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Finally off Abilify (and on Amisulpride)

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AAPs are part of my cocktail for intrusive thoughts of OCD.

Started with Risperidone, switched to Abilify because of blood cholesterole levels. When I found out that Risperidone was not the cause I tried going back on it but couldn't tolerate the second-time-new side effects.

Abilify is good for the purpose, but it does feel like it is “pushing too many buttons”. Never felt really “right” with this one.

Lately I started feeling the notorious flat affect, even on the minimal dose.

My pdoc said that I do need an AP so simply dropping Abilify is not an option. So he switched it for Amisulpride.

Does anyone have any experience with it?

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  • 2 weeks later...

I've never personally taken it, but I'm curious to see how you do with it. It isn't approved here in the U.S.

It's classified as an atypical, but it has much higher affinity for dopamine receptors than serotonin receptors like 5HT2A. That being said, I'm reading about it now, and the research seems to indicate that there are two specific things about amisulpride that make it useful for depression.

1. At low doses, it prefers the pre-synaptic auto-receptors. When those are blocked, it encourages dopamine release. However, without blocking the post-synaptic receptors, you would get a solid antidepressant effect.

2. Amisulpride has a relatively high affinity for the 5HT7 receptor which has known pro-cognitive, pro-circadian, and antidepressant effects in a few different models.

So this basically tells me that with amisulpride for low mood (dysthymia), low dose is key. However, I'm not sure how that would fair against OCD. I too have intrusive thoughts / obsessive ruminations, and antipsychotics are the only thing that has been able to quiet that racing/ruminating thought process, but if you don't antagonize the post-synaptic dopamine receptors, can you still get the same effect? That I'm not sure. However, I generally don't hear of Abilify being particularly good for OCD as a general rule. I imagine it works for some, but I also imagine the agitation would exacerbate symptoms of OCD and vice versa. One thing is for sure though that Abilify and amisulpride are two very different beasts.

Also of note is its high affinity for the GHB (gamma-hydroxybutyric acid) receptor so it should be a nice sedative in the evenings.

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Right now the direction is downhill.

I am worse than I've been for quite a long time now. Don't know if Amisulpride is to blame or it is the lack of Abilify which (apparently) was effective.

The one thing that makes me temporarily feel like myself is Clonazepam.

Pdoc appointment in 2 days...



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Another day on the same cocktail.

Not doing much better.

Worth noting though that my appetite is pretty much gone. I do eat, but I don't feel the need to.

Good for weight loss but a bit weird.

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I was taking 50mg, then 100mg.

Now 50mg again on the way back to Abilify, this time I will be taking 5mg instead of 2.5.

Still not sure if Amisulpride took away all my motivation or rather the lack of Abilify. Now I am  between meds and between feelings.

Better than yesterday at least ?

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If I know Abilify based on what others have described, it's probably that the Abilify is missing. And more than likely the 100mg dose of amisulpride was too high. For dysphoria, the positive effects are probably relegated to that 50mg dose, but MAYBE 100mg would do it too. Not sure. What I read didn't indicate when amisulpride loses its preference for pre-synaptic receptors, which is critical.

Doing the 5mg of Abilify seems to make sense to me. It should get calming as you get to higher doses. I've heard a lot of people say it switches by about 10mg or so but it can depend from person to person.

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