Posted by Christ_empowered on October 20, 2012, at 18:48:43
In reply to Re: Depression supplements Updated, posted by Lao Tzu on October 17, 2012, at 10:30:24
Hey man. Sorry it took a bit for me to answer. I don't check this board all that often.
I'm on Abilify primarily because its the only AAP I can tolerate at full dose for any extended period of time. Back in the early days of my psychotic+mood+anxiety "thing," even Abilify gave me a mild tremor. With the whole Orthomolecular line up on board and w/ a lot of psychosocial issues resolved (fewer issues=fewer meds), I tolerate a full 30mgs/day (biggest tablet they make) fairly well. I also take (or am supposed to take...) 900mgs/Neurontin, which I think is a fairly standard (perhaps low?) dose for anxiety+agitation+"crazy."
Anyway, my former shrink explained it to me like this, and experience has proven her correct, at least for me. Lower doses=more stimulating, which could be good or bad. The usual minimum for psychosis is 10mgs/day. The "target" is 15. That's what they used to start everybody on, for pretty much everything.
Above 10-15, it's apparently more "soothing." I personally found that, as long as I can tolerate 20-30, I get more cognitive benefits. I have no idea what that's about. That may not be the case for you.
Everybody's always talking about akathisia with Abilify. Honestly, the other AAPs--particularly Risperdal and Zyprexa--were worse in this regard for me than Abilify. I don't require benzos or propranolol with Abilify to control akathisia, eps, etc. Actually, I think I have some weird dopamine "thing" going on, because full dose AAPs (besides Abilify) make me a bit *more* anxious. Sounds strange, until you realize that sufficiently high doses of D2 blockers induce varying degrees of Parkinson's, and Parkinsons is often accompanied and/or preceded by anxiety.
The whole anti-depressant thing has, in my opinion, been blown out of proportion. I either get some kind of schizophrenic depression (if you believe that diagnosis), or psychotic depression. Either way, because I'm so prone to depression, other AAPs aren't that great for me. I'll mellow out short term, get really sad more long term. Abilify @ 30 at least doesn't make depression worse and doesn't seem to induce any depressive episodes, although I've heard that some people get really dysphoric on Abilify (probably true of any AP or AAP).
I wouldn't do antipsychotic polypharmacy, personally. If, for whatever reason, I was on risperdal or some other D2 blocker and wanted to switch, I'd just switch over from drug A to Abilify, and just start the Abilify at a higher-than-normal dose, to prevent over-activation. After a while, you could reduce it. Or, your doc could do a more conservative, gradual switch, maybe with some kind of sedative (neurontin, lyrica, vistaril, a benzo...something) on board to smooth things over during the transition phase. A lot of people take benzos for 1-2 weeks when starting Abilify, anyway.
Hope this helps.
poster:Christ_empowered
thread:1028356
URL: http://www.dr-bob.org/babble/alter/20120530/msgs/1029268.html