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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by psychobot5000 on October 3, 2006, at 14:45:54
This is my account of a nasty experience trying abilify for treatment-resistant depression.
On paper it looks good, as atypical antipsychotics are known to help with depression, and abilify/aripiprazole has a better looking profile than most (D2 partial agonism, rather than antagonism, 5ht2 blocking, 5ht1a agonism). It is also considered a 'nonsedating' antipsychotic.
Well, my experience was frankly awful (on 5-10mg/day). At first I thought I was sick. Side-effects included: somnolence, increased time in bed, physical weakness, nausea, and reduced awareness. It was awful, and I struggled to get by. Add to this that abilify has a damnably long half-life of 75 hours--once you take it, you're stuck with the stuff for several days.
I went off it for about six days, then tried one more dose, and all the nastiness came back. I do not recommend this medication.
P-bot
Posted by pseudoname on October 3, 2006, at 15:07:00
In reply to Beware Abilify augmentation, posted by psychobot5000 on October 3, 2006, at 14:45:54
Hi P-bot.
My own Abilify experience was ultimately mixed, so unless I get some way to counteract the fiendish worry-making effect it had, I won't be trying it again myself.
But I was able to manage the physiological side-effects you report – especially that awful drowsiness! — by taking just 2.5 mg every other day. I think the sedation was gone for me about 2½ weeks after starting 5 mg/day.
That's one way to use a long half-life to advantage: spread out the doses over days.
Can I ask how long you were on it? Thanks. In some ways it was helpful to me, but too much of a mixed bag, alas.
–pn
Posted by SLS on October 3, 2006, at 15:35:14
In reply to Beware Abilify augmentation, posted by psychobot5000 on October 3, 2006, at 14:45:54
> This is my account of a nasty experience trying abilify for treatment-resistant depression.
> I do not recommend this medication.
Well, you know, I find it to be an exceptionally clean drug that helps me steer clear of suicidality, much like Zyprexa, but without the weight gain and vague psychotropic effects.
I can understand how this drug could produce a nasty reaction in some people, though. Early in treatment, it can produce anxiety, agitation, insomnia, restlessness, and perhaps even true akathisia. This very often passes, though.
Sorry the drug didn't agree with you. What else are you taking?
- Scott
Posted by pseudoname on October 3, 2006, at 15:52:15
In reply to Re: Beware Abilify augmentation, posted by SLS on October 3, 2006, at 15:35:14
Scott, what do you think of Abilify + Paxil? I want to try Paxil for help with some of my crazy fears, but maybe it would also let me benefit from Abilify without the adverse anxiety-increasing effect it had.
Posted by Emme on October 3, 2006, at 16:03:59
In reply to Beware Abilify augmentation, posted by psychobot5000 on October 3, 2006, at 14:45:54
My own Abilify experience has been decent. It helps with depression and improves my motivation. I had insomnia at the beginning, which resolved after a couple of months. It's a lot cleaner for me than many other drugs. It also seemed to cure some restless legs symptoms I had been having. I do suspect that it may be making me feel extra chilly now that autumn's coming in. Nothing's perfect.
emme
Posted by psychobot5000 on October 3, 2006, at 17:14:48
In reply to How long were you on it? » psychobot5000, posted by pseudoname on October 3, 2006, at 15:07:00
Hmm...a lot of interesting posts here--and positive responses to the med.
I wasn't on it very long--only about 7 days. For me the surprisingly intense drowsiness, physical weakness, and cognitive effects are really pretty hard to live with, even in the short term. I take Tianeptine (3x 12.5mg/day), by the way, as another part of my regimen, along with methylphenidate 18mg, on some days.
Still, I have been feeling pretty well (slightly elevated mood) now that the drug is 'more or less out of my system.' Except that with a 75-90 hour half-life, a small amount would still be there (I only stopped it about five days ago). Perhaps the med will actually be useful in very small doses--2 or 2.5mg every two days actually sounds like a decent idea. Once I let the substance taper down, I may even try that. I'll keep you people informed. Maybe, just maybe, it will help some after all.
