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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Bob on July 12, 2010, at 16:30:09
I'm always seeing advertisements for Otsuka and Bristol-Myers Squibb's Abilify indicating it as an augmentation to the popular SSRI/SNRI antidepressants. Why don't I see similar indications for Janssen's Risperdal? Has Abilify proven more effective as an adjunct in this regard than Risperdal? Is one of them easier to tolerate than the other?
-Bob
Posted by Phillipa on July 12, 2010, at 16:56:02
In reply to AD augmentation with AAPs, posted by Bob on July 12, 2010, at 16:30:09
I feel from a lot of the post on here that people are indeed using low doses of abilify for depression. Phillipa
Posted by Emily Elizabeth on July 13, 2010, at 23:02:40
In reply to Re: AD augmentation with AAPs » Bob, posted by Phillipa on July 12, 2010, at 16:56:02
My sense is that Abilify invested the $$ to get approval to advertise as an adjunct for SSRI and SNRI's. Actually, according to my pdoc abilify can be taken w/o an SSRI or SNRI and still have AD properties.
BTW, Abilify has been my miracle drug for severe depression.
Best,
EE
Posted by Bob on July 14, 2010, at 0:05:04
In reply to Re: AD augmentation with AAPs, posted by Emily Elizabeth on July 13, 2010, at 23:02:40
> My sense is that Abilify invested the $$ to get approval to advertise as an adjunct for SSRI and SNRI's. Actually, according to my pdoc abilify can be taken w/o an SSRI or SNRI and still have AD properties.
>
> BTW, Abilify has been my miracle drug for severe depression.
>
> Best,
> EE
Emily,I'm glad that Abilify has worked so well for you. My pdoc has mentioned that it has worked very well for some. He has also said that about Zyprexa too. It has shown some great promise at times for me, but alas proves too hard to tolerate in the end. It creates anxiety and restlessness eventually.
May I ask how much you take and if it is part of a combination, such as an add-on to an antidepressant?
-Bob
Posted by Emily Elizabeth on July 14, 2010, at 9:19:07
In reply to Re: AD augmentation with AAPs » Emily Elizabeth, posted by Bob on July 14, 2010, at 0:05:04
Lately, I have been playing w/ my meds a little in order to reduce how much i take. At one point I tried to get rid of the abilify and that was a disaster. So I'll be taking at least a little abilify for the foreseeable future.
Right now I'm only on 5mg along w/ 150 of Wellbutrin and 10 of Lexapro. However, I am in the process of dropping the lex. I haven't decided about whether to keep the Wellbutrin or not.
In the past, I have been up to 30 mg of abilify w/o ill effects. However, my current pdoc says that for depression you don't really need such a high dose. It shouldn't make too much of a difference.
Hope that helps! Let me know if you have any more ?'s!
Best,
EE
Posted by jade k on July 17, 2010, at 7:01:16
In reply to AD augmentation with AAPs, posted by Bob on July 12, 2010, at 16:30:09
> I'm always seeing advertisements for Otsuka and Bristol-Myers Squibb's Abilify indicating it as an augmentation to the popular SSRI/SNRI antidepressants. Why don't I see similar indications for Janssen's Risperdal? Has Abilify proven more effective as an adjunct in this regard than Risperdal? Is one of them easier to tolerate than the other?
>
> -BobHi Bob,
I had reservations when I saw all the ads for abilify a/d augmentation. I have to say though I've talked to enough people using it successfully, for that purpose, that I'm a believer. Haven't heard of anyone using Risperdal for that. Probably a reason.
~Jade
Posted by Christ_empowered on July 17, 2010, at 15:11:46
In reply to Re: AD augmentation with AAPs, posted by jade k on July 17, 2010, at 7:01:16
Risperdal is kind of hard core, as the atypicals go. In "Mad in America" the author critiques the risperidone studies on a number of fronts. Apparently, risperidone is only somewhat atypical; from what I've read, its kind of like a transition drug from the old-to-new neuroleptics. I would imagine you'd have more of a problem with metabolic and movement disorders w/ risperidoneps than w/ abilify, but that's just a guess. Based on personal experience, I'd also expect that it'd be more sedating and prone to creating dysphoria, instead of activating and prone to an anti-depressant effect...but that's just a guess.
According to the shrink @ The Last Psychiatrist, aripiprazole really isn't that great for augmenting antidepressants, anyway; its more likely to cause akathisia (according to the posting I saw) than to relieve your depression. That said, some people love the stuff for depression.
Posted by jade k on July 17, 2010, at 15:46:25
In reply to Re: AD augmentation with AAPs, posted by Christ_empowered on July 17, 2010, at 15:11:46
> According to the shrink @ The Last Psychiatrist, aripiprazole really isn't that great for augmenting antidepressants, anywayAccording to people I personally know, who use it in small doses, it IS an effective augment.
> its more likely to cause akathisia (according to the posting I saw) than to relieve your depression. That said, some people love the stuff for depression.I haven't heard that from people who use it in small doses, and it seems unlikely if used in that way it would cause akathisia. I suppose there are going to be exceptions. Its never "one fits all" is it.
~Jade
Posted by europerep on July 17, 2010, at 16:11:22
In reply to Re: AD augmentation with AAPs » Christ_empowered, posted by jade k on July 17, 2010, at 15:46:25
>
> I haven't heard that from people who use it in small doses, and it seems unlikely if used in that way it would cause akathisia. I suppose there are going to be exceptions. Its never "one fits all" is it.
>hmm, unfortunately even the "atypical" AP, and even in small doses, can produce the "typical" AP side effects. I just read a letter to the editor in the JCP that described two cases, an adolescent and a 50-year old, who were given aripiprazole for short times, who never took other AP before, and who developed dystonia that needs to be treated despite quitting the drug.
that's why I would personally be very wary of these augmentation strategies with AAPs, especially in cases of long-term use.
