I also asked myself why in all this time haven't you experimented with Abilify to test the same thing you are recommending?
I tried Abilify in place of amisulpride about 8 years ago just out of curiosity, and also more recently a few month back as a result of all the current interest in Abilify. Unfortunately on both occasions I got an unpleasant overstimulation effect from Abilify, which I do not get from amisulpride.
Because of the long half life, just one dose of Abilify causes this overstimulation to last the for much of the week. It's then a relief when the Abilify finally wears off, and I can go back to a relatively relaxed mental state.
I expect this overstimulation comes from the adrenergic receptor agonism of Abilify. If I could find a workaround (to block the adrenergic receptors), then I could try Abilify, which I would very much like to do. Of course, it could be that the adrenergic agonism is part of the therapeutic effect of Abilify, and so if I block that, it might prevent Abilify from working.
Why not starting with methylphenidate, the stimulant used on Narcolepsy and ADHD?
it works quickly and a few days trial is enough to test if brain Dopamine level (or norepinephrine to a lesser extent) is involved.
It may not be dopamine levels per se which are the issue in ME/CFS. Abilify and amisulpride are dopamine stabilizers
, which means they reduce dopamine receptor agonism when the dopamine signal is strong, but increase receptor agonism when the dopamine signal is weak.
Abilify and amisulpride are analogous to a musical compressor effects pedal
(often used by guitarists), which boosts the volume of musical notes played softly, but reduces the volume of notes played loudly. A compressor thus reduces the dynamic range of the music. Likewise, Abilify and amisulpride reduce the dynamic range of the dopamine signal.
You cannot mimic the dopamine stabilizing effects of Abilify and amisulpride with just simple dopamine agonists or antagonists.