Posted by ed_uk2010 on August 18, 2018, at 19:08:06
In reply to Re: POT and Abilify » ed_uk2010, posted by Prefect on August 17, 2018, at 20:40:13
Hi Prefect,
>Oh yes, I'm taking Trintellix at highest available dosage and it's not doing anything, in fact I think it's making me worse.
In that case, I would definitely discuss stopping vortioxetine with your doctor. There really isn't any justification for trying to augment a drug which is potentially making you feel even worse.
>But do non-schizophrenic people take abilify on its own?
Yes, sometimes, especially in bipolar disorder. In depression, Abilify is only officially approved as an add on to conventional antidepressants, but I wouldn't personally worry about this. For a start, it doesn't sound clear that 'major depression' is necessarily even an accurate diagnosis for you. Although depressive illness is exceptionally heterogeneous, your symptoms do sound particularly atypical. From what you described, you seem to be suffering from a complex neuropsychiatric illness of initial medical/organic origin characterised by frequent dissociative symptoms and some form of sensory processing disorder. Problems with sensory processing normally begin in childhood rather than after an infection, which makes your situation slightly unusual. Sensory processing issues are particularly common in children on the autistic spectrum, for example, and also in a subset of children with ADHD. In adults, extreme sensitivity to sensory stimulation can be seen due to withdrawal from benzodiazepines or alcohol - symptoms improve after a few weeks of abstinence.
1. When did you last try fluvoxamine on its own? It is possible that you may respond to it again after the treatment break. If your doctor prescribes it, I would suggest allowing vortioxetine to completely clear from your system first, to reduce the potential for adverse effects. Sigma-1 agonism is theorised to improve cognitive functions, so you could be right that this is what helped, rather than the SSRI effect. Alternatively, it might not have been anything to do with sigma receptors. Unfortunately, it is not really possible to know. It is still possible than a different SSRI could be beneficial even though sertraline didn't help. Escitalopram often helps anxiety so you could consider that.
2. With respect to aripiprazole, I think it would be worth trying it on its own to find out whether or not it helps. The feeling of sensory overload might potentially be reduced by an antipsychotic.
3. It is possible to take fluvoxamine (Luvox) and aripiprazole together - with caution. Fluvoxamine is a moderate CYP 3A4 inhibitor and may increase aripiprazole levels to some extent, so it would be wise to be cautious with the aripiprazole dosage. In rats, the combination causes elevation of liver enzymes. In humans, liver problems are rare with aripiprazole.
poster:ed_uk2010
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URL: http://www.dr-bob.org/babble/20180728/msgs/1100438.html