Posted by Christ_empowered on December 27, 2013, at 3:43:05
I used to mostly get psychotic depression, with fits of agitation (teen years). Then, in my early 20s, I went batsh!t, and now I apparently have bipolar I w/some psychotic features (still mostly psychotic depression).
I don't like AD drugs :-( . The more sedating ones are nice when I'm agitated, but they prove too tranquilizing over the long haul, especially since I'm on a high dose (20-30mgs/day) Abilify.
Prozac has been good to me. More stimulating/less sedating. The start up was a little rough...I felt like I'd taken a low dose of Ritalin or something. My OCD-ish "issues" have been reduced considerably. I'm not looking to be the picture of mental health or anything; I just want to function reasonably well.
My shrink seems to think that I should taper the Prozac ASAP, or at least as soon as I can get my act together...which leads to the Q: what to do about future depressive episodes (both prevention and treatment), especially since I have a history of psychotic depression?
I was thinking to eventually drop the Prozac and ask for Lamictal on top of everything else (Abilify 30, Neurontin 300, Trileptal 1200), but that rash of death really scares me.
Seroquel/Seroquel XR seems logical, since it can help reduce agitation, anxiety, and depression as monotherapy. Problem is...my depression makes me T-I-R-E-D and, just at an intuitive level, something tells me good ole quetiapine might be an absolute disaster. Also, I'm looking to keep my neuroleptic exposure as minimal as possible, so its either Abilify OR Seroquel, ideally not both. Since I'm so prone to depression, too much AP makes me sad :-( probably true of a lot of people, now that I think about it.
Is there some kind of Abilify-to-Seroquel XR conversion formula? Which do you think has a lower long-term EPS risk? My shrink said she's never seen TD from *just* Abilify, but she also said she usually prescribes Zyprexa or Seroquel. I've read elsewhere that Abilify may actually have a higher-than-usual rate of TD (for an "atypical"), especially considering the relatively low rate of early onset EPS. That's perfectly terrifying, honestly.
Ugh. I don't know what to do. My dream combo would keep psychosis and agitation at bay while controlling anxiety and preventing a relapse into depression. Any ideas?
poster:Christ_empowered
thread:1057026
URL: http://www.dr-bob.org/babble/20131209/msgs/1057026.html