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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Christ_empowered on March 7, 2022, at 18:58:22
I'm "in recovery" (which apparently never ends?), in part because of aripriprazole.
A former treatment provider brought up Vraylar. I thought it sounded an awful lot like a cleaned up Haldol, with a high D2 occupancy rate. I decided to stick with Abilify.
Rexulti kind of interests me. Aripiprazole has been good to me, overall...I mean, as good to me as any major tranquilizer could possibly be...but Rexulti seems like it might represent a minor advance over aripiprazole, in terms of tolerability and possibly help with low mood/"negative symptoms," that kind of thing.
Is there a reason to even think about perhaps asking about a trial of Rexulti? I've been doing the DIY Orthomolecular thing for years upon years now, and I do think that it helps -considerably- with reducing adverse effects. Akathisia was never a big problem for me with aripiprazole, but an odd tremor popped up at times (pre-vitamins) that has not been an issue with the vitamins and antioxidants, etc.
"hope springs eternal" or...something like that, anyway. I skimmed over some meta-analysis that would indicate that both aripiprazole and Seroquel can cause depression and also exacerbate low mood states. what fun. :-(
since the low end of things is my major "issue," and since most other "atypical" tranquilizers seem to magically knock me down directly into tranquilized-misery...
I was kind of hoping that maybe someone would have something good to say about Rexulti, perhaps. I'm also a bit curious about Caplyta, but not super-mega-intrigued or anything.
thank you all, as always. :-)
Posted by Lamdage22 on March 8, 2022, at 1:23:06
In reply to D2 partial agonists, posted by Christ_empowered on March 7, 2022, at 18:58:22
You could feel worse for weeks. What are you hoping to achieve with a switch to one of the newer partial agonists?
Posted by SLS on March 8, 2022, at 6:36:09
In reply to Re: D2 partial agonists, posted by Lamdage22 on March 8, 2022, at 1:23:06
I thought cariprazine (Vraylar) had a higher ratio of D3/D2 occupancy than aripiprazole (Abilify).
I found this:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5035321/
And this PDF:
- Scott
Posted by Jay2112 on March 8, 2022, at 13:47:11
In reply to D2 partial agonists, posted by Christ_empowered on March 7, 2022, at 18:58:22
Hi C_e:
Myself, I would stick with what works. It seems, even the most minute change(S) can possibly REALLY muck things up. (IMHO) I remember reading a story where a person had actually found combining small amounts of Haldol with one of the new D2 partial agaonists was the only thing that worked for him. He decided to drop the Haldol, and everything went south.
Not sure if this is very helpful, but the 'temptation' to even bring a minor improvement is always there. I completely understand. But, your use of vitamins should be able to bring the extra change you need...I mean, you are probably just looking for a 'minor tweak', no? Have you thought about adding herbal remedies? There are A LOT out there besides the 'traditional' ones.
Best,
Jay
Posted by undopaminergic on March 8, 2022, at 14:21:10
In reply to D2 partial agonists, posted by Christ_empowered on March 7, 2022, at 18:58:22
I've used both aripiprazole (Abilify) and cariprazine (Reagila; also known under the dumb name Vraylar), and if I had to choose I'd rather take cariprazine. At a low dose of course. I'm judging by the effect on depression and negative symptoms of schizophrenia.
-undopaminergic
Posted by Christ_empowered on March 8, 2022, at 23:40:59
In reply to Re: D2 partial agonists » Christ_empowered, posted by Jay2112 on March 8, 2022, at 13:47:11
hi. thanks for the replies.
I think my itch to tinker with "the line up" (just aripiprazole and lamictal, very low dose as needed gabapentin...-very exciting-...) has to do with the constant, and I do mean constant, change of (prescribing) treatment providers at the clinic.thankfully, I've been "in recovery" (not to whine, but "recovery" seems to be endless and poorly defined...and yet, I am thankful to -not- be state hospital material...) for a while now, I have an excellent support system, and my overall health and psychosocial factors are good, so...
blah blah blah. new psych prescriber, more questions about "have you considered...???," on and on and on. what bothers me, now more than in years past...
if it wasn't for my support system and such, I'd be on something closer to the standard issue combos coming out of the clinic, which seem to be: sedating "atypical" + sedating "mood stabilizer," usually combined with some flavor SSRI, often with varying amounts of hydroxyzine in the mix.
not to ramble and whine, but...wow. just...wow. I came in on aripiprazole. Apparently, the clinic does use aripiprazole...
mostly in the form of the (very much on patent) depot/long acting injection. which raises the obvious question: what is with the power trips and general cruelty of the mental health industry?
I am thankful to be healthy and able to get my abilify, etc. and just...try to get on with life, as best I can. -not the issue-
the issue? mental health, inc. I've had the same counselor for a long, long, long time now, and...
apparently, that's not how the clinic usually does things. At best -- the most humane treatment usually provided, it seems -- I'd do med checks and talk to a nurse a couple of times, yearly...no counseling. thing is...
I'm not doing any "in depth" counseling, just breezing in for 30-45 minute sessions, maybe every 6-8 weeks. the med checks seem to be fairly infrequent, maybe every 3 months or so (the prescriber decides), so...
what gives? not to ramble and whine, but I get the sense that I'm actually somewhat resented, at the clinic and wherever the clinic's reach extends (long story...), for getting "special treatment."
ugh. I wanted to just go to a family doctor and get meds, but the family doctor/primary care physician said I needed to go to a "psych specialist," because...???
and then I have to dread going to the clinic, hearing from the clinic, and sometimes I even dread picking up the prescriptions...because the pharmacy techs hate having to deal with "mental patients," too, even ones who just roll up when the refill reminder comes thru on text and pay the copay and drive away.
ok. maybe I'm being whiney? or...not? does it matter, anyway?
I'll just stick with aripiprazole and lamictal. the vitamin mix -does- seem helpful, more now than in years past. The Orthomolecular experts write about the increased probability a true, meaningful recovery -- in the sense of a law abiding, meaningful, more or less normal life in society. and...
-sigh- here and there, Hoffer touches on what I'm experiencing -now- , which is...how society, itself, seems to be rather spiteful towards those who were sick (did I mention being state hospital material? yeah...) and then gradually become well enough to be normal(ish)...
and how often, the psych industry, too, contributes to the creation and eventual destruction of "mental patients."
ugh. thanks again for the replies. :-)
Posted by Jay2112 on March 9, 2022, at 23:35:34
In reply to Re: D2 partial agonists, posted by Christ_empowered on March 8, 2022, at 23:40:59
I've got a friend who just had his first pdoc appointment today. It was over the phone, and I was listening (he wanted me to). My friend was in tears over the horrid anxiety and panic attacks he dealt with constantly, 24 hrs a day. After an hour, the pdoc basically said "Well..ok...if you need me give me a ring sometime.". I was like..WTF?? She would not even script him and SRI, and had absolutely NO reason not to! He wasn't "drug seeking"...anything like that..nadda!
Good pdocs should prescribe not just for medicine, but for compassion, to alleviate suffering! So, ya, I hear you about the f'ed up mental health system!
Ugghh..
Jay
This is the end of the thread.
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