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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by poser938 on September 6, 2011, at 1:33:40
hmm... when you block off the presynaptic autoreceptors, therefore increasing dopamine release, is it known if that dopamine stimulates the postsynaptic receptors? my knowledge on things like this isn't too great but i'm trying to read into it. i'm about to start taking the amisulpride becaue of long term/permanent mirapex induced anhedonia and i was confused about how it caused anhedonia, so i thought maybe i could kinda undo the effects of mirapex with risperdal, but after 6 weeks on it i felt no effect from it at all. then i found an article explaining that mirapex stimulates the dopamine autoreceptors, therefore decreasing dopamine release. so if that's true then an autoreceptor antagonist should be exactly what I need, right?
and then there's this article
http://www.ncbi.nlm.nih.gov/pubmed/9137910
explaining how mirapex can act as an antipsychotic specifically in low doses (less than 1mg) and as as an antiparkinsons med in higher doses. but, now im confused because i took mirapex from 1 to 2mgs and it still had an antipsychotic effect on me by blunting my emotions strongly.AHHHH!!!!
Posted by bleauberry on September 8, 2011, at 19:14:47
In reply to Question about Low Dose Amisulpride, posted by poser938 on September 6, 2011, at 1:33:40
We can talk about med mechanisms and theories and stuff but I think we need to keep in perspective that what we know is only a sliver of what we don't know. There is much more to these meds we aren't even aware of. That's why it's so hard to predict or figure out what did what.
I think the autoreceptors will adjust to the increased dopamine release but that it is somehow tied into the longer term "kicking in" thing. Or maybe they adjust and the good effect goes away. Or maybe amisulpride blocks them just a tiny bit, just enough to prevent excessive adjustment. I mean, it is preferential for certain receptors at certain doses, but it isn't perfect. It will hit other stuff to some degree. I'm just trying to point out that these meds don't do just what we think they do and nothing else, and even if they did, we don't really know what that means from one patient to another. It just aint that simple.
On the topic of anhedonia I just wanted to comment that while dopamine gets all the fanfare on that topic, the neurotransmitter I have found to be most strongly associated with my own battles of anhedonia is norepinephrine. A little bit dopamine, but mostly norepinephrine. I know it is tempting to point the finger at mirapex and immediately conclude dopamine....but as tried to say, it aint that simple. IMO. Sure, maybe we can fairly confidently point the finger at mirapix in your case, but that in no way points the finger conclusively at dopamine. There is too much other stuff involved with that med.
Anyway, my best anti-anhedonia strategies involved norepinephrine, not dopamine. Amisulpride was pretty good, but milnacipran was better. Super low doses of either is the key for me. If the dose is too high you will know because the flatness gets worse.
I do agree with your theory to attempt a reverse strategy...with amisulpride. But if your dose is too high it won't be any different than taking any other antipsychotic. For me I found 12.5 pretty potent, not quite enough, but 25mg was just a bit too much. In literature they usually talk in terms of 50mg to 100mg which in my opinion is past the point of being specific for the pre-receptors and is instead hitting all receptors. That is based on my own experience and observing comments of others at this board who have tried amisulpride.
I recall one of the most bizarre stories was someone who popped in about a year ago....long bad history like all of us....and came in just to say hi and how well he was doing....all his previous med failures became history when he started taking just a tiny crumb of amisulpride. Another person took a tiny crumb every other day instead of every day. That's the way it usually works best for me too though I never got the complete remission they did. My best dose is in the 18mg-23mg range. It is that finnicky.
Posted by poser938 on September 8, 2011, at 21:01:49
In reply to Re: Question about Low Dose Amisulpride, posted by bleauberry on September 8, 2011, at 19:14:47
well, the one med that used to help alot was cyproheptadine, i believe to its 5ht2c antagonism. i know that when you block this receptor it takes the brakes off dopamine release. but it's much different than something like ritalin. i never felt stimulated by it, it just worked to make me normal, which was great. to a certain extent it cured my adderall induced anhedonia in the past after about a month. but this time with ritalin it is beiing MUCH more difficult. i actuallly took cyproheptadine for 8 months, and had to raise my dose every couple of days because i would becoome tolerant fast. i got to a much too high dose and had to stop, and 8 months later my tolerance to it has still not gone away even though i most of the effects of it have gone away day by day. oh and i believe 5ht2c antagonism also increases norepinephrine release. i dont know what you're experiencing exactly, but maybe 5ht2c antagonism would be good for you if you havent tried it already.
more recently i tried buspar after reading about its beneficial effects on dopamine due to 5ht1a agonism, but it made me much worse after a single dose. so it seems 5ht1a agonism can either have a beneficial effect on libido for some people OR it could be bad for others. i've tried to read into why this might be,and cant come with anything. i know the reason is genetics, but you wouldnt happen to have any info in this would you? like maybe buspar stimulates presynaptic receptors in some and postsynaptic receptors in others? or it could maybe just be explained that it's simply effects people different because of genetics.
i'm trying to have a bacu-up plan in case amisulpride doesnt agree with me... so do you happen if Viibryds 5ht1a agonism may be a bit different?
Posted by poser938 on September 8, 2011, at 22:07:53
In reply to Re: Question about Low Dose Amisulpride, posted by poser938 on September 8, 2011, at 21:01:49
do you order amisulpride online?
if you do please email me
Michael10364@aol.com
Posted by Conundrum on September 9, 2011, at 12:01:46
In reply to Re: Question about Low Dose Amisulpride, posted by bleauberry on September 8, 2011, at 19:14:47
I wonder if the low dose of milnacipran is key to its effectiveness. Everything I've seen with normal doses does not look very promising.
Mirapex didn't do jack for my anhedonia. Most of the studies using it for anhedonia are in Parkinson's patients who have depleted dopamine, so it makes sense when we see it work in those cases.
>
> On the topic of anhedonia I just wanted to comment that while dopamine gets all the fanfare on that topic, the neurotransmitter I have found to be most strongly associated with my own battles of anhedonia is norepinephrine. A little bit dopamine, but mostly norepinephrine. I know it is tempting to point the finger at mirapex and immediately conclude dopamine....but as tried to say, it aint that simple. IMO. Sure, maybe we can fairly confidently point the finger at mirapix in your case, but that in no way points the finger conclusively at dopamine. There is too much other stuff involved with that med.
>
> Anyway, my best anti-anhedonia strategies involved norepinephrine, not dopamine. Amisulpride was pretty good, but milnacipran was better. Super low doses of either is the key for me. If the dose is too high you will know because the flatness gets worse.
>
> I do agree with your theory to attempt a reverse strategy...with amisulpride. But if your dose is too high it won't be any different than taking any other antipsychotic. For me I found 12.5 pretty potent, not quite enough, but 25mg was just a bit too much. In literature they usually talk in terms of 50mg to 100mg which in my opinion is past the point of being specific for the pre-receptors and is instead hitting all receptors. That is based on my own experience and observing comments of others at this board who have tried amisulpride.
>
> I recall one of the most bizarre stories was someone who popped in about a year ago....long bad history like all of us....and came in just to say hi and how well he was doing....all his previous med failures became history when he started taking just a tiny crumb of amisulpride. Another person took a tiny crumb every other day instead of every day. That's the way it usually works best for me too though I never got the complete remission they did. My best dose is in the 18mg-23mg range. It is that finnicky.
This is the end of the thread.
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