Posted by AndrewB on July 23, 2000, at 19:28:52
In reply to Re: Amisulpride Question? -- KarenB, anyone, posted by shellie on July 22, 2000, at 20:27:07
Shellie,
Shellie,
I have included below the abstracts of two studies that indicate that amisulpride is effective for major depression in partial remission.
To my knowledge, in actual practice amisulpride is normally reserved for use in social anxiety, dysthymia and atypical depression.
It may have a place as an adjunct (add-on) medicine in major depression. Maybe it can play a role similar that Zyprexa plays as an adjunct.
At some point you may wish to discuss with your doctor having a trial with Zyprexa, a week should do. If you experience improvement, aside from any side effects such as sedation or hunger, it is an indication you may respond well to amisulpride.
The good thing about a trial with either amisulpride or Zyprexa is that they can be done quickly and side effects, if they do occur, are quite tolerable over the short term.
A poster here has combined amisulpride with Parnate without ill effect. The combo of amisulpride and Nardil may increase hypotension. I wonder how often a neuroleptic is combined with an MAOI with good results.
AndrewB
===========================Title: Amisulpride versus fluoxetine in patients with dysthymia or major depression in partial remission: a double-blind, comparative study.
Author Smeraldi E
Address Istituto Scientifico Ospedale San Raffaele, Department of Neuropsychiatric Sciences, University of Milan-School of Medicine, Italy.
Source J Affect Disord, 48(1):47-56 1998 FebIn a multicentre, double blind, parallel group study 281 patients with DSM III-R diagnosis of dysthymia or a single episode of major depression in partial remission were randomised to 3 months of treatment with amisulpride 50 mg/day or fluoxetine 20 mg/day. The baseline Montgomery and Asberg Depression Rating Scale (MADRS) total score was reduced by at least 50% in 74.1% of patients (103/139) with amisulpride and 67.4% (87/129) with fluoxetine (P =0.230). No significant differences between treatment groups were found in the reductions in mean total score with the MADRS, Widl¨ocher psychomotor retardation scale, Sheehan disability scale, and CGI. Anxiety measured by HAM-A total mean score decreased significantly more with amisulpride (63%) than with fluoxetine (54%; P = 0.021). There were 13 dropouts due to adverse events with amisulpride and ten with fluoxetine. The number of patients reporting at least one adverse event was similar in the two groups (amisulpride 47.5%; fluoxetine 40.9%). As expected, in the amisulpride group endocrine-like adverse events in female patients were the most common, while nausea, dyspepsia, anorexia and insomnia occurred more frequently with fluoxetine.
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Title Amisulpride versus imipramine and placebo in dysthymia and major depression. Amisulpride Study Group.Author Lecrubier Y; Boyer P; Turjanski S; Rein W
Address Unit´e INSERM 302, H^opital Salpetri`ere, Paris, France.
Source J Affect Disord, 43(2):95-103 1997 AprAmisulpride, a selective antagonist of D2 and D3 dopamine receptors, acts preferentially on presynaptic receptors increasing dopaminergic transmission at low doses. In a multicentre, 6 months, placebo-controlled trial, amisulpride (50 mg/daily) was compared to imipramine (100 mg/daily) in the treatment of patients with DSM-III-R criteria for primary dysthymia, dysthymia with major depression or major depression in partial remission. A total of 219 patients were included. Both analyses (intention-to-treat and "per protocol' analysis) detected significant differences between groups (active treatment vs. placebo) on all main rating scales (CGI, MADRS, ERD, and SANS). The number of patients reporting at least one adverse event was higher in the imipramine group than in the two other, mainly due to anticholinergic effects. Endocrine symptoms were more frequent in female patients treated with amisulpride. These results confirm the interest of a drug acting on dopaminergic transmission such as amisulpride in the treatment of depressed patients.
poster:AndrewB
thread:40578
URL: http://www.dr-bob.org/babble/20000717/msgs/41269.html