Posted by jade k on July 17, 2010, at 16:38:11
In reply to Re: AD augmentation with AAPs, posted by europerep on July 17, 2010, at 16:11:22
>
> >
> > I haven't heard that from people who use it in small doses, and it seems unlikely if used in that way it would cause akathisia. I suppose there are going to be exceptions. Its never "one fits all" is it.
> >
>
> hmm, unfortunately even the "atypical" AP, and even in small doses, can produce the "typical" AP side effects. I just read a letter to the editor in the JCP that described two cases, an adolescent and a 50-year old, who were given aripiprazole for short times, who never took other AP before, and who developed dystonia that needs to be treated despite quitting the drug.
> that's why I would personally be very wary of these augmentation strategies with AAPs, especially in cases of long-term use.Hi er,
These two cases were treated with small doses then?
~Jade
>
>
Posted by emmanuel98 on July 17, 2010, at 19:42:03
In reply to Re: AD augmentation with AAPs, posted by jade k on July 17, 2010, at 16:38:11
I augmented lexapro with abilify and my depression disappeared within days and stayed disappeared until I ended the abilify due to weight gain. I don't think there's anything special about abilify as far as AAPs go. Risperdal had the same effect on me and so did zyprexa. Also cause massive weight gain.
Abilfy's makers have been heavily promoting it as an adjunct to AD's. They have a study their reps have been giving out (my p-doc gave it to me), but the measure of anti-depressant effect is based on clinician observation rather than self-report, which is pretty wierd.
Posted by jade k on July 17, 2010, at 20:01:43
In reply to Re: AD augmentation with AAPs, posted by emmanuel98 on July 17, 2010, at 19:42:03
> Abilfy's makers have been heavily promoting it as an adjunct to AD's. They have a study their reps have been giving out (my p-doc gave it to me), but the measure of anti-depressant effect is based on clinician observation rather than self-report, which is pretty wierd.Yeah, at first I thought it was just a marketing ploy to get more milage out of the med. I have to say though, I've talked to several people who swear by a small dose as an a/d effect. Now get higher, and well, you know. You couldn't pay me to take the larger dose of Abilify.
I have to admit though, I'm considering, maybe, a trial of the small dose.
~Jade
Posted by europerep on July 18, 2010, at 12:35:59
In reply to Re: AD augmentation with AAPs » emmanuel98, posted by jade k on July 17, 2010, at 20:01:43
hey!
yes, the doses were rather low, I can look it up exactly next time I'm at the library...
abilify does affect serotonin, so if that is not good for you, then you should start with a very small dose, maybe 2.5mg.. I took 5mg for two days, and it was awful, it was exactly how I imagine serotonin syndrome to be, although I cannot be sure of course. but if other people profit from it that's great of course.. I am just scared of adding other tardive side effect stuff to the problems I already have, that's why I'm not so much into APs...
Posted by jade k on July 18, 2010, at 14:37:23
In reply to Re: AD augmentation with AAPs » jade k, posted by europerep on July 18, 2010, at 12:35:59
> hey!
>
> yes, the doses were rather low, I can look it up exactly next time I'm at the library...
>
> abilify does affect serotonin, so if that is not good for you, then you should start with a very small dose, maybe 2.5mg.. I took 5mg for two days, and it was awful, it was exactly how I imagine serotonin syndrome to be, although I cannot be sure of course. but if other people profit from it that's great of course.. I am just scared of adding other tardive side effect stuff to the problems I already have, that's why I'm not so much into APs...Hey er,
Yeah, the 2.5 dose abilify is as high as I would go. Another poster actually started with that and is going to add small dose of a/d after. It will be interesting to see how that turns out.
~Jade
Posted by europerep on July 23, 2010, at 14:33:36
In reply to Re: AD augmentation with AAPs, posted by jade k on July 18, 2010, at 14:37:23
hmm, so I looked it up and it was a middle-aged woman who took 5mg of aripiprazole for about three months.. so that's not really to comforting.. I hope I won't get tardive dyskinesia from my two days of 5mg haha..
well, personally, I'll really try to stay far away from these drugs, but I didn't want to keep you from trying it.. after all, it's just one case report (entirely AP- or dopamine-mediated drug-free tho) and a lot of meds have a lot of severe side effects listed as "rare", etc..
Posted by jade k on July 23, 2010, at 15:04:04
In reply to Re: AD augmentation with AAPs, posted by europerep on July 23, 2010, at 14:33:36
Hey er!
> hmm, so I looked it up and it was a middle-aged woman who took 5mg of aripiprazole for about three months.. so that's not really to comforting.. I hope I won't get tardive dyskinesia from my two days of 5mg haha..
hey, you didn't have to do all that but thanks. Its good to do your homework before trying something thats a little sketchy I geuss. I think I'll try to stay away from that. Tardive dyskinesia doesn't sound to great either!!
>
> well, personally, I'll really try to stay far away from these drugs, but I didn't want to keep you from trying it.. after all, it's just one case report (entirely AP- or dopamine-mediated drug-free tho) and a lot of meds have a lot of severe side effects listed as "rare", etc..Okay, well, write me back cause I'm not sure about what you're doing, what meds etc. We haven't posted recently that I remember.
Thanks again!
~Jade
Posted by emmanuel98 on July 23, 2010, at 20:01:15
In reply to Re: AD augmentation with AAPs » europerep, posted by jade k on July 23, 2010, at 15:04:04
I took 10mg, then cut to 5mg. Tried 2.5mg but that had no effect. Tardive dykinesia is pretty rare with AAPs -- that's there whole selling point. But weight gain is not. Though abilify and geodon are supposedly the least likely to cause weight gain.
This is the end of the thread.
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