P-bot
Posted by Phillipa on October 3, 2006, at 21:18:48
In reply to Re: How long were you on it? » pseudoname, posted by psychobot5000 on October 3, 2006, at 17:14:48
Post more about these two drugs together. I know someone who is interested in the two. Thanks Phillipa
Posted by SLS on October 3, 2006, at 22:14:04
In reply to Abilify + Paxil? » SLS, posted by pseudoname on October 3, 2006, at 15:52:15
> Scott, what do you think of Abilify + Paxil? I want to try Paxil for help with some of my crazy fears, but maybe it would also let me benefit from Abilify without the adverse anxiety-increasing effect it had.
My first reaction is to say that the Paxil would not prevent the anxiety produced by the Abilify. I am assuming that this anxiety is due to its akathisia-like limbic dopaminergic activity. The anxiety is most likely to be temporary. Perhaps you can try taking Ativan during the first 1-2 weeks. Were you thinking of beginning both drugs at the same time? You might want to establish the Paxil first. Beginning both at the same time might produce a great deal of anxiety as there could be a synergism between the startup anxiety that both drugs have the potential to produce.
- Scott
Posted by psychobot5000 on October 3, 2006, at 23:16:55
In reply to Re: How long were you on it? » psychobot5000, posted by Phillipa on October 3, 2006, at 21:18:48
Posted by pseudoname on October 4, 2006, at 9:52:44
In reply to Re: Abilify + Paxil? » pseudoname, posted by SLS on October 3, 2006, at 22:14:04
> The [Abilify] anxiety is most likely to be temporary. Perhaps you can try taking Ativan during the first 1-2 weeks.
That would be good news. If I had thought so earlier, I might've stuck it out a while longer, especially with Ativan.
I also wonder if buprenorphine may be contributing to my intermittent anxiety problems, which I never had before taking bupe. Perhaps another holiday from bupe is in order to test that.
> My first reaction is to say that the Paxil would not prevent the anxiety produced by the Abilify.
That's too bad.
> You might want to establish the Paxil first.
Paxil for a month or so at therapeutic dose first is my plan; then adding back the Abilify. I guess I'll also have to remember that Paxil may increase anxiety at first.
Thanks, Scott. I appreciate your brain on this.
Posted by psychobot5000 on October 5, 2006, at 8:41:51
In reply to Re: How long were you on it? » psychobot5000, posted by Phillipa on October 3, 2006, at 21:18:48
> Post more about these two drugs together. I know someone who is interested in the two. Thanks Phillipa
I think that I will not be taking any more Abilify--as it clears my system, I am feeling better, and my head is clearer. I did, one day during treatment, allow the Tianeptine to pass out of my system long enough to see that the negative effects (weakness, cognitive difficulty, somnolence, slightly reduced consciousness) seemed to persist with Abilify alone. I added the tianeptine back in, a day later.
I attribute my bad experience to a poor reaction to Abilify on my part. It might be different in someone else.
Tianeptine alone is great, though. As I've mentioned elsewhere, it helps anxiety, elevates and stabilizes mood, helps a little with OCD (as much as the SSRIs), and basically has no side-effects, though a minority complain about insomnia. Even so, it has such a short half-life, that one can avoid taking a dose in the evening, and the insomnia can be avoided. It also helps with chronic pain, and prevents stomach and lower GI discomfort.
Disadvantages are dubious legality in some English-speaking countries, and 3 times a day dosing. Now that the Abilify is more or less out of my system, I am combining it with fish oil and green tea, with some success. (enough that for the moment I'm removing the psychostimulant which I normally take).
That's all I really have, for now.
P-bot
Posted by Phillipa on October 5, 2006, at 20:28:00
In reply to Re: end abilify regimen, tianeptine. » Phillipa, posted by psychobot5000 on October 5, 2006, at 8:41:51
Thanks but isn't green tea similar to coffee or real black tea in caffeine? Love Phillipa
Posted by psychobot5000 on October 5, 2006, at 23:22:51
In reply to Re: end abilify regimen, tianeptine. » psychobot5000, posted by Phillipa on October 5, 2006, at 20:28:00
> Thanks but isn't green tea similar to coffee or real black tea in caffeine? Love Phillipa
I'm something of a tea-lover, so the answer I'll give is a little complicated. Let me start by saying that there are tea-extract capsules that have the caffeine removed, but leave the other important chemicals.
