/Abilify was rough-ish, but I think it was just a sudden reduction in sedation levels. They really should make a 25mgs tablet.

like most antidepressants, Wellbutrin increases abilify blood levels. ugh. I'm going back down to 20 soon.

 

Re: Primavanserin (Nuplazid) - A new antipsychotic?

Posted by SLS on December 9, 2017, at 9:00:56

In reply to Re: Primavanserin (Nuplazid) - A new antipsychotic?, posted by Christ_empowered on December 9, 2017, at 1:06:04

> hi. Wellbutrin is somewhat stimulating, in a good way. its like...the few things I liked about Ritalin, without the jitters and agitation. something like that, anyway.
>
> I just brought up buspirone because I'm not gung ho about 2 tranquilizers all the time. risperidone has been great for agitation and such, but...whoa. I could -not- take it daily, not at 2mgs or more, anyway.
>
> the jump from 30 to 20/Abilify was rough-ish, but I think it was just a sudden reduction in sedation levels. They really should make a 25mgs tablet.
>
> like most antidepressants, Wellbutrin increases abilify blood levels. ugh. I'm going back down to 20 soon.

Sounds like a good plan.

Have you ever tried Effexor? Effexor + Wellbutrin makes for a good combination to treat depression.


- Scott

 

Re: Primavanserin (Nuplazid) - A new antipsychotic?

Posted by linkadge on December 9, 2017, at 10:47:57

In reply to Re: Primavanserin (Nuplazid) - A new antipsychotic?, posted by SLS on December 9, 2017, at 9:00:56

I can't see how this drug will catch on with such a high cost and narrow indication.

By the name of the drug, I am guessing it is related to ritanserin and mianserin (and hence mirtazapine?). If it only acts on the 5-ht2a receptors, it may not have as much theraputic applicaiton as other antipsychotics. Perhaps it may work in milder cases of schizophrenia (or prodromal) with fewer adverse effects.

I've often felt that mirtazapine acts like an antipsychotic / mood stabilizer.

Linkadge

 

Re: Primavanserin (Nuplazid) - A new antipsychotic?

Posted by Christ_empowered on December 9, 2017, at 12:36:52

In reply to Re: Primavanserin (Nuplazid) - A new antipsychotic?, posted by linkadge on December 9, 2017, at 10:47:57

that's interesting. I just read over some material on mirtazapine for negative symptoms and also to treat akathisia.

 

Re: Primavanserin (Nuplazid) - A new antipsychotic?

Posted by linkadge on December 9, 2017, at 12:49:40

In reply to Re: Primavanserin (Nuplazid) - A new antipsychotic?, posted by Christ_empowered on December 9, 2017, at 12:36:52

A common feature of 'atypical' antispychotics is that they inhibited 5-ht2a/c and so (presumably) less dopamine antagonism was required for a theraputic effect.

I have not heard of a pure 5-ht2 antagonist working for schizophrenia. However, they could likely block visual hallicunations.

Linkadge


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