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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by JohnX2 on May 2, 2002, at 18:32:25
People have been mentioning the efficacy of
amilsupride for Social Phobia?I know this is a dopaminergic medicine, does it help in any way to relieve anxiety?
Just Wondering,
JX2
Posted by JonW on May 2, 2002, at 21:54:55
In reply to amislupride and anxiety, posted by JohnX2 on May 2, 2002, at 18:32:25
John,
It didn't help my social anxiety at all! However, a 50mg amisulpride made me feel like I feel after one beer. So in a way it was anxiolytic for me, and slightly mood elevating like a stimulant.
Jon
>
> People have been mentioning the efficacy of
> amilsupride for Social Phobia?
>
> I know this is a dopaminergic medicine, does it help in any way to relieve anxiety?
>
> Just Wondering,
> JX2
Posted by JahL on May 2, 2002, at 22:09:20
In reply to amislupride and anxiety, posted by JohnX2 on May 2, 2002, at 18:32:25
>
> People have been mentioning the efficacy of
> amilsupride for Social Phobia?
>
> I know this is a dopaminergic medicine, does it help in any way to relieve anxiety?I use Sulpiride for s. phobia. Been pretty helpful for a coupla' years now. No EPS for me. Definitely helps with general anxiety; it particularly helps dampen my anxious ruminations (unsurprisingly for an AP).
J.
Posted by tex1 on May 3, 2002, at 2:51:41
In reply to amislupride and anxiety, posted by JohnX2 on May 2, 2002, at 18:32:25
>
> People have been mentioning the efficacy of
> amilsupride for Social Phobia?
>
> I know this is a dopaminergic medicine, does it help in any way to relieve anxiety?
>
> Just Wondering,
> JX2
Since, as you've said, amisulpride is a dopaminergic agent (used here in europe for many years) I would not say that it helps to deal with anxiety. Is pretty much activating instead. It's useful in anergic-elderly forms of depression.Best luck
Tex
Posted by Ken on May 3, 2002, at 17:58:13
In reply to Re: 'Sulpiride' and anxiety, posted by JahL on May 2, 2002, at 22:09:20
> I use Sulpiride for s. phobia. Been pretty helpful for a coupla' years now. No EPS for me. Definitely helps with general anxiety; it particularly helps dampen my anxious ruminations (unsurprisingly for an AP).
>
> J.Since sulpiride (like amisulpride) has opposite effects on DA neurotransmission at "low" (dopaminergic) doses versus the higher (anti-dopaminergic) dosages... Can you tell us what dosage of sulpiride you take to achieve the above results? 50 mg? 100 mg? More? Less?
Thanx,
Ken
Posted by jonh kimble on May 3, 2002, at 18:16:56
In reply to Re: amislupride and anxiety » JohnX2, posted by JonW on May 2, 2002, at 21:54:55
hey everybody. still very interested in amisulpride/ sulpride. to jonw. you said it feels like 1 beer. i personally do very well as far as energy, confidence all that even after 1 beer. i dont mean to be nossy, but what medications or even substances period have helped you with social anxiety. i have failed with everything common like nardil, klonopin, and adrafinil. simply no effect. i do very well on dopaminergics in general, execpt for poop out. if you could give me some insight it could really help me decide if amisulpride could help me. next step, find out how to get it in canada. thanks so much
jon
Posted by JahL on May 3, 2002, at 20:19:33
In reply to Re: 'Sulpiride' and anxiety » JahL, posted by Ken on May 3, 2002, at 17:58:13
> Since sulpiride (like amisulpride) has opposite effects on DA neurotransmission at "low" (dopaminergic) doses versus the higher (anti-dopaminergic) dosages... Can you tell us what dosage of sulpiride you take to achieve the above results? 50 mg? 100 mg? More? Less?
Hi Ken. 150mg is about optimum for me; there are no further benefits beyond that point and sedation starts to kick in. This dose seems to be fairly standard (if a little on the low side) going by what pdocs have told me.
Hi John. Contrary to the claims of an earlier poster, both Amisulpride & Sulpiride most certainly do possess anxiolytic properties; if they didn't they wouldn't be regularly prescribed for anxiety (& particularly s. phobia) by, amongst others, the staff of the Maudsley hospital (the UK's pre-eminent, or at least most famous, psych unit.). I've seen a few pdocs & profs there over the years and all of them, w/o exception, viewed both drugs as 'effective' (like all drugs, only for certain individuals) second or third line agents for anxiety, and not depression (they are used for that purpose on the Continent but the consensus here seems to be that the AD effect, when apparent, is fairly mild).
