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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by Jeroen on February 21, 2009, at 12:06:23
how do i know i am gonna get better with INVEGA???
i only respond to Seroquel and thats pooped out!!!!!!??????????????????????????
Posted by JadeKelly on February 21, 2009, at 23:04:59
In reply to how do i know i am gonna get better with INVEGA???, posted by Jeroen on February 21, 2009, at 12:06:23
> how do i know i am gonna get better with INVEGA???
>
>
> i only respond to Seroquel and thats pooped out!!!!!!??????????????????????????Jeroen, I didn't know you took Seroquel! It was a wonder drug for my son! Could you tell me how much you pooped out at (mg per day) and for how long you took it? Months? weeks?
Did you get any antidepressant or stabilizing effect from it? Thats important because we would hope this Invega has some of the same properties!
If it does, will you give a good chance to work?Anyway, if you'll post me right back with that info, I'll go right now and find the similarities between Invega and Seroquel.
DEAL????? Jade ;-)
Posted by Zyprexa on February 22, 2009, at 3:09:42
In reply to how do i know i am gonna get better with INVEGA???, posted by Jeroen on February 21, 2009, at 12:06:23
If seroquel poops out take a higher dose!? This could also be a bad sign from the abilify.
Posted by Jeroen on February 22, 2009, at 5:25:56
In reply to Re: how do i know i am gonna get better with INVEGA???, posted by Zyprexa on February 22, 2009, at 3:09:42
i took 100 mg in the evening for 3 months, i got amazing anti depressant from it, psychosis entirely gone, no paranoia, concentration was very good, socializing was also very good
like a miracle it was but it only happened once, glad it happened once and not never : )
Posted by SLS on February 22, 2009, at 7:21:36
In reply to Re: how do i know i am gonna get better with INVEGA???, posted by Zyprexa on February 22, 2009, at 3:09:42
> If seroquel poops out take a higher dose!? This could also be a bad sign from the abilify.
How so?
You know, I was at a clinic where just about every person with schizophrenia was on Abilify plus another neuroleptic, usually Seroquel.
Are you talking your own theoretics, or is there some evidence you would like to present?
- Scott
Posted by SLS on February 22, 2009, at 7:43:58
In reply to Re: how do i know i am gonna get better with INVEGA??? » Zyprexa, posted by SLS on February 22, 2009, at 7:21:36
Hi.
You are partially right about Abilify (aripiprazole), it seems. I am looking hard for evidence of aripiprazole causing a poop-out of quetiapine, but I haven't found anything yet.
What I did find was a nice piece written by Stephen Stahl that reveals that aripiprazole can produce psychosis in vulnerable individuals. He also has reversed his stance on the utility of aripiprazole as an antipsychotic. He now feels that a D2 partial agonist tends to be only partially effective in schizophrenia compared to pure antagonists or even inverse agonists. However, he does recommend combining aripiprazole with other antipsychotics for a variety of reasons.
I now feel that your reservations regarding Abilify are valid, especially if used as monotherapy. Still, if I were in Jeroen's position, I would not hesitate a single day to raise the Abilify to 20mg without adding any other drugs. I have witnessed it help many people with schizophrenia whom had not reacted in a stable fashion to any other antipsychotic. I cannot reconcile this with Stephen Stahl's current beliefs.
- Scott
Posted by SLS on February 22, 2009, at 7:45:08
In reply to Re: how do i know i am gonna get better with INVEGA??? » SLS, posted by SLS on February 22, 2009, at 7:43:58
Posted by Phillipa on February 22, 2009, at 10:31:54
In reply to Re: how do i know i am gonna get better with INVEGA??? » SLS, posted by SLS on February 22, 2009, at 7:43:58
Jeroen could you let your doc in the hospital know about the study? Love Phillipa
Posted by JadeKelly on February 22, 2009, at 17:08:50
In reply to to JadeKelly, posted by Jeroen on February 22, 2009, at 5:25:56
> i took 100 mg in the evening for 3 months, i got amazing anti depressant from it, psychosis entirely gone, no paranoia, concentration was very good, socializing was also very good
>
> like a miracle it was but it only happened once, glad it happened once and not never : )
Jeroen,100mg Seroquel is NOTHING! Why can't you go up in dose at least to where my son is? 300mg? He takes 100mg in morn, and 200mg at night.
HE noticed antidepressive effects before we knew it had any! They said minimum 300mg. Why aren't they just increasing that?!
~Jade (be patient w/me, I don't know your history)
Posted by Zyprexa on February 23, 2009, at 15:23:23
In reply to Re: how do i know i am gonna get better with INVEGA??? » Zyprexa, posted by SLS on February 22, 2009, at 7:21:36
I'm talking my own theorys. What happened is I took the abilify with the zyprexa and the zyprexa stoped working eventualy. When I went off the abilify the zyprexa started working again, in time.
I wonder if the same could be happening to Jeroen?
