Posted by med_empowered on August 18, 2005, at 18:32:32
In reply to Re: Could Abilify work as when being ON and OFF me » med_empowered, posted by tepiaca on August 18, 2005, at 8:44:10
hey! Early on, I did notice a little bit of drug-induced apathy or...something on Abilify. Its hard to describe...I felt somehow less spontaneous and less connected both to my inner self and the outside world...it felt like things were filtered a bit, like through a windshield. But...when I started the really low doses, I couldnt even walk down the street without going into panic mode, so getting rid of that was a *big* improvement...plus, it seemed to help boost my mood a bit, so that was nice. At 15mgs I lost some of the antidepressant effects and the "glassy" feeling intensified a bit; I thought at the time that it might just be antidepressant poop out, but I later came to think that the dosage increase was creating a sort of "neuroleptic induced dysphoria". Anyway, I have a kind of odd variant of bipolar, which has also been diagnosed as mood disorder nos w/ anxiety nos and psychotic disorder nos (notice all the "not otherwise specifieds"? You'd think I'd fit in *some* diagnosis in the DSM). My shrink at the time wanted to go above 15mgs to take care of the mixed episodes and occasional paranoia (not fully psychotic, but definitely *NOT FUN*) *and* get rid of the anxiety, which she said had to have some sort of psychotic component because of its severity. Anyway, "the road to hell is paved with good intentions," as they say...when I hit the 20-30mg mark, I was flattened out, apathetic, and shaking (my doc considered it a pre-exisiting "essential tremor" and RX'd propranolol and upped my benzo). I stopped taking it, had weird withdrawal-emergent muscle jerks and shakes and what not, but nothing permanent. If you have depression, I'd recommend *only* very low dose abilify for a *limited* amount of time--2-4 weeks, then taper. The new meds are better than, say, Haldol, but tardive dyskinesia, EPS, etc. are still a definite problem. For mania/mixed-episodes, I'd say low-dose it till the episode is over, then taper. But infrequent, low-dose, as needed use seems like it could help. When I took 5mgs or so, my depression lifted in less than a week; it wasn't until I hit 10mgs+ that problems started to pop up. Abilify seems to make some people anxious...I did develop a sort of akathisia/"neuroleptic-induced dysphoria" after a while, but it seems that lots of people get "start up anxiety," which I did not. I don't know what the effects of PRN dosing would be on neuroleptic side-effects...my wild guess would be that if you keep it at a low-dose, especially with abilify, and take the med relatively infrequently, you'd get a boost w/ little, if any, risk of EPS. I read a study once where they found that with Abilify the big jump in EPS came when people were moved from 10 to 15mgs in treatment for social phobia...I suppose at that point the D2 blockade got a little out of hand. If EPS has been a problem for you, but you still think you need to use an atypical for an as-needed "boost," I bet you could get your doc to RX some Cogentin or propranolol...you could also take some Benadryl or a benzo. But...I'm prone to EPS at low doses (100mgs seroquel, 2.5mgs zyprexa), so I've opted to avoid all neuroleptics.
poster:med_empowered
thread:542443
URL: http://www.dr-bob.org/babble/20050816/msgs/543605.html