Posted by SLS on November 6, 2000, at 22:05:37
In reply to Amisulpride: Adjust Dose Up or Down?, posted by Seamus2 on November 6, 2000, at 21:02:48
Dear Seamus,
I think you might be better served by taking your vacations in Jamaica and bringing your Parnate along with you.
:-)
Seriously.
If I were you, I would take whatever works indefinitely without disruption. Your history indicates that this is probably in your best interests. There is a tendency for someone to become more and more difficult to treat with subsequent depressive episodes (relapses). To discontinue a drug and restart it often results in its diminished effectiveness.
Unless there are significant adverse effects when you take 30mg of Parnate, I don't see any advantage to reducing the dosage to 20mg. Keep the system stable (homeostasis).
If you cannot find an alternate treatment to Parnate, I would suggest that you carefully consider taking Parnate 30mg or more for the rest of your life. You don't want to endanger your responsiveness to the only drug that works for you.
It is not such a big deal once you accept it.
Really.
Sincerely,
Scott
> History of unipolar major depression for twenty years. Stable for the past 10 using MAOI's, the last 7 on Parnate 10 mg BID or TID during winter months (Oct - Feb).
>
> "Drug vacations" lead to another episode sooner or later, so I've been pretty cautious and taken my maintenance doses regularly. I discontinued the Parnate end of July and was okay until beginning of October (start of the SAD season, always predisposing) at which time I started Amisulpride 50 mg/day because I was starting to slip. I got an immediate "lift" out of it; or rather, it lifted me. The effect was subtle, but my mood and affect seemed to have more bouyancy. No side effects except for slighly limper erections.
>
> Added Adrafanil 100 mg BID two weeks ago to combat anhedonia and improve motivation, and except for some mild psychmotor activation (nervous tics, pacing) I'm starting to slip again. So far I haven't noticed it does much.
>
> Question for the gallery: Do I increase the Amisulpride to 100mg/day or do I decrease it to 25/day? Should I give the Adrafanil another few weeks, or should I push the dose to 200 mg BID. Or both?
>
> Thanks,
>
> Seamus
poster:SLS
thread:48304
URL: http://www.dr-bob.org/babble/20001102/msgs/48315.html