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Very low dose Saphris: antidepressant, a2 ant.

Posted by fafner on January 5, 2013, at 12:51:16

Hi babblers.

I would like to share my experience with a very low dose Saphris (asenapine). I am talking of a eight out of a 5 mg pill. Of course this is meant to be an anecdote and no piece of advice.

My mood swung from depression to very breaf moment of light euphoria leading to long lasting angst and panic (I experienced racing thoughts, too, but never mania or a full mixed status). AD's of any kind worsen my condition. All of this got me a diagnosis of Bipolar II.

I did not respond to mood stabilizers. Saphris was my first AP, taken as monotherapy (as you may know in Italy drugs are free for all citizens, and for some reason our healthcare system seems to be fond of prescribing asenapine).

The prescribed dose (5 mg twice a day) was intolerable to me: I felt sleepy all the time and incapable of thinking clearly. My psychiatrist is an advocate of the drug: he advised me to restart treatment with just half a pill daily. But I did need to be as functional as I could be, so for security I sliced the 5 mg pill (easily done: it's a soft wafer) in eight part. I took just an eighth before going to bed.

As a result, this very low dose asenapine worsened my inner sense of angst, but made me functional and clear-minded; it gave me rock-hard erections (I am a male) and raised my libido. After experimenting different drugs and combinations of drugs, I found out that adding Lamictal (100 mg twice a day) makes me at peace. Surprisingly enough, my (5 mg * 1/8 =) 0,625 mg dose asenapine prevents any cognitive impairment.

So I am quite happy, and so is my psychiatrist as long as I take asenapine.

I suspect that so low a dose might emphasize alpha2 antagonist action of asenapine, but I am a lawyer, so... ;) Still I hope this remark proves of any use for the depressed friends of this forum.





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