I was first prescribed Sulpiride (indication: anxiety) by a provincial pdoc so, whilst it may not be a commonly used drug, its anxiolytic properties are recognised beyond the confines of teaching hospitals.
Regards,
J.
Posted by katekite on May 3, 2002, at 20:28:08
In reply to Re: 'Sulpiride' and anxiety » Ken, posted by JahL on May 3, 2002, at 20:19:33
Anyone know the proposed mechanism for it working for anxiety? I was reading something just now on both that seemed to suggest that sulpiride would be better for anxiety than amisulpride (sp? on the names there) just because there is a greater gap with sulpiride between effects on serotonin receptors and dopamine receptors. ie at low doses does serotonin but if go too high get antagonism of dopamine which might not help. But I don't know how they are supposed to work....anyone?
kate
Posted by tex1 on May 4, 2002, at 7:12:30
In reply to Re: 'Sulpiride' and anxiety » Ken, posted by JahL on May 3, 2002, at 20:19:33
> Hi John. Contrary to the claims of an earlier poster, both Amisulpride & Sulpiride most certainly do possess anxiolytic properties; if they didn't they wouldn't be regularly prescribed for anxiety (& particularly s. phobia) by, amongst others, the staff of the Maudsley hospital (the UK's pre-eminent, or at least most famous, psych unit.). I've seen a few pdocs & profs there over the years and all of them, w/o exception, viewed both drugs as 'effective' (like all drugs, only for certain individuals) second or third line agents for anxiety, and not depression (they are used for that purpose on the Continent but the consensus here seems to be that the AD effect, when apparent, is fairly mild).
>
> I was first prescribed Sulpiride (indication: anxiety) by a provincial pdoc so, whilst it may not be a commonly used drug, its anxiolytic properties are recognised beyond the confines of teaching hospitals.
>
> Regards,
> J.The anti-anxiety effects does exist, but not at the dosage reccomended for depression (as here in Europe is prescriped mostly for this). The amisulpride dosage is usually 50 mg day in this case. Over this dosage you're surely going to feel an anti anxiety effect due to the dopaminergic receptors blockage. So it mostly looks like an "anergic" and "ataraxia" effect than a pure anti-anxiety effect.
Best luck
Tex
Posted by JahL on May 4, 2002, at 9:08:02
In reply to Re: 'Sulpiride' and anxiety, posted by tex1 on May 4, 2002, at 7:12:30
> The anti-anxiety effects does exist, but not at the dosage reccomended for depression (as here in Europe is prescriped mostly for this). The amisulpride dosage is usually 50 mg day in this case.We'll have to agree to disagree :). I suggest maybe going back through the archives and reading some of AndrewB (a v. well respected & knowledgable 'old timer')'s posts. He achieved a "pure anxiety effect" for social phobia at precisely the Amisulpride dose you mention, possibly less. We've emailed one another once or twice in the past & the guy definitely knows what he's talking about.
>Over this dosage you're surely going to feel an anti anxiety effect due to the dopaminergic receptors blockage. So it mostly looks like an "anergic" and "ataraxia" effect than a pure anti-anxiety effect.
The idea that APs only relieve anxiety through sedation (I assume this is what you mean by 'anergic effect', though I could be wrong) is an old one and is not entirely true. Besides, the higher my Sulpiride dosage goes over 200mg, the LESS effective it becomes for anxiety.
Even at tiny doses of Sulpiride (ie a quarter of the smallest tablet available) I experience a clear "pure anti-anxiety effect", ie a meaningful reduction in the frequency and intensity of anxious thoughts. Of course my experience isn't necessarily typical but I am proof positive that at low doses, Sulpiride can be, *for some people*, a 'pure' anxiolytic. I do not experience sedation, or any other side-effect w/ Sulpiride.
I'm not sure you can predict the response an individual will experience with a given drug just by analysing its pharmacological profile. Would you believe, for example, that I also take low-dose Methadone for *energy* and *mental clarity*, both of which are adversely affected by opioids, according to conventional wisdom?
Ataraxia means 'peace of mind'. Isn't that analogous to 'reduction of anxious thoughts'?
Anyway, that's me done.
Best regards,
J.
