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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by plusfours on November 14, 2010, at 19:21:29
Hi Everyone. I'm wondering if some of the folks on here who know a bit about how these meds work might be so kind as to enlighten me on a dilemma I'm having.
I'm currently taking Adderall for ADD-PI and Zoloft and Abilify for Depression/Social Anxiety/PTSD. I also take a little bit to Klonopin (2 mg per day). Abilify has been great for me at the dose of 2.5 mg per day except for one problem... it takes a lot of the "kick" out of the Adderall I've been taking and I really need that focus as I'm in school now and taking a few challenging classes.
I know that this probably has something to do with the dopamine that the Adderall would normally provide being blocked by the Abilify, so I'm wondering, has anyone else had any success taking an AAP and a stimulant for ADHD at the same time? Is it just a matter of lowering the dose on the Abilify or raising the dose for the Adderall?
This is such a frustrating situation because the Abilify is a Godsend for giving me the stability to go to class and study every day, it just makes me a bit of an airhead at times, and seems to cancel out the Adderall, which I cannot afford.
Any ideas on what is happening chemically here? Thanks so very much! :)
Posted by Conundrum on November 15, 2010, at 9:12:13
In reply to Abilify, Adderall, and Zoloft. Dosage issues., posted by plusfours on November 14, 2010, at 19:21:29
I think you hit the nail on the head, the drugs have opposing mechanisms of action. So in order for abilify to work, it will have to block some of the effect of adderall. Are you taking the abilify for mood stability issues?
> Hi Everyone. I'm wondering if some of the folks on here who know a bit about how these meds work might be so kind as to enlighten me on a dilemma I'm having.
>
> I'm currently taking Adderall for ADD-PI and Zoloft and Abilify for Depression/Social Anxiety/PTSD. I also take a little bit to Klonopin (2 mg per day). Abilify has been great for me at the dose of 2.5 mg per day except for one problem... it takes a lot of the "kick" out of the Adderall I've been taking and I really need that focus as I'm in school now and taking a few challenging classes.
>
> I know that this probably has something to do with the dopamine that the Adderall would normally provide being blocked by the Abilify, so I'm wondering, has anyone else had any success taking an AAP and a stimulant for ADHD at the same time? Is it just a matter of lowering the dose on the Abilify or raising the dose for the Adderall?
>
> This is such a frustrating situation because the Abilify is a Godsend for giving me the stability to go to class and study every day, it just makes me a bit of an airhead at times, and seems to cancel out the Adderall, which I cannot afford.
>
> Any ideas on what is happening chemically here? Thanks so very much! :)
Posted by plusfours on November 15, 2010, at 14:16:02
In reply to Re: Abilify, Adderall, and Zoloft. Dosage issues. » plusfours, posted by Conundrum on November 15, 2010, at 9:12:13
> I think you hit the nail on the head, the drugs have opposing mechanisms of action. So in order for abilify to work, it will have to block some of the effect of adderall. Are you taking the abilify for mood stability issues?
Yes, that is what the Abilify does for me at 2.5 to 5 mg. And it's great at getting that stability without all the bad effects of the SSRIs that I otherwise would have to use in high doses. I'm just not a chemist of any kind so when I read that Abilify is a "partial dopamine agonist" I think... "Hey! Good news!" But it's only "partial" and as understand it there are different types of dopamine receptors just as there are for seratonin.
Posted by Christ_empowered on November 16, 2010, at 9:19:04
In reply to Re: Abilify, Adderall, and Zoloft. Dosage issues. » plusfours, posted by Conundrum on November 15, 2010, at 9:12:13
Hey. I used to take Abilify with Adderall. I think the doses of both meds were a little too high for me at the time (15mgs Abilify, 60mgs Adderall), plus I was also on Klonopin and some random other stuff.
Anyway, in my limited experience, Abilify is hard to mix with stimulants (I also tried it with varying doses of