Posted by Zyprexa on February 23, 2009, at 15:26:45
In reply to Re: how do i know i am gonna get better with INVEGA??? » SLS, posted by SLS on February 22, 2009, at 7:43:58
You say you have not found anything stating seroquel with abilify. But how about zyprexa with abilfiy?
Posted by SLS on February 23, 2009, at 15:52:23
In reply to Re: how do i know i am gonna get better with INVEGA??? » SLS, posted by Zyprexa on February 23, 2009, at 15:26:45
> You say you have not found anything stating seroquel with abilify. But how about zyprexa with abilfiy?
I take you at your word. I'll try to keep an open mind because your theory might be accurate. It is possible that Abilify occupies too many D2 receptors in the agonist state to be helpful for psychosis. I'll take a look at the binding affinities to get a better idea.
- Scott
Posted by Zyprexa on February 23, 2009, at 15:54:40
In reply to Re: how do i know i am gonna get better with INVEGA??? » Zyprexa, posted by SLS on February 23, 2009, at 15:52:23
Posted by SLS on February 23, 2009, at 16:10:45
In reply to Re: how do i know i am gonna get better with INVEGA??? » Zyprexa, posted by SLS on February 23, 2009, at 15:52:23
> > You say you have not found anything stating seroquel with abilify. But how about zyprexa with abilfiy?
>
> I take you at your word. I'll try to keep an open mind because your theory might be accurate. It is possible that Abilify occupies too many D2 receptors in the agonist state to be helpful for psychosis. I'll take a look at the binding affinities to get a better idea.I think you might be right.
Dissociation constants are roughly as follows:
Abilify 0.75
Zyprexa 10.00
Seroquel 500.00The smaller the number, the more potently the drug attaches to the receptor. Abilify binds tighter by far than does Seroquel. As you suggest, taking Abilify might produce a requirement that far more Seroquel is needed to antagonize enough receptors to have an antipsychotic effect. A friend of mine was taking Abilify 30mg, and needed 800mg of Seroquel to prevent a psychotic breakthrough. I don't speak to her anymore, but it would have been interesting to see what would happen were she to discontinue the Abilify.
In answer to your question, I think it is very possible that Abilify is interfering with Jeroen's Seroquel treatment. We really do lack hard evidence, though. However, it might be something Jeroen can ask his doctor about.
You might have hit the nail on the head.
- Scott
Posted by Jeroen on February 23, 2009, at 16:21:23
In reply to Re: how do i know i am gonna get better with INVEGA??? » SLS, posted by SLS on February 23, 2009, at 16:10:45
when i quit to test i could go on with seroquel alone like before by quiting abilify, the psychosis came back immediatelly even when taking seroquel
so it might be correct info
Posted by SLS on February 23, 2009, at 16:30:56
In reply to an answer, posted by Jeroen on February 23, 2009, at 16:21:23
> when i quit to test i could go on with seroquel alone like before by quiting abilify, the psychosis came back immediatelly even when taking seroquel
>
> so it might be correct info
I don't understand.Does Abilify help improve your psychosis?
If so:
1. Increase Abilify to 20-30mg.
2. If no further improvement, add Seroquel up to 800mg.
3. If improved, don't do anything.
4. If improvement remains stable for 6 months, try to reduce Abilify back to 20mg if you had been at 30mg.
- Scott
Posted by Jeroen on February 23, 2009, at 17:00:12
In reply to Which answer is right for you? I'm not sure. » Jeroen, posted by SLS on February 23, 2009, at 16:30:56
abilify helps improve my psychosis yes
im trying invega for now if that doesnt help i stick to seroquel high dose and i will up my abilify dosage too
Posted by SLS on February 23, 2009, at 17:55:09
In reply to Re: Which answer is right for you? I'm not sure., posted by Jeroen on February 23, 2009, at 17:00:12
> abilify helps improve my psychosis yes
>
> im trying invega for now if that doesnt help i stick to seroquel high dose and i will up my abilify dosage too
I like your plan. I think it will work.
- Scott
Posted by Zyprexa on February 24, 2009, at 12:00:02
In reply to Re: how do i know i am gonna get better with INVEGA??? » SLS, posted by SLS on February 23, 2009, at 16:10:45
Glad to know that I'm not compleatly crazy!
Posted by Zyprexa on February 24, 2009, at 12:07:40
In reply to an answer, posted by Jeroen on February 23, 2009, at 16:21:23
Thats what happened to me. When I quit the abilify it took 1.5-2 years for the zyprexa to compleatly work like before. I only had taken the abilify for about 6 months. I've noticed the same thing each time I did this. It would take aproximatly 3-4 times as long as I was on the abilify to come down off it. No reducing just stop the abilify and start the zyprexa right away again. This last time I required a titeration down on zyprexa. Starting with much higher doses of zyprexa imediatly after the abilify, and slowly cutting down on zyprexa as it workes better.
This is the end of the thread.
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