It's been a while since I've posted on MM. Hope everyone here is still well.
Currently withdrawing from a bunch of stuff including atomoxetine and memantine and a bunch of herbs/supplements. Formally diagnosed BP2, main issues these days are motivation, cognition/memory, seasonal mood issues, attention regulation, social phobia/motivation, and sleep. So lots of prefrontal hypoactivity essentially. Strattera worked at the beginning when I started it this year, but it has pooped out.
WIll be staying on Pramipexole ER 2.25, Vyvanse 40mg (lowest semi-effective dose, been tapering down for the past year), and 2mg guanfacine.
Convinced my doc to let me try Amisulpride, low dose, due to what i've read over the years about it's effectiveness in mood issues, the fact that it's not a SSRI, and the fact that it may work on dopamine in a novel way. Amisulpride looks like a good one to try also given the role 5ht7 plays in sleep and cognition/memory/mood.
Been on mirapex various times over the years, this latest round its been about 6-8 weeks. It may be helping but just a bit, hard to tell.
Curious as to a few things:
1) Best way to start amisulpride -- both so it's not a "shock" to the dopaminergic system given i'm already on Mirapex and Vyvanse (i'm 220lbs, so vyvanse 40mg is barely enough to be noticable, and I still take a few nicotine lozanges).
Read a few conflicting things that starting from say 50 or 100 and going DOWN gives it a stronger action. Others say titrate up from 25mg. Not clear. Anyone have experience or insight into the psychopharmacology?
2) Possible conflict with Mirapex or Vyvanse -- mirapex especially. I have read a few threads here that have been going on re: Mirapex and quite frankly I am pretty freaked out. Been on Mirapex a few times over the years, though never probably longer than 6-9 months. It does seem effective for me, at least at the beginning. And I always taper off pretty slowly. But this DAWS stuff is scary and have certianly struggled with anhedonia and motivation issues in the past.
3) Any other updated personal experiences with amisulpride alone or in combo. How long did it take to kick in? Any risk of mania? Novel subjective experience compared to other A/D or stimulants? Any sense of cognition improving due to 5ht7?