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Has anybody have tried amisulpride ? Did anyone had problems with prolactin, EPS symptoms and qtc prolongation while being on this drug ? How was your experience like while being on this drug.

I'm thinking about asking my pdoc for this.

I'm gaining alot of weight on clozapine and valproate combination. Also I'm sleeping 12-13 hours at night on clozapine. Stephen stahl book and other pubmed studies say amisulpride is less likely to make u gain weight [1]. And amisulpride seems to be as effective as olanzapine in terms of reducing positive symptoms.

Any thoughts ?

[1] http://www.kcl.ac.uk/ioppn/news/events/2013/september/Leucht-2013-15-antipsychotics-meta-analyses.pdf

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It was really good antipsychotic, not sedating and had antidepressant/mood stabilizing effect, but unfortunately had to go off due high prolactin. I took only 200mg. (100 AM; 100 PM).

 

No EPS and qtc prolongation for me.

Edited by centaurus
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3 minutes ago, centaurus said:

It was really good antipsychotic, not sedating and had antidepressant/mood stabilizing effect, but unfortunately had to go off due high prolactin. I took only 200mg. (100 AM; 100 PM).

 

No EPS and qtc prolongation for me.

Arent there drugs which lower prolactin. I read that abilify can lower prolactin.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3004714/

http://www.ncbi.nlm.nih.gov/pubmed/20814333

http://www.ncbi.nlm.nih.gov/pubmed/19038534

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I don't know about aripiprazole, but there is more "gold standart" meds to counteract hyperprolactemia like  bromocriptine and cabergoline. I think its worthless take dopamine partial agonist (aripiprazole) with antagonist (amisulpride) not only aripriprazole won't work like it should, its also more expensive than bromocriptine.

But anyway it's not actual for me right now.

Edited by centaurus
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1 hour ago, centaurus said:

I don't know about aripiprazole, but there is more "gold standart" meds to counteract hyperprolactemia like  bromocriptine and cabergoline. I think its worthless take dopamine partial agonist (aripiprazole) with antagonist (amisulpride) not only aripriprazole won't work like it should, its also more expensive than bromocriptine.

But anyway it's not actual for me right now.

Arent cabergoline and bromocriptine associated with worsening of psychosis.,as they increase dopamine.

I'm running out of options. Amisulpride increases prolactin but is not generally associated with weight gain, so I thought i might try it. I have read that Paliperidone/Risperidone/Quetiapine are effective but cause weight gain, with the first 2 antipsychotics causing extremely high prolactin levels. I have tried abilify before at max dose of 10mg, it didnt do anything for my psychosis at this dose, doses above 10mg was making me extremely lethargic - couldnt get out of bed.

Edited by clinic
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Yes they can, but you have  to consult with your pdoc, to find right dose. Also it's worth give a chance Abilify at higher dosage and see if lethargy wore off after some time, and if not than counter act it with some wakefulness promoting agent like modafinil. There is also Rexulti, with lower side effect (not my exp.) however im not familar with it yet.

Does quetiapine was more sedating than clozapine? 

How about ziprasidone,latuda? 

 

http://www.ncbi.nlm.nih.gov/pubmed/11194712 read this

Edited by centaurus
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27 minutes ago, centaurus said:

Yes they can, but you have  to consult with your pdoc, to find right dose. Also it's worth give a chance Abilify at higher dosage and see if lethargy wore off after some time, and if not than counter act it with some wakefulness promoting agent like modafinil. There is also Rexulti, with lower side effect (not my exp.) however im not familar with it yet.

Does quetiapine was more sedating than clozapine? 

How about ziprasidone,latuda? 

 

http://www.ncbi.nlm.nih.gov/pubmed/11194712 read this

I used to take modafinil, but later it started worsening my psychosis. I stopped it. I have tried abilify for 7 months, the lethargy does not wore off unless i reduce the dose. Rexulti and latuda are not available in my country.

I have not tried quetiapine, but as per the meta analysis i posted on the first post, it is as sedating as zyprexa. My pdoc said quetiapine is usually associated with weight gain.

I have not tried ziprasidone.

Edited by clinic
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If Risperidone was effective i suggest talk with pdoc about adding low dose bromocriptine. Also you can try Seroquel XR it's less sedating.

1 minute ago, clinic said:

Have u tried bromocriptine or cabergoline for hyper prolactin before ? How was it like ?

No I haven't.

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2 minutes ago, centaurus said:

If Risperidone was effective i suggest talk with pdoc about adding low dose bromocriptine. Also you can try Seroquel XR it's less sedating.

Sorry i have not tried risperidone/paliperidone/quetiapine. I was referring to side effects of these drugs as i read on the meta-analysis study. I would probably try amisulpride first.

Edited by clinic
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It's not said that you will have all these side effects who you are reading. There is no perfect drug,you have to with pdoc approval  try drugs and then watch out side effects. Meds especially psych, can be different for one people  to another. Also hyperprolactemia can be asymptomatic.

Edited by centaurus
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14 minutes ago, clinic said:

Sorry i have not tried risperidone/paliperidone/quetiapine. I was referring to side effects of these drugs as i read on the meta-analysis study. I would probably try amisulpride first.

As centaurus correctly pointed out, just because a med can cause a side effect doesn't mean it will cause that side effect in you. And then if you get an undesirable side effect, you deal with it when it happens. You can't worry about every single side effect before you take the med or else you will never find an acceptable med.

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I wouldn't base your decision of an AP on the potential side effects. Everyone reacts differently. I think polypharm is worse than trying a new med, unless you just absolutely cannot tolerate anything else. Most people here have been through the gamut of drugs until they found something that works. It sucks, but I think it's safer than chasing SEs with new meds.

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11 minutes ago, jt07 said:

As centaurus correctly pointed out, just because a med can cause a side effect doesn't mean it will cause that side effect in you. And then if you get an undesirable side effect, you deal with it when it happens. You can't worry about every single side effect before you take the med or else you will never find an acceptable med.

The side effects i pointed out are listed under "notable side effects" in the stephen stahls prescribers guide to psychopharmacology book. I had tried paliperidone for 2 weeks before, and I had sexual dysfunction as pointed out by stahl.

Well so far my experience has been that the higher the dose u take of a particular drug, the more likely the side effect u will get as mentioned by stephen stahl. While other side effects r transient and go away with time, and some stay as long as your taking the drug.

Edited by clinic
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Even the side effects mentioned by Stahl are statistical. Yes, some side effects are more likely than others, but there is no guarantee that you will get the side effect. I took risperidone, and I got 0 (zero) side effects. It really depends on the person.

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