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Dr. Bob is Robert Hsiung, MD,
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Posted by Lamdage22 on May 28, 2018, at 15:47:54
In reply to Re: Switching from Abililfy to Saphris., posted by Lamdage22 on May 28, 2018, at 5:54:19
and it gets the job of protecting you from mania and psychosis done?
Posted by SLS on May 29, 2018, at 23:53:02
In reply to Re: Switching from Abililfy to Saphris., posted by Lamdage22 on May 28, 2018, at 15:47:54
> and it gets the job of protecting you from mania and psychosis done?
That is very astute of you. That is my hope. I did not experience a single manic episode during the 13 years that I took Abilify for. I have had manic reactions to MAOIs in the past. With a little luck, Saphris will help with depression and prevent mania.
I performed an experiment with Saphris. I stopped taking it. I wanted to be sure that it was absolutely necessary before moving on to months of different drug trials. I was so excited that I felt better on Saphris, but I wanted to explore the possibility that my improvement was due to the discontinuance of Abilify. After a week without Saphris, my bipolar depression deteriorated rapidly. I restarted it this afternoon. I allowed several days to pass before I began to descend into the abyss. I pushed and pushed as my conditionn grew worses and worse. I guess I have my answer. Now comes allowing the neuroendocrine systems to settle down under its new conditions. Once I feel stable, I will taper and discontinue Parnate in preparation for taking Trintellix.
- Scott
Posted by Lamdage22 on May 30, 2018, at 2:55:41
In reply to Re: Switching from Abililfy to Saphris., posted by SLS on May 29, 2018, at 23:53:02
It sounds like it is helping. Did you do alot of destructive stuff when you were manic/psychotic?
Posted by Lamdage22 on May 30, 2018, at 3:05:23
In reply to Re: Switching from Abililfy to Saphris., posted by Lamdage22 on May 30, 2018, at 2:55:41
Did your food cravings lessen? If not you can still try Metformin. It sounds like it could help you.
Are you still volunteering?
Posted by SLS on May 30, 2018, at 6:04:10
In reply to Re: Switching from Abililfy to Saphris., posted by Lamdage22 on May 30, 2018, at 3:05:23
Hi Lamdage.
My manias were indeed severe and overtly psychotic. Religiosity was the major theme. Mania for me is generally dysphoric. Parnate more so than Nardil. Although I was energetic and industrious at the beginning of each mania, the mania became destructive as it grew more severe. I lost my job and my marriage.
My depression has eased this morning. I took a 10 mg dose yesterday. It was too much all at once. I thought I could take a loading dose. I was impatient. I was left dizzy and sedated. It wasn't pleasant. I'm okay now, and will remain at 10 mg/day taken in divided doses.
Thanks for reminding me about metformin. If I have the same weight-gain and triglycerides issues with Saphris that I had with Abilify, I will ask my doctor about it.
I'm not volunteering right now. I left my position last August when my mother had spinal surgery. Afterwards, I had my bout with septic shock. The commute was getting too expensive, anyway. My guess is that I will feel employable later this summer as I eventually discontinue the Parnate and move on to Trintellix and Effexor.
Do you have a plan in place to treat your condition(s)? Have you reduced your dosage of Seroquel?
I always appreciate your kind concern.
- Scott
Posted by Lamdage22 on May 30, 2018, at 9:42:12
In reply to Re: Switching from Abililfy to Saphris., posted by SLS on May 30, 2018, at 6:04:10
> Hi Lamdage.
>
> My manias were indeed severe and overtly psychotic. Religiosity was the major theme. Mania for me is generally dysphoric. Parnate more so than Nardil. Although I was energetic and industrious at the beginning of each mania, the mania became destructive as it grew more severe. I lost my job and my marriage.I am sorry to hear that. I was destructive, too, but everyone involved forgave me. Also religious. You werent angry that a psychmed sent you into that? I was for sure.
> I'm not volunteering right now. I left my position last August when my mother had spinal surgery. Afterwards, I had my bout with septic shock. The commute was getting too expensive, anyway. My guess is that I will feel employable later this summer as I eventually discontinue the Parnate and move on to Trintellix and Effexor.