Posted by jonh kimble on May 4, 2002, at 12:33:23
In reply to Re: 'Sulpiride' and anxiety, posted by JahL on May 4, 2002, at 9:08:02
hi jahl. hope everythings well with you. i was wondering if you wouldnt mind telling me a little bit about how your social anxiety has been helped. specifically, i feel very hypersensitive to criticism, and i always feel so afraid of criticism even towards others, even when im not the one doing it. does sulpride help with this sort of thing? why does it seem like many people prefer amisulpride over sulpride? thanks for your time
jon
Posted by JahL on May 4, 2002, at 13:46:01
In reply to Re: 'Sulpiride' and anxietyjahl, posted by jonh kimble on May 4, 2002, at 12:33:23
> hi jahl. hope everythings well with you. i was wondering if you wouldnt mind telling me a little bit about how your social anxiety has been helped. specifically, i feel very hypersensitive to criticism, and i always feel so afraid of criticism even towards others, even when im not the one doing it. does sulpride help with this sort of thing?
Hi John. Sulpiride helps my condition as a whole. So yes, I am less hyper-sensitive to criticism. In social situations I feel a little more at ease and I can engage in conversation more readily. I am not as obsessed with the thought of strangers scrutinising me (in a critical way) and I don't (subconsciously) try and second guess what others are thinking about as much, or read too much into what they might say.
Physical symptoms are also helped; I don't feel so 'panicky' and I don't sweat profusely as before. Which is nice :) . I don't feel as tense when I'm out and about. Don't feel as 'threatened' either; means I'm not quite so likely to 'fly' at someone.
Put simply, Sulpiride benefits my s. phobia as a whole, probably bringing about a 50% improvement, which, whilst being far from ideal, is 50% more than any other drug has managed. However, I'm actively searching for something more effective, and something w/o the risk of TD.
I don't think anyone who knows me would guess I'm s. phobic (I'm perceived to be some kind of 'tough guy') and Sulpiride helps me keep it under my hat.
I have no idea why one might be more popular than the other. Having differing pharmacological profiles, I imagine one might benefit a given individual more than the other (*if at all*). This was so in my case. Maybe Amisulpride is mentioned more often than Sulpiride is because it is widely available throughout Continental Europe and so is easier to obtain w/o a prescription ('back in the days' there was a lot of talk here of how to obtain Amisulpride). [that is NOT a tip, Dr B!]
Best,
J.>why does it seem like many people prefer amisulpride over sulpride? thanks for your time
>
> jon
Posted by JonW on May 5, 2002, at 13:54:41
In reply to Re: amislupride and anxietyto jonw, posted by jonh kimble on May 3, 2002, at 18:16:56
Hi Jon,
I'm in a very similar situation as you. Nothing has really worked for me so far. I think I mentioned this in one of my other posts but I don't think it was to you... anyway, a lot of us here who make the claim that a drug doesn't work haven't really given it a fair trial. Many people in the paxil studies for social phobia were non-responders after 8 weeks but were considered responders after 12 weeks. I've taken Paxil, but not for 12 weeks and so I'm really not sure if it would've been effective. Right now, I'm working with Dr. Liebowitz to come up with a long-term solution. I absolutely hate waiting for the solution, but I believe he can do it. I don't know how long you've been on the drugs you've been on, but I used to change drugs every week. The best doctors that I've worked with all agree that it takes time. I used to take each drug and see what my reaction was, and so I have a long history of things seeming to initially work and then stop, but that's not how the best in the business treat social anxiety disorder. It's just hard to accept when you get a *WOW* reaction after taking something. I wonder why can't that last? But for the most part those were all bipolar reactions. Have you ever been evaluated for bipolar disorder? I don't know if you can relate to any of this, but I thought I'd share just in case. Well, make sure you're working with a good doctor and be persistent and patient. Hang in there!
Jon
> hey everybody. still very interested in amisulpride/ sulpride. to jonw. you said it feels like 1 beer. i personally do very well as far as energy, confidence all that even after 1 beer. i dont mean to be nossy, but what medications or even substances period have helped you with social anxiety. i have failed with everything common like nardil, klonopin, and adrafinil. simply no effect. i do very well on dopaminergics in general, execpt for poop out. if you could give me some insight it could really help me decide if amisulpride could help me. next step, find out how to get it in canada. thanks so much
>
> jon
Posted by JohnQ on May 6, 2002, at 17:11:14
In reply to Re: 'Sulpiride' and anxiety » jonh kimble, posted by JahL on May 4, 2002, at 13:46:01
<<Put simply, Sulpiride benefits my s. phobia as a whole, probably bringing about a 50% improvement, which, whilst being far from ideal, is 50% more than any other drug has managed. However, I'm actively searching for something more effective, and something w/o the risk of TD.>>
What did your doctor tell you about the risk for TD? Is it a big risk at the lower dosage range? I want to try it or Amisulpride, but I'm reluctant because of this. TD is not something I want to chance.
This is the end of the thread.
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