Amisulpride for CFS

[FunkOdyssey]

Eur Neuropsychopharmacol. 2011 Mar;21(3):282-6. Epub 2010 Nov 26.
Amisulpride vs. fluoxetine treatment of chronic fatigue syndrome: a pilot study.

Pardini M, Guida S, Primavera A, Krueger F, Cocito L, Gialloreti LE.

Department of Neurosciences, Ophthalmology and Genetics, University of Genoa, Genoa, Italy. matteo.pardini@gmail.com
Abstract

Different pharmacologic agents have been evaluated in the treatment of Chronic Fatigue Syndrome (CFS), albeit with moderate efficacy. Among the compounds thought to present with potential to be efficacious in CFS patients stands out low-dose amisulpride, a substituted benzamide that has been shown to be an useful treatment for conditions which exhibit some overlap with CFS such as dysthymia and somatoform disorders. We thus recruited forty non-depressed CFS patients that were randomized to receive either amisulpride 25mg bid, or fluoxetine 20mg uid; all subjects were un-blinded to the treatment regimen. At the time of enrollment in the study and after twelve weeks of treatment, enrolled subjects completed the Krupp Fatigue Severity Scale, the Hospital Anxiety and Depression Scale and a visual analog scale focused on pain and bodily discomfort. Moreover, all subjects were evaluated by a clinician, blinded to the treatment regimen, using the Clinical Global Impression Severity Scale. Our data revealed a significant improvement both in self-report, and observer-based measures for the amisulpride-treated, but not for the fluoxetine-treated patients. Amisulpride-treated subjects also presented with a significant reduction of somatic complaints, while the amisulpride effect on anxiety and mood levels was not significant. Both drugs were equally well tolerated. Summing up, we showed a positive symptomatic effect of amisulpride, compared to SSRI treatment, in a group of non-depressed CSF patients on self-report and on observer-based measures of fatigue and somatic complaints. If confirmed by larger, blinded studies, amisulpride thus could represent an effective approach to this difficult-to-treat condition.

This strikes me as having potential to not only improve symptoms but also the disease process at a core level, because the negative effects of dopamine on retroviral replication are mediated primarily by the D2 receptor. See the following posts:

Aripiprazole reduces HIV viral load likely via D2 antagonism w/ supporting references

More warning regarding dopaminergic drugs and retroviral infection

Pure speculation: it may even be possible to safely use some of those contraindicated dopaminergic drugs to improve quality of life if you have some adjunctive D2 antagonism on board to mitigate the negative effects.

The following thread contains a fairly comprehensive collection of amisulpride studies at the proposed 50mg dose: Amisulpride Update: still wiping out social phobia. From what I can tell, the only significant side effects at this dose seem to be hyperprolactin'ish endocrine stuff in women. Not clear why it doesn't cause as much trouble for men, I'll have to do more research.

 

[Jenny]

Thanks for posting this Funk. I think it's worth looking into problems in relation to neurotransmitters.

Jenny

 

[knackers323]

anyone tried this? or know where to get it online?

 

[Snow Leopard]

I'm sceptical of this study as the patients were not blinded as to what they were taking and there were no objective results, nor a control group.

 

[Alesh]

I have experience with amisulpride: Nothing special with both low or high doses. It causes hyperprolacitnemia, which can be useful in suppressing testosterone, if testosterone causes XMRV to replicate with higher rates.