Posted by med_empowered on August 16, 2005, at 18:25:57
In reply to Could Abilify work as when being ON and OFF meds?, posted by tepiaca on August 16, 2005, at 12:04:10
hey! I imagine going on-and-off abilify could be helpful...zyprexa is being used a good bit "as-needed" for those with bipolar disorder, some people with anxiety and/or depression, and those with Borderline Personality Disorder. In borderline in particular, antipsychotics (Zyprexa and Abilify among them) are sometimes used strictly as-needed to calm down uncontrollable emotions and help with "dysphoric episodes". As for how exactly Abiify works its antagonist/agonist magic...I've read a couple possible explanations, but none of them are considered the "true" reason (like most other psychiatric drugs, the exact mechanisms of abilify remain unknown). One is that Abilify regulates dopamine differently dependning on the *region* of the brain. So, in the frontal lobes it can boost dopamine (potentially alleviating depression and "negative symptoms") and in other parts of the brain it can damped dopamine (presumably leading to a calming action and control of "positive symptoms"). The other I've heard is that because of the serotonin anatagonist/agonist action AND the similar action at dopamine, Abilify is able to maintain a steady rate of serotonin/dopamine...since blocking serotonin can boost dopamine, it can do that as well as then dampening or slightly boosting dopamine, and vice versa. Anyway, the levels of dopamine+serotonin antagonsim/agonism seem, from my experience, to be very depenedant upon dosage. At sub-therapeutic (under 10mgs) dosages, Abilify seemed to me to do a good bit of mild serotonin blockage (reduced anxiety, kind of like Buspar,only more effective and faster-acting) and a pleasant amount of dopamine agonism (increased alertness and energy, more happiness overall). At 10mgs, it seemed ideal for more severe disorders (I had a very severe depressive episode ath time);antidepressant action, with more pronounced dopamine action (definite mood-stabilizing qualities, with a little bit of apathy). At 15mgs, Abilify was much more like the other atypicals on the market I've taken; less antidepressant action, more flatness. Above 15mgs, it wasn't a good medication *at all,* though I imagine it would compare well to higher-end doses of Zyprexa or Risperdal. The great EPS profile of Abilify I think will hold true mostly for low-end doses; at a certain point, I doubt it will be much more tolerable than other atypicals or low-dose conventional antipsychotics. As for starting/suspending...since it is an antipsychotic, your brain would theoretically adapt to it after a couple weeks, then return more or less to baseline functioning with regards to serotonin and dopamine after a washout period. But...since it does agonism and antagonsim, it seems like Abilify would work *with* your brain chemistry rather than doing the kind of one-size-fits-all modifications with most other psychiatric drugs...but some people have reported a kind of tolerance to Abilify, so stopping-and-restarting might work...then again, with some antidepressants it seems that starting-and-stopping will make the med *less* effective, so who knows.
poster:med_empowered
thread:542443
URL: http://www.dr-bob.org/babble/20050816/msgs/542612.html