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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by stargazer on March 26, 2007, at 0:50:40
Hi, I just started on Abilify on 3/20 at 5 mg, although my pdoc had suggested 10mg.
I have TRD, and have been on Emsam since November with minimal response to 6 mg, I increased to 9 mg with a better response, then regressed and increased to 12 mg, but I stated to have an increase in hypotension and lightheadedness, so I went back to 9 mg, added Provigil (Not good), and when I started abilify, the dose of Emsam was decreased to 6 mg.
What is Abilify doing for you, specifically, if you can discern this, especially if you are on other meds with it.
And how long have you been on it and what SE's are you experiencing. Any movement disorders like TD? Weight gain?
And are any of you taking a low dose like 5 or 2.5 mg and having luck at that dose?
I want to compare my experience with others and know how long you have been taking it with good results. I haven't had another AP work for me before so I am thrilled that Abilify seems to be taking some of my inability to focus and eliminate the brain scattering effect which I have been plagued with this time around.
Thanks for your feedback on Abilify...and whatever else you take with it.
Stargazer
Posted by football on March 26, 2007, at 2:36:39
In reply to ABILIFY... what dosage/what condition/effects/SE's, posted by stargazer on March 26, 2007, at 0:50:40
Abilify was the worst drug I've ever taken. At just 10 MG, I encountered the dreaded akathisia (AKA the worst feeling in the world) that is fairly common with it.
If you decide to take it, I wish you luck, because if you do develop akathisia, you will feel unbearably miserable.
Thankfully, there are ways to treat it, so if I were you, I would demand that your doc give you something to take if, the akathisia becomes to unbearable.
Good luck.
Posted by med_empowered on March 26, 2007, at 2:53:17
In reply to Re: ABILIFY... what dosage/what condition/effects/, posted by football on March 26, 2007, at 2:36:39
hey. I've taken abilify. Low doses were OK, but I had some intense agitated depression to deal with...@ 10 or above, it sucked. The worst thing was that the akathisia didn't really go away; sometimes, at 10mgs or above, I'd take my pill and just start sobbing. It wasn't psychological, either; Abilify just had this weird effect that was at once intensely blunting and flattening but also strangely activating, so I was stimulated enough to see how blunted I was being made.
Plus...there's no PROOF that abilify has any lower incidence of TD than any other medication. Cases of TD have already been reported (they should be on pubmed if you want to look it up).
Why is your shrink so hot-to-trot with the antipsychotics? I mean, its kind of normal to use a low-dose antipsychotic for a little while with an MAOI--thats an old trick to reduce agitation--but has she/he explained why they want to do this long-term??
Abilify tends to be kind of activating, and there are definite akathisia problems, so its probably not the best choice for reducing agitation, anyway--for that you might be better off with a benzo, a more sedating antipsychotic, or maybe some non-BZD GABAergic drug, like Depakote,Lyrica, Neurontin, etc.
Anyway, Abilify was OK, I guess, at low-doses, but it wasn't particularly magical or anything, and it still carries the same risks as other neuroleptics...its too new on the market for anyone to know just how good or bad it is, so be careful. You don't even NEED an antipsychotic to counter AD-induced agitation; there are other strategies that involve fewer risks and use much less expen$ive drugs.I think you should talk to your doc about drugs that don't have the same awful risks associated with neuroleptics. TD is a less likely with new meds than old ones (although the rate for abilify specifically is unknown), but that's no reason to risk it when there are other alternatives. Its like minor surgery--surgery is only minor when its *not* being done on you.
Good luck.
Posted by stargazer on March 26, 2007, at 10:47:12
In reply to Re: ABILIFY... what dosage/what condition/effects/, posted by med_empowered on March 26, 2007, at 2:53:17
ME,FB
The only reason we're trying Abilify is that I had a second opinion and it was suggested, as was Depakote, ECT (refused)or TMS. I know about all the terrible SE's of the AP's and that is why I have elected to start at 5 mg rather than 10 mg, as my pdoc advised. I am scared to death of SE's as I have been on med trials since 1987 with horrible SE's. I have taken a few AP's before Abilify without any improvement and I refused to increase them as I was too scared and believe most drugs that eventually work show some effect early on. Abilify showed a response within a day. No other class of meds has helped me over the last 2 years so I was up against a wall with uncertainty.All I know is that the Abilify is helping even at 5 mg, so I am happy to have some effect at all. I was losing the fight to continue to try more meds since none were working anyway.
Remember my depression has a long history and has gotten worse with every episode and i'm sure I've had more than 10 severe relapses in 25 years. One or two good (mediocre)years on SSRI's in combo with stims and Wellbutrin.
I know you mean well by advising all the negatives
but I am well aware of this and have opted to risk that rather than give up on ever recovering, although this early response may not last, as so many fade over time.If I don't get out of this situation and stay out of it, I have the names of two experts in the area that I can hopefully see before my insurance runs out. Abilify is being tested now for treatment resistent depression and anxiety, so there must be studies showing its efficacy despite it's high risk profile.
I'm at 5 mg and intend to stay there or even reduce to 2.5 to keep SE's at bay. I am not an uninformed patient, I read as much as my depression allows me to and I question my docs constantly, given my ability to challenge the logic or lack thereof. When you get to this point, you really don't care too much anymore, it's either life or life with SE's, so the decision has become a no brainer, whereas I used to refuse to try AP's, thinking "I'm not psychotic".
Thanks for your responses...Stargazer
Posted by Honore on March 26, 2007, at 10:55:07
In reply to Re: ABILIFY/Med empowered/Football, posted by stargazer on March 26, 2007, at 10:47:12
I use 2.5 mg/day of Abilify with Emsam and it's extremely helpful.
