How about low dose amisulpride for negative symptom schizophrenia?

Chess24 · May 18, 2017, 5:52pm

In randomised, double-blind trials involving patients with predominantly negative symptoms of schizophrenia, amisulpride 50 to 300 mg/day was more effective than placebo.
At low dosages of amisulpride (< or =300 mg/day), the incidence of adverse events (including extrapyramidal symptoms) reported with amisulpride was similar to that with placebo.

ncbi.nlm.nih.gov

Amisulpride: a review of its use in the management of schizophrenia.

MP Curran and CM Perry, Drugs, 2001

Amisulpride, a substituted benzamide derivative, is a second-generation (atypical) antipsychotic. At low doses, it enhances dopaminergic neurotransmission by preferentially blocking presynaptic dopamine D2/D3 autoreceptors. At higher doses, amisupride antagonises postsynaptic dopamine D2 and D3 receptors, preferentially in the limbic system rather than the striatum, thereby reducing dopaminergic transmission. In patients with acute exacerbations of schizophrenia, the recommended dosage of amisulpride is 400 to 800 mg/day, although dosages < or =1200 mg/day may be administered. In comparative trials, amisulpride administered within this range (400 to 1200 mg/day) was as effective as haloperidol 5 to 40 mg/day, flupenthixol 25 mg/day and risperidone 8 mg/day in patients with acute exacerbations of schizophrenia with predominantly positive symptoms. Amisulpride was more effective than haloperidol but equally effective as risperidone in controlling negative symptoms. Amisulpride 400 to 800 mg/day was more effective than haloperidol, risperidone and flupenthixol in controlling affective symptoms in these patients. In randomised, double-blind trials involving patients with predominantly negative symptoms of schizophrenia, amisulpride 50 to 300 mg/day was more effective than placebo. Amisulpride is effective as maintenance therapy in patients with chronic schizophrenia. Long-term treatment with amisulpride was associated with improvements in quality of life and social functioning. Amisulpride is generally well tolerated. In well-controlled trials, the neurological tolerability profile (including ratings on extrapyramidal symptom scales) of amisulpride 400 to 1200 mg/day was superior to that of the conventional antipsychotics (haloperidol or flupenthixol), but was similar to that of the atypical antipsychotic risperidone. At low dosages of amisulpride (< or =300 mg/day), the incidence of adverse events (including extrapyramidal symptoms) reported with amisulpride was similar to that with placebo.In comparative trials, amisulpride 400 to 1200 mg/day showed efficacy in reducing overall symptomatology and positive symptoms similar to that of conventional antipsychotics and newer atypical antipsychotics in patients with acute exacerbations of schizophrenia. Moreover, its effective alleviation of negative and affective symptoms, its lower association with extrapyramidal symptoms and loss of cognitive function than conventional antipsychotics and its long-term efficacy justifies consideration of the use of higher dosages of amisulpride in this group of patients. Consequently, the dosage of amisulpride that is recommended in patients with acute exacerbations of schizophrenia is 400 to 800 mg/day, although dosages < or =1200 mg/day may be administered. Lower dosages of amisulpride (50 to 300 mg/day) should be considered for the management of patients with negative symptoms of schizophrenia. Amisulpride is a first-line treatment option in the management of schizophrenia in the acute phase and for the maintenance of treatment response.

@Andrey @far_cry0

Anon10 · May 18, 2017, 6:37pm

Amisulpride sounds like my dream drug, I really want to try it for its pharmacokinetics and D2 binding are similar to seroquels. Basically I want to replace seroquel because of the progressive weight gain. I think amisulpride would cure me if it were available in the US.

Andrey · May 19, 2017, 10:52am

I was on amisulpride right after my psychotic break. But it was a high dose - 800mg - and I was having severe extrapyramidal side effects. Maybe I would try a lower dose (200mg) but for now my pdoc doesn’t want to ditch Abilify…

Hadeda · May 19, 2017, 4:11pm

I’m on amisulpride 200mg now and it works well but I need a combo of it as well as a low dose of olanzapine to take my negative symptoms away. When I relapsed my dose of amisulpride was 400mg and one stage even 600mg but I found 200mg works well not lower than that. I think it works equally well to risperdal which I took years ago and went into remission.

Chess24 · May 19, 2017, 4:17pm

I may try amisulpride at a dose lower that 50 mg to stimulate the dopamine in my brain.
Perhaps raising dopamine will work like a charm .

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How about low dose amisulpride for negative symptom schizophrenia?

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