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Is Keppra effective in combating side effects of Amisulpride?

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Posted on Thu, 18 Sep 2014
Question: I am on Keppra 1000mg as mood stabilizer, Klonopin 3mg, Lexapro 10 mg and Solian (amisulpride) 100mg. I have some problems with Solian, since at this dosage (100mg) because of antagonism of 5HT7 and 5HT2b it creates to me some OCD and phobia symptoms. Sometimes this symptoms can disappear at low dosages of lexapro, but now my psychiatrist decided to give a higher dosage. The symptoms don't disappear for example with Lamictal (lamotrigine),but they disappear sometimes with a good dosage of Keppra. I would like to know if a higher dosage of Keppra can make all those effects of Amisulpride softer.
Thanks beforehand
doctor
Answered by Dr. Chintan Solanki (2 hours later)
Brief Answer:
No it is not like that

Detailed Answer:
Hello,


Thanks for using healthcaremagic.

Amisulpride at 100 mg dose preferentially block presynaptic D(2)/D(3)-dopamine autoreceptors, thereby enhancing dopaminergic transmission. This may cause some worsening of OCD and phobia symptoms but it self can not create such symptoms.However at higher doses block postsynaptic receptors, thus inhibiting dopaminergic hyperactivity.This may help in OC symptoms.
Antagonism of 5HT7 and 5HT2b rather help in depressive symptoms so can also help in phobia symptoms.But antagonism of 5HT7 and 5HT2b can also indirectly induce dopamine system and worsen the OC fetures. Exact mechanisms still under investigation.

Keppra has no role in interaction with solian at pharmacodynamic, neurochemical or at metabolisam level.So keppra is not making effects of solian softer. However keppra itself useful in resistant OCD which is helping you.

Hope I have answered your query, I will be happy to help further.

Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Chintan Solanki (25 minutes later)
Dear Doctor,
Your explanation is very clear and i undrstand now very well what's happening. I just have another question. what dosage of Keppra can be useful for resistant OCD? My dosage is too lower or it's ok?
Thanks beforehand,
XXXX
doctor
Answered by Dr. Chintan Solanki (15 minutes later)
Brief Answer:
no it is not lower but it can be increased if need

Detailed Answer:
Hi XXXXXXX

Thanks for follow up question.

Keppra can be given up to 3000 mg dose in required situation specifically in epilepsy.Maximum 60 mg/kg in divided doses.

In OCD doses generally range fro 250 to 2000 mg depending upon severity of the symptoms, other medicines going on with keppra and person's ability to tolerate the drug.

In your case if you are well on 1000 mg, it is good dose. If not feeling well or need more improvement, dose can be increased also. However dose is for sure not too lower.

Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
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Answered by
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Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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Is Keppra effective in combating side effects of Amisulpride?

Brief Answer: No it is not like that Detailed Answer: Hello, Thanks for using healthcaremagic. Amisulpride at 100 mg dose preferentially block presynaptic D(2)/D(3)-dopamine autoreceptors, thereby enhancing dopaminergic transmission. This may cause some worsening of OCD and phobia symptoms but it self can not create such symptoms.However at higher doses block postsynaptic receptors, thus inhibiting dopaminergic hyperactivity.This may help in OC symptoms. Antagonism of 5HT7 and 5HT2b rather help in depressive symptoms so can also help in phobia symptoms.But antagonism of 5HT7 and 5HT2b can also indirectly induce dopamine system and worsen the OC fetures. Exact mechanisms still under investigation. Keppra has no role in interaction with solian at pharmacodynamic, neurochemical or at metabolisam level.So keppra is not making effects of solian softer. However keppra itself useful in resistant OCD which is helping you. Hope I have answered your query, I will be happy to help further. Regards, Dr.Chintan Solanki.