Posted by Ritch on May 20, 2003, at 11:33:14
In reply to Re: abilify/trileptal/zoloft » Ritch, posted by e503 on May 20, 2003, at 9:42:21
> > > > > > > I weaned Ben off of trileptal, which he had been on since february. I realized now that was activated by it, as now he is actually VERY sedate. TOO sedate. So, my question is this: he is taking abilify 10 mg./day - split into an a.m. and p.m. dose (he seems to need this). He has been taking zoloft and buspar for a long time also. About a year or more ago he had a very rough time, and I forget who it was (ritch, maybe???) who helped me figure out what was up. It turned out we had been giving ben his zoloft (75 mg/day) at bedtiime. During the day he was wild. As soon as we switched it to a daytime dose, it calmed him down. SOOOO, now he is taking the abilify, zoloft and buspar in the a.m. and he seems somewhat sedate, not his usual somewhat "perky" (hypomanic?) self. I am wondering if abilify and zoloft interact somehow to cause this sedatedness? Maybe I should try giving him all the zoloft in the p.m.? Ben is autistic and cannot tell me how he feels, although I can tell my looking at him that he is just not "right". Does anyone take this combination?
> > > > > > > thanks,
> > > > > > > elise
> > > > > > > Thanks for all responses.
> > > > > >
> > > > > >
> > > > > > Trileptal had an stabiizing/energizing quality to it that I liked-the damn stuff just made me uncontrollably nauseous! Maybe he just needed a *lower* dose of Trileptal instead?
> > > > > >
> > > > >
> > > > > last night when i just gave him 150 mg. he got agitated and more obsessed!
> > > >
> > > > Did you give him his 10mg Abilify dose at the same time you tried the Trileptal? If so, it could have been the Abilify-or some other med. Just a quick question: Is his doctor allowing you fairly wide latitude on fine-tuning his meds (since he is autistic-and doesn't communicate well how he is feeling)? I guess I am just wondering how you have that all worked out. Some docs are more uptight than others about this thing. My pdoc is very patient and gives me fairly wide latitude. Just wondering.
> > >
> > > Ben has been real agitated since beginning of february when we had to switch from tegretol (low wbc)to trileptal. I thought it may have been just getting used to the meds....but it continued until we started the abilify.....everything just makes too much sense to think it is anything other than trileptal. I have been working with my pdoc for a long time (maybe 5 years?). I do call him and tell him when I see problems. Ben is typically a very fun loving (he is verbal) child- class clown....loves I love lucy, three stooges, etc. When I see him looking "out of it" and/or he gets aggressive/ocd I know something is not right. Too bad he was doing ok on the tegretol for a long time.
> > > I spoke to the pdoc after I spoke to his teacher this afternoon (she said he was very lethargic)and he told me to stop the trileptal and cut the abilify to 7.5 (5 during the day and 2.5 p.m.). I hope this helps and I get my kid back.
> > > elise
> >
> > Oh, thanks, that makes things a lot clearer to me. There *are* differences between Tegretol and Trileptal. It may be that it is hyped a little too much as being a perfect(safer) Tegretol replacement, when that may not be the case for everybody (efficaciousness-wise). I tried Tegretol a long, long time ago (as a lithium switch) and it didn't seem to help me, but I was in the middle of a bigtime depression and didn't have the time to burn to figure out why I was feeling worse (or to have the patience for the Tegretol to "kickin"). Interesting that his pdoc wants to cut the Abilify down-I wonder what his reasoning there is?? did he say..
>
> The pdoc wants to cut the abilify down because ben is a zombie. Yesterday was not great either, as ben was acting like I have never seen before. He was very obsessive (goal driven???) but not as agitated, it was almost as if his brain was manic, but he wasn't. It's hard to explain. I am thinking that maybe the abilify IS at too high a dose---and maybe it is causinig this? So.....I decreased it even more (2.5 mg. 2 x a day instead of 5 mg. 2 a day) to see what happens. I know abilify has a long half life, when do you th ink I might see any difference at the lower level? Do you think the abilify is causing this "driveness"? Is this mania?
> thanks,
> elise
It is good that "physically" he isn't agitated and restless, and he is "quiet"-so it doesn't "sound" like mania. I've rarely experienced racing thoughts without also being physically agitated as well. You're picking up on something though.. maybe he is over-focused on one particular thing.. possibly over-sedated on the Abilify as well. It does have a long half-life. It may take a week or longer for the drug's level to reach a steady state. That's one thing I don't like about meds with lengthy half-lives like that--you don't see the response of a dose change for a long time-- and the longer the time goes by the easier it is to confuse with "typical" mood-cycling patterns.
poster:Ritch
thread:227600
URL: http://www.dr-bob.org/babble/20030520/msgs/227878.html