I had a pretty good response to Emsam over the course of four months previously, but had to stop for other reasons.
When I started again, I asked my pdoc about Abilify, and he said it's a good combination. (He's very uptodate on things and very good.)
He also said the following:
1. about 20% of people experience nausea, which causes them to stop
2. about 20% of people experience agitation which causes them to stop
3. you'll pretty much know, if you've done ADs and have a sense of your reactions, if the Abilify is helping within 10 days or maybe 2 weeks at most. Could be less.He gave me 2.5 mg== and there' s no question in my mind that it's making a very great difference. I had a much better, and also fuller and quicker response to Emsam with the small dose of Abilify than w/o.
No reason to take more Abilify than you need. Lots of people stick with small doses and have good results. So if you're not in the 40% with bad SEs, it might do you some real good.
Give it a while, but you should have a sense of it without waiting that long.
Good luck,
Honore
Posted by TheMeanReds on March 26, 2007, at 12:04:13
In reply to Whoa Nellie! I think Abilify can be good with Ems, posted by Honore on March 26, 2007, at 10:55:07
I had a trial of Abilify, to treat occational depression.
I was also on Lamictal, Klonopin, and Seroquel. I took Abilify for 2 weeks at 2.5/mg.
I describe it very similar to smoking marijuana. Its definately a happy drug for me, and had only mild side effects.
Unfortunately I would forget what my point was while in the middle of conversation with someone (like I would with marijuana). So I decided to stop taking it.
Posted by Phillipa on March 26, 2007, at 12:12:39
In reply to Re: ABILIFY/Med empowered/Football, posted by stargazer on March 26, 2007, at 10:47:12
Good luck stargazer I'm crashing hard. Love Phillipa
Posted by stargazer on March 26, 2007, at 23:03:46
In reply to Whoa Nellie! I think Abilify can be good with Ems, posted by Honore on March 26, 2007, at 10:55:07
Honore, thanhk you for your response. You sound just like me, I thought your response was the one I had written, so weird.
I felt a response after one day so I know it's doing something, tomorrow it will be one week of 5 mg for a few days followed by last few days at 2.5 mg. I don't feel any differently on the 2.5 although it might have less effects on my BP. I have alot of dizziness on most meds due to orthostatic BP effect.
Thank you for validating my meds despite the controversy over SE's, I know them all too well and know enough not to take more than needed.
Too many are using doses that are off the radar. I don't say anything but always think, that can be very dangerous and cause long term effects if not monitored very closely, and lets face it who's doctors are doing that?
Pharmas only tell you about the horrible SE's years later. I just read that the FDA has allowed pharms to submit their followup data after the drug is approved and most pharmas are not doing it, well duh, why would they unless required? They don't want to submit that data, it makes them look BAD and sales will be affected if people know they will get fat or develop diabetes or TD, etc.
Thanks again Honore, I haven't lost it this time!
Stargazer
Posted by stargazer on March 26, 2007, at 23:12:14
In reply to Re: Abilify, posted by TheMeanReds on March 26, 2007, at 12:04:13
See there again, how doyou know what the Abilify was doing on it's own when you took it with Lamictal, Klonopin and Seroquel, another AP. Why would your doc add Abilify to seroquel, that is like adding one SSRI to another SSRI, thus potentiating the serotonin syndrome effect, which is asking for trouble.
There's no way you can tell how abilify would work on its own or with perhaps one other med. Once you get beyond that, you really don't know what med is causing what effects.
And what do you mean by occasional depression? Is that a simple depression, as in not too severe? Why would an AP be used for that when they are usually only used for TRD, unresponsve to AD's, typically used for deprssion?
SG
Posted by TheMeanReds on March 27, 2007, at 11:39:48
In reply to Re: Abilify/TheMeanReds, posted by stargazer on March 26, 2007, at 23:12:14
Well by the time the Abilify was added to my cocktail, yes I was on Lamictal 100/mg, Klonopin 2/mg, and Seroquel 100/mg. I have BPII, and with all of these meds I listed, I was still feeling occational depression, because I suppose that is the way BPII is for me. The cycling thing? My doc said the Abilify may help with the cycling depression. As for the seroquel, I actually have the best sleep, and insomnia I dred.
I dont know wether I was asking for trouble myself, or my doc was asking for trouble with the med mix.
I never took Abilify alone. I was addicted to klonopin, so I couldnt/wouldnt stop taking it because of withdrawls. I really like Lamictal so I didnt want to discontinue that med.
I suppose one could be right that I wouldnt have the slightest clue what I feel on an additional med. But I believe that I could feel the effects of the Abilify.
My depression is on again off again. Sometimes moderate, sometimes very crappy. SSRIs do not treat my depression, so I do not take them.
Sorry if my past post was choppy and did not help in any way. I only thought I'd put my 1/2 a cent in.
Posted by theo on March 27, 2007, at 19:42:23
In reply to Whoa Nellie! I think Abilify can be good with Ems, posted by Honore on March 26, 2007, at 10:55:07
When do you take your Abilify, morning or evening?
Posted by Honore on March 27, 2007, at 21:21:20
In reply to Re: Whoa Nellie! I think Abilify can be good with Ems » Honore, posted by theo on March 27, 2007, at 19:42:23
I take mine in the late morning, although my pdoc said to take it at night. I'm not sure it matters a lot, although I do feel as if I get some energy from it. It has a very long half-life, so I tend to wonder if that isn't just a placebo effect--
I think it depends on how much it's activating, as opposed to stabilizing, for you.
Honore
This is the end of the thread.
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