Amisulpride for ADHD
Amisulpride is an atypical antipsychotic.
Amisulpride is a dopamine receptor antagonist.1
Low dose (e.g., 100 mg): primarily blockade of presynaptic (transmitter nerve) D2 and D3 reuptake receptors. This leaves more dopamine in the synaptic cleft for uptake at the postsynapse (receiving nerve), which may alleviate ADHD symptoms.
High dose: Blockade of postsynaptic D2/D3 receptors in the limbic system.
Higher doses (400 mg) of amisulpride can significantly improve excessive affinity for drug-associated stimuli (cue reactivity) and inability to tolerate delayed rewards (reward delay aversion). While cue reactivity was improved as well as by a nonspecific opioid receptor antagonist (naltrexone, 50 mg), the improvement in reward delay aversion by amisulpride was significantly better.2
Amisulpride is mainly used in schizophrenia. Schizophrenia is characterized by dopamine deficiency with regard to negative symptoms and by dopamine excess in the relevant brain areas with regard to positive symptoms.
Some of the negative symptoms of schizophrenia can also be found in a similar form in the spectrum of ADHD symptoms.
Amisulpride is not a typical ADHD medication.
Edel, Vollmoeller (2006): Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung bei Erwachsenen, Seite 45 ↥
Weber, Beck-Schimmer, Kajdi, Müller, Tobler, Quednow (2016): Dopamine D2/3- and μ-opioid receptor antagonists reduce cue-induced responding and reward impulsivity in humans. Transl Psychiatry. 2016 Jul 5;6(7):e850. doi: 10.1038/tp.2016.113 ↥