I watched your experiment with Saphris with some concern but i changed my mind. I hope the other change pays works out for you as well. I am kind of conservative. I rather not try everything because of the risks involved. It could be better with a new med, but it could also be worse. Thats kind of my thinking here. I am pretty stable and i dont want to mess this up.
> Do you have a plan in place to treat your condition(s)? Have you reduced your dosage of Seroquel?
I have gone from 1000mg to 900mg. But i did not have the nasal congestion again. I have picked up frequent exercise again and besides that i am kind of waiting for stuff like Rapastinel to come onto the market.
>
> I always appreciate your kind concern.
>
>
> - ScottSure thing;)
Posted by Lamdage22 on May 30, 2018, at 13:24:01
In reply to Re: Switching from Abililfy to Saphris., posted by Lamdage22 on May 30, 2018, at 9:42:12
And i do healthy eating and supplements. I believe that is a hugely overlooked factor. I feel so much better!
Of course its hard to live healthily when you take meds that make you crave unhealthy foods. For me Metformin fixed that.Maybe i will open a new thread on healthy living. Where should i post?
Posted by SLS on June 3, 2018, at 20:55:58
In reply to Re: Switching from Abililfy to Saphris., posted by SLS on May 17, 2018, at 7:48:04
Hi, Folks.
> > I have been taking 15 mg/day of Abilify for quite a few years. I gained 50 pounds and my triglycerides are 450 mg/dL. I would like to reverse these conditions. I took my first 5 mg dose of Saphris tonight. My plan is to cross-titrate the two drugs. My hope is that Saphris will provide approximately the same antidepressant effect as Abilify, but without the weight gain and metabolic side effects.
> >
> > We shall see.> So far, so good. I have been on Saphris 10 mg/day for a week, and discontinued Abilify 3 days ago. I feel better now than I did before making the switch. Of course it could be temporary. Abilify leaves the body somewhat slowly. Its half-life is 3 days. However, I remain optimistic. I have more energy and accomplish a bit more during the day. My thought speed and memory have improved. I am more social. My affect is less flat and my thoughts and feelings are more positive. I still suffer from laziness and a lack of interest and motivation. I also remain in a brain fog and stare off into space a lot. These things, while being symptoms of depression, are made worse by Parnate. This is my reason for wanting to switch from Parnate to Trintellix. I will do this once I have been stabilized on Saphris for a few weeks. Trintellix was my doctor's idea. I originally wanted to go back to Effexor, a drug that I have had partial success with in the past. His idea is much better. I am excited to make the switch.
So far, not so good.
Things have turned foul on me. Not only did I lose the improvement that I enjoyed during the first week or two on Saphris, but I am feeling decidedly worse. I'm pretty sure that I am in a darker place now than I was before adding Abilify to my treatment in 2002. I have decided to discontinue Saphris for now and plan to switch from Parnate to Trintellix. However, I don't plan to add back Abilify - at least, not yet. My main consideration for avoiding Abilify is that I am unhappy with the weight gain and elevated triglycerides it produces.
- Scott
Posted by ed_uk2010 on June 4, 2018, at 16:38:07
In reply to Re: Switching from Abililfy to Saphris., posted by SLS on June 3, 2018, at 20:55:58
Hi Scott,
Sorry to hear that asenapine didn't suit you.
How quickly do you plan to stop Parnate?
Posted by sigismund on June 4, 2018, at 18:52:59
In reply to Re: Switching from Abililfy to Saphris., posted by SLS on June 3, 2018, at 20:55:58
>Things have turned foul on me. Not only did I lose the improvement that I enjoyed during the first week or two on Saphris, but I am feeling decidedly worse.
The effects of Saphris change with the dosage?
How can you know what dose might be helpful if the effect is not linear?
Just a thought.
Posted by sigismund on June 4, 2018, at 19:00:00
In reply to Re: Switching from Abililfy to Saphris. » SLS, posted by sigismund on June 4, 2018, at 18:52:59
There's a lot of 1s and 5s for Saphris on askapatient and not too many 3s. Doses from 5 to 20.
