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Neuroleptic withdrawal syndrome

C

coriolis

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Joined
Aug 21, 2007
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51
Many years ago I was given the diagnosis of schizophrenia despite I never satisfied neither the ICD-10 nor the DSM-IV-TR criteria for this illness and I never believed that I suffer from this disease. Recently it was found by an eminent neurologist that I was right. My current, and as all evidence indicates, right diagnosis is Lyme encephalopathy or postprocessual impairment of brain tissue due to spirochetal infection, i.e., neuroborreliosis. For nearly five years I was treated, non lege artis (neither positive nor negative symptomatology present), by an antipsychotic amisulpride. I took only a low dose of it, i.e., 200 mg daily, however, continuously for nearly five years. It's 18 days since I stopped taking amisulpride. When I wake up in the morning I feel good and I am able to work mentally quite satisfactorilly. But roughly at 2 p.m. the following symptoms emerge: bradypsychism, poor memory and concentration, physical exhaustion and dysthymia.

I would like to ask you to answer the following question: Is there an estimate of how long the molecules of amisulpride "sit" as antagonists at the dopamine receptors? What drug(s) could help to minimize the length of duration of this neuroleptic withdrawal syndrome?

Kindest Regards

coriolis
 
These are antagonists. I've never heard anything about a withdrawal syndrome resulting from any sort of antagonist.
 
Ham-milton said:
These are antagonists. I've never heard anything about a withdrawal syndrome resulting from any sort of antagonist.
Click to expand...

what about caffeine? it is an adenosine antagonist and can cause a withdrawal syndrome.
i have no idea concerning the neuroleptics though.
 
There can be a mild withdrawal sydrome from neuroleptics, and is generally dose dependent. Why didn't you taper down (yes 200mg is a low dose, but as you mentioned, you've been taking it for 5 years). I have definately heard of withdrawal symptoms from phenothiazines, risperidone and olanzapine (special case i know), so it certainly could happen with amisulpride. Are the symptoms at least improving, after these 18 days?

Spirochetal diseases are very disturbing (late stage syphilis, lyme, weils, all terrible)...
 
Is the withdrawal syndrome the result of sudden adenosine activation or rather decreased activity at some downstream location?
 
I think it may just be that when you remove the blockade there is a cholinergic response, resulting in a brief (not sure of precise duration) withdrawal syndrome. At least this what I had once read (as proposed by Beggin or perhaps Breggin?). However I am unsure if this would account for strange things like bradypsychism (im not even 100% what this means; talking slow or converting thoughts to words in a slow manner?)
 
Ham-milton said:
Is the withdrawal syndrome the result of sudden adenosine activation or rather decreased activity at some downstream location?
Click to expand...

the withdrawal syndrome is because of adenosine receptor regulation (and i'd guess downstream events). the adenosine rebound lasts hours whereas the withdrawal lasts a few days.
 
If the adenosine rebound only lasts a few hours, it can't be responsible for the withdrawal syndrome at all. Removing the blockade and allowing downstream activities to return to normal seems like the real cause.

I think the biggest problem with caffeine withdrawal are the headaches- which are probably the result of neuro blood vessels returning to normal size.

I'm not sure what the actual mechanism for constricting them is with caffeine.

I'd love to see any papers on this.
 
Thank you for your replies. Yes, after 18 days I feel better. Some sources state that neuroleptics intake should be diminished slowly, i.e., by 25% of the current dose every month. Another sources say that the neuroleptic withdrawal syndrome can last even for years. I hope this will not be my case :)
 
lyme symptomology

coriolis said:
Many years ago I was given the diagnosis of schizophrenia despite I never satisfied neither the ICD-10 nor the DSM-IV-TR criteria for this illness and I never believed that I suffer from this disease. Recently it was found by an eminent neurologist that I was right. My current, and as all evidence indicates, right diagnosis is Lyme encephalopathy or postprocessual impairment of brain tissue due to spirochetal infection, i.e., neuroborreliosis. For nearly five years I was treated, non lege artis (neither positive nor negative symptomatology present), by an antipsychotic amisulpride. I took only a low dose of it, i.e., 200 mg daily, however, continuously for nearly five years. It's 18 days since I stopped taking amisulpride. When I wake up in the morning I feel good and I am able to work mentally quite satisfactorilly. But roughly at 2 p.m. the following symptoms emerge: bradypsychism, poor memory and concentration, physical exhaustion and dysthymia.

I would like to ask you to answer the following question: Is there an estimate of how long the molecules of amisulpride "sit" as antagonists at the dopamine receptors? What drug(s) could help to minimize the length of duration of this neuroleptic withdrawal syndrome?

Kindest Regards

coriolis
Click to expand...

What you are describing could actually be the lyme disease symptoms. I have ME which is symptomatically similar to lyme and those are some of the symptoms I experience. I have never been on neuroleptics.
 
Hi,

the neuroleptics are rather diabolical :) After 3 weeks after the discontinuation of amisulpride I experienced states that could be described as "bouts of catatonia". The withdrawal symptoms markedly resembled negative symptoms of schizophrenia, symptoms I have never had before. I had to give up and start taking amisulpride again in the "homeopathic" dose of 175 mg. The obvious question is whether the appearing of pathognomonic signs after the sudden discontinuation of a neuroleptic medicacion used to treat schizophrenias, schizoaffective disorders etc. indicates a relapse or just some long term withdrawal symptoms.

As to the ME/CFS and related diseases: Yes, I believe I perhaps suffer from some of these not yet fully understood brain diseases. I have tried about 95 neuropharmaceuticals, the most prominent improvement came after citalopram, which is an SSRI, and modafinil. My explanation of the effect of citalopram is that it is a strong immunomodulator that inhibits the central proinflammatory cytokines. Thanks to the neuropharmacology I am now able to work mentally at about 70% of the premorbid functioning. During the first 5 years of my illness it was 5-10%, it resembled a dementia. Ten years ago, when I was 22, just before I fell ill I published in Phys. Rev. Lett. Now it seems I will have a small article in Physiol. Res., but I know nearly nothing about physiology, I am only a "modest observer" of mathematics and its application to biology :)

Applogies for my non native English
 
mhhh have you given a thought to the idea of getting back on them (maybe even just 1/4th of your normal dose), and then slowly weaning yourself off them?
 
[ bradypsychism (im not even 100% what this means; talking slow or converting thoughts to words in a slow manner?)/QUOTE]

I think this may refer to something AKA poverty of thought and other negative symptoms of schizophrenia. Or not. never heard the term either.
Click to expand...
 
Hi Coriolis,

How are you?
Do you still take amisulpride?
If you stoped - do you took something else to help give up amisulpride? (I mean to help increase activity, motivation).
I wonder if selegiline (MAO-B, mainly dopamine... ) or wellbutrin (bupriopion, NDRI) would help?
 
You took a realtively low dose. Low doses of amisulpride primarily counteract the negative symptoms of schizofrenia by enhancing dopmaninergic tramsmission throug pre-synaptic dopamine autoreceptor blockade. Bradypsychism, bad concentration, physical exhaustion and dysthymia is probably related to overall reduced limbic dopaminergic transmission. Poor memory could be atributed to amisulprides 5-HT 7 antagonism wich is suposed to increase cognition and memory and therefore cause a rebound effect on Abstinence.


Dont worry about amisulpride still being in your system, it must be completely eliminated after 18 days.

If the symptoms bother you too much i also suggest that you keep taking the drug and slowely decrease dose over time.
 
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