Short answer is that the tea I've been drinking is very low-caffeine, though it does have some. Here's the long answer below.
As for green tea, the caffeine content is quite variable, but it is generally somewhat less than in black tea, and far less than in coffee. The amount of caffeine depends on various factors: how much the leaves are fermented (very little for green tea), the size of the leaves picked, growing conditions for the plant, how the tea was processed after it's picked...the resulting beverage varies greatly, but each type of tea (i.e. dragon well, english breakfast, earl grey) has a certain range of caffeine that's usually pretty consistent--it's not an exact science.
But the tea I've been drinking lately is Hojicha (a green), which is very low in caffeine, perhaps 5-12 mg per 8 ounce cup, compared to 30-50 for a black tea, and maybe 80 for coffee. So I get a lot of other green-tea chemicals without much caffeination. The average cup of green tea might have more like 25mg.
Still, there are some other more minor stimulants in tea, besides the caffeine--it's a more complex chemical cocktail than coffee, but I suppose that's why it's useful to us people.
Best,
P-bot
Posted by Declan on October 6, 2006, at 16:17:55
In reply to Re: green tea and caffeine » Phillipa, posted by psychobot5000 on October 5, 2006, at 23:22:51
Hojicha? Isn't that Japanese yellow tea? Hardly any caffeine, hey? Oolong and good white tea are very nice too.
Posted by psychobot5000 on October 6, 2006, at 21:56:43
In reply to Re: green tea and caffeine » psychobot5000, posted by Declan on October 6, 2006, at 16:17:55
It's a japanese roasted tea (hojicha). I haven't heard it described as yellow, but I certaintly know nothing of japanese tea terminology, so it well may be. Mine produces a medium-green liquor.
I like oolongs, too. And many strains of green--dragonwell is very green and vegetal, mao jian I like the clear and floral taste of--very nice.
Anyway.
Psychbot
Posted by jaclinhyde on October 8, 2006, at 16:24:54
In reply to Beware Abilify augmentation, posted by psychobot5000 on October 3, 2006, at 14:45:54
For my family Abilify has been a godsend. My 11 year old is bipolar and was raging constantly. In the space of 2 days on Abilify he became a sweet kid. He did a complete 180 thanks to this med. It is turning out to be a really amazing drug for children who are BP.
Terri
Posted by psychobot5000 on October 8, 2006, at 19:37:07
In reply to Re: Beware Abilify augmentation, posted by jaclinhyde on October 8, 2006, at 16:24:54
> For my family Abilify has been a godsend. My 11 year old is bipolar and was raging constantly. In the space of 2 days on Abilify he became a sweet kid. He did a complete 180 thanks to this med. It is turning out to be a really amazing drug for children who are BP.
>
> TerriI know a doc who prescribes Abilify a fair amount--says he tends to get very good responses from a variety of patients. It's good to hear success stories.
Posted by TJO on October 9, 2006, at 6:19:02
In reply to Re: good to hear positives about Abilify, posted by psychobot5000 on October 8, 2006, at 19:37:07
Hi,
I'm bipolar and for me Abilify has been a great medication-i felt a mils antidepressant effeect from in within 1/2 hour of my first dose. Had a little akathesia for the first week or 2 then it went away. It has been a good drug for me.Tammy
Posted by Reggie BoStar on October 12, 2006, at 18:22:53
In reply to Re: good to hear positives about Abilify, posted by TJO on October 9, 2006, at 6:19:02
I told my pdoc that my sleeping habits had become bizarre. I was sleeping 4 hours one night, then 20 the next, etc. He gave me 5.0 mg/day of Abilify.
Now I'm sleepng 20+ hours EVERY day. I think he was under the impression that I had insomnia because of the 4 hour sleeping shifts, and because he seems to have entirely missed what I said about the 20 hour sleeping shifts.
I've seen other posts in this thread suggesting that anxiety and insomnia are side-effects of Abilify. I get the anxiety all right, but mainly because I can't get out of bed for more than 3-4 hours per day; and when I do, my arms and legs feel like lead weights. It's scary, especially the pounding heart when I try to move around much.
My experience is that Abilify is worse than a dud - it's a land mine that knocks me off my feet big time.
Reggie BoStar
This is the end of the thread.
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