Posted by SLS on June 4, 2018, at 20:04:40
In reply to Re: Switching from Abililfy to Saphris. » SLS, posted by sigismund on June 4, 2018, at 18:52:59
> >Things have turned foul on me. Not only did I lose the improvement that I enjoyed during the first week or two on Saphris, but I am feeling decidedly worse.
>
> The effects of Saphris change with the dosage?
>
> How can you know what dose might be helpful if the effect is not linear?
>
> Just a thought.That's a very good thought!
Thank you.
- Scott
Posted by SLS on June 4, 2018, at 20:15:08
In reply to Re: Switching from Abililfy to Saphris. » SLS, posted by ed_uk2010 on June 4, 2018, at 16:38:07
> Hi Scott,
>
> Sorry to hear that asenapine didn't suit you.
>
> How quickly do you plan to stop Parnate?I have begun to taper the dosage of Parnate as of today. I've done this before, of course. One of the most prominent withdrawal symptoms has been profound fatigue. I guess it is similar to coming off of amphetamine. I might use Focalin judiciously to help create a bridge for the worst of it. Similarly, I can use Abilify as a bridge as was suggested by my doctor. I will try not to do this, though. One day at a time.
- Scott
Posted by Lamdage22 on June 4, 2018, at 21:42:11
In reply to Re: Switching from Abililfy to Saphris. » ed_uk2010, posted by SLS on June 4, 2018, at 20:15:08
That is why i have become more careful with med changes. I hope it turns out ok for you.
Posted by Lamdage22 on June 4, 2018, at 21:54:42
In reply to Re: Switching from Abililfy to Saphris. » ed_uk2010, posted by SLS on June 4, 2018, at 20:15:08
So what is the plan now? You are changing two parameters at the same time?
Posted by SLS on June 5, 2018, at 13:06:11
In reply to Re: Switching from Abililfy to Saphris., posted by Lamdage22 on June 4, 2018, at 21:54:42
Hi, Lamdage.
> So what is the plan now? You are changing two parameters at the same time?
The plan is to switch from Parnate to Trintellix. Right now, I am not taking Abilify or Saphris. Having already gone through the bulk of Abilify and Saphris withdrawals, I am reluctant to return to either one of them. My doctor suggested that I could go back to Abilify and use it as a temporary bridge if necessary as I taper Parnate and wait 7-10 days before beginning Trintellix.
- Scott
Posted by ed_uk2010 on June 5, 2018, at 15:09:45
In reply to Re: Switching from Abililfy to Saphris. » ed_uk2010, posted by SLS on June 4, 2018, at 20:15:08
>I have begun to taper the dosage of Parnate as of today.
How long do you think it will take Scott?
Posted by SLS on June 5, 2018, at 18:03:44
In reply to Re: Switching from Abililfy to Saphris. » SLS, posted by ed_uk2010 on June 5, 2018, at 15:09:45
> >I have begun to taper the dosage of Parnate as of today.
>
> How long do you think it will take Scott?I am hoping to discontinue Parnate in 10 days. I'll be pushing it. However, I am allowing myself flexibility in the taper period. I don't know what to expect with respect to the severity of depression. I am expecting profound fatigue, though. This is what I've experienced in the past. I'm guessing it is similar to amphetamine withdrawal.
My doctor will let me go with a 7-10 day washout period. Serotonin syndrome is a concern as I prepare to begin Trintellix treatment.
- Scott
Posted by ed_uk2010 on June 6, 2018, at 0:45:00
In reply to Re: Switching from Abililfy to Saphris. » ed_uk2010, posted by SLS on June 5, 2018, at 18:03:44
Hi Scott,
That is a fast withdrawal! But if you allow yourself flexibility it should be ok.
I can see why you would be keen to start something new, so it makes sense.
Hope it works out well. Let me know.
Posted by SLS on June 6, 2018, at 8:32:28
In reply to Re: Switching from Abililfy to Saphris. » SLS, posted by ed_uk2010 on June 6, 2018, at 0:45:00
> Hi Scott,
>
> That is a fast withdrawal! But if you allow yourself flexibility it should be ok.
