Hi Noa.
It's nice to see you again.
Abilify can indeed produce metabolic changes. Weight-gain can be latent and insidious. It doesn't happen right away, and then sneaks up on you little by little. I take Abilify 10 mg/day. It helps with motivation. Abilify is a unique drug, though, and might be worth a try. If you don't like what you see, you can stop taking it. Weight gain is just as likely at 2.0 mg/day as it is at 20.0 mg/day.
I like Pristiq better than Effexor. Pristiq (desvenlafaxine) is the major active metabolite of Effexor. You can get a robust therapeutic effect at a much reduced dosage. You might be able to push the drug to 100 mg/day or higher without suffering cognitive side effects. 100 mg/day is very often the optimal dose.
Have you tried adding Wellbutrin or nortriptyline to Effexor? A friend of mine is doing very well with a combination of Pristiq 100 mg/day and Wellbutrin. She failed to respond to quite a few drugs, including Parnate.
You could try adding Lamictal 200 mg/day. It can help with both mental energy and motivation. Abilify and Lamictal seem to work well together.
If you decide not to go with Abilify immediately, the following plan might make some sense as an alternative:
1. Switch from Effexor to Pristiq
2. Add Wellbutrin
3. Add Lamictal
4. Switch from Wellbutrin to nortriptyline
5. Add Abilify
6. Smile and be happy
Like I said, if you opt to go with Abilify now, you can always stop taking it if you don't like what you see. Just know that some people experience significant anxiety as a withdrawal effect. I couldn't guess as to how often this occurs.
Take care of yourself.
- Scott
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