Posted by SLS on February 9, 2016, at 14:35:03
In reply to Abilify questions again Hoping SLS will respond, posted by Noa on February 9, 2016, at 11:37:58
> Hi, Scott. So I've been on Abilify about a month and a half, and I did start seeing improvement in my ability to do things that had been feeling too overwhelming. It wasn't dramatic...just small difference.
>
> Then I went away to visit family for a week, had a good time. Since coming home, I'm feeling kind of back to where I was...not motivated, overwhelmed by the idea of doing the things that need to get done, etc.> I had been taking 1 mg/day (ie half a pill). I'm thinking maybe I should increase to 2 mg/day (ie a full pill).
I would not hesitate to raise the dosage. It is too low. If adverse effects emerge, at least you will have explored a therapeutic dosage. Most people need at least 2 mg/day of Abilify as an augmenter of antidepressants.
Have you ever tried desipramine? Desipramine is a TCA that helps with energy and motivation, and is sometimes prescribed for ADD.
> I have concerns about possible side effect increases (I've already seen increased appetite and some weight gain, somnolence and/or restlessness). And I'm concerned about the effects on my blood sure and cholesterol/lipids, etc.
My triglycerides have been elevated significantly by Abilify at 10 mg/day. I can't attest to the degree to which this is dosage-dependent. Interestingly, it seems that weight gain is not. You would gain as much weight at 20 mg/day as you would at 2 mg/day. For elevated triglycerides, you could take Lovaza. It's a good excuse to get a healthy dose of fish oil.
> My question is this: if I do find the SEs worsen with the dose increase, and decide to go back to the 1 mg, will the therapeutic effect of abilify be affected (ie, weakened),
I don't think so. I have not seen anyone describe tolerance or dosage escalation. When I have gone to 20 mg/day and then reduced to 10 mg/day, I did not lose the improvement. I reduced the dosage back to 10 mg/day because I felt flat at the higher dosage. 5 mg/day is simply too low for me.
> or is it likely to still be effective proportionately to the dose size?
From what I see in myself, I think it is likely that you will retain the improvements at 1 mg/day if you were to raise the dosage temporarily. However, what exactly would you be giving up therapeutically were this not true? You are not gleaning a substantial improvement right now anyway.
If you experience an increase in restlessness (not true akathisia) upon dosage increase, try to give it 5 days or so for it to lessen or disappear.
There is a new Abilify-type drug due to arrive in pharmacies soon. It is called Vraylar (cariprazine). I am betting that it will be a better antidepressant than Abilify. (Vraylar binds to more dopamine D3 receptors). Initial restlessness and akathisia might still be problems as they are with Abilify, but weight gain may not be. Vraylar is not as much of an antihistamine as is Abililfy. Most antihistamines are weight-gainers. I might try switching to Vraylar when it becomes available. Even if I don't see fireworks, it would be worth it for minimizing weight gain and, perhaps, elevated triglycerides.
- Scott
Some see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1086061
URL: http://www.dr-bob.org/babble/20160131/msgs/1086073.html