Posted by LlurpsieNoodle on July 29, 2007, at 7:16:30
In reply to Re: startup of abilify + zoloft OR geodon withdraw, posted by Keith Talent on July 29, 2007, at 3:28:32
> Don't know your diagnos(i/e)s
Being treated for bipolar symptoms (mood swings like CRAZY) and also psychotic perceptual and memory disturbances related to the trauma part of PTSD. Also meet Dx criteria for major depression at the moment, probably since April
>but I would gradually stop all except the Abilify. Take just 2.5 mg in the morning for 8 weeks, then evaluate. If it provided no benefit, stop it; if some benefit, add an antidepressant or lamotrigine. If you go the Zoloft route, it might be best to take it twice daily, as the short half-life can result in withdrawal side effects.
Since I was in suicidal crisis last week, I think pdoc (T agrees) wants to treat me with some new meds to try to get me out of the suicidal depression. It's a dangerous illness :( Also, since I was on SUCH a high dose of Geodon for the last 4 months, I'm not sure that I would respond too well to a small dose of abilify. pdoc told me that 5 mg is a fairly small dose. I'm going to need some neuroleptics to control the psychotic stuff :( I accept that. begrudgingly.
Also, I don't really feel that I have the luxury of trying an extended trial of one drug. This is the long-term goal, of course, to get me off of all meds, but not really the time or the place. Given that I was recommended by T and pdoc to go to hospital last week but decided to stick it out and wait until my next office visits.
>Also Zoloft needs to be taken at 100-200 mg/day by most patients (although you might be lucky enough that 50 mg/day does the trick). Again, take it for a full 8 weeks once you've reached a dose that your psychiatrist believes will be effective. Making only one medication change at a time can be SO important.
I think the idea is to work with a really small dose of Zoloft, maximum 50mg. Something gentle to my system, since so many things are changing all at once. I totally agree with you. I *wish* I were in the situation to make only one change at a time.
I believe that there is empirical evidence (at least my old pdoc told me) that as far as neuroleptics are concerned, it's best to keep neuroleptic 1 at the the therapeutic dose while tapering up to neuroleptic 2, and then gradually decrease neuroleptic 1. The idea is to get the patient (me) stabilized and prevent some kind of psychosis. This approach worked really well when I switched from seroquel to geodon.
Sorry that I seem to disagree with your suggestions. In a perfect world, I totally agree with you. Very sensible, but this is kind of a touch-and-go thing.So far though, I feel okay. I even got 8 hours of sleep last night with no toss and turn. ((((sleep))))
best to you K.T.
-Ll
poster:LlurpsieNoodle
thread:772561
URL: http://www.dr-bob.org/babble/20070719/msgs/772672.html