>
> I can see why you would be keen to start something new, so it makes sense.
>
> Hope it works out well. Let me know.Thanks, Ed.
:-)
- Scott
Posted by Lamdage22 on June 25, 2018, at 10:27:06
In reply to Re: Switching from Abililfy to Saphris. » ed_uk2010, posted by SLS on June 6, 2018, at 8:32:28
Hey Scott,
how you doing? You are brave. Are you fully withdrawn from Neuroleptics? Just watch out before you get another destructive Mania/Psychosis phase. I think you have lost enough relationships to Psychosis. Me too :(
Keep us posted.
Posted by SLS on June 25, 2018, at 13:02:46
In reply to Re: Switching from Abililfy to Saphris., posted by Lamdage22 on June 25, 2018, at 10:27:06
Hi Lamdage.
> Hey Scott,
>
> how you doing? You are brave.:-)
> Are you fully withdrawn from Neuroleptics?
Yes.
> Just watch out before you get another destructive Mania/Psychosis phase.
That's great advice. Thank you. I'll try to be careful. I am relying on family members to recognize the emergence of mania. They know what to look for. I can only hope that I am receptive to their advice. So far, the only manic episodes I've had have been in association with MAOIs. It is likely that Abilify acted as a prophylactic against manic reactions to both Nardil and Parnate. Latuda maybe?
I have mostly recovered from withdrawal effects for having discontinued Abilify and Parnate. I didn't expect that I would be hit so hard. There is some residual anxiety, but the depression has stabilized. I am on day 4 of Trintellix treatment. I'm taking 5.0 mg/day. I felt numb and slowed-down initially, but that seems to be subsiding.
I needed to do something. I was stuck for too many years.
Thanks again.
- Scott
Posted by Robert_Burton_1621 on July 2, 2018, at 4:42:08
In reply to Re: Switching from Abililfy to Saphris. » Lamdage22, posted by SLS on June 25, 2018, at 13:02:46
I do hope the substitution of vortioxetine for parnate does the trick, Scott.
I tried vortioxetine between stopping parnate and then resuming it, unsuccessfully - the main effects were agitation and hyper-sexuality. However, my psychiatrist at the time, a specialist in TRD, had done his own study of the drug with 100 of his own TRD patients, and overall it was successful.
At one point I had looked into the properties of the drug, and it seemed to be rather similar to Abilify *without* the dopamine antagonism. That was only my initial impression.
Posted by SLS on July 2, 2018, at 8:26:56
In reply to Re: Switching from Abililfy to Saphris. » SLS, posted by Robert_Burton_1621 on July 2, 2018, at 4:42:08
Hi, Robert.
> I do hope the substitution of vortioxetine for parnate does the trick, Scott.
>
> I tried vortioxetine between stopping parnate and then resuming it, unsuccessfully - the main effects were agitation and hyper-sexuality. However, my psychiatrist at the time, a specialist in TRD, had done his own study of the drug with 100 of his own TRD patients, and overall it was successful.
>
> At one point I had looked into the properties of the drug, and it seemed to be rather similar to Abilify *without* the dopamine antagonism. That was only my initial impression.Thanks for the information, Robert. It helps to give me hope. I am on day 10 of treatment. I don't know what to think. I have some background anxiety, which isn't normal for me. Maybe this is how I experience the agitation you describe. Yesterday was not a good day, but not the worst. I will continue at 10 mg/day for two weeks until I see my doctor.
What dosage of vortioxetine did you try? How long did you take it for?
- Scott
Posted by ed_uk2010 on July 2, 2018, at 14:39:09
In reply to Re: Switching from Abililfy to Saphris. » Robert_Burton_1621, posted by SLS on July 2, 2018, at 8:26:56
> I have some background anxiety, which isn't normal for me. Maybe this is how I experience the agitation you describe.
Might it help to have a small dose of a benzodiazepine for a couple of weeks until you get used to the vortioxetine? Eg. lorazepam 0.5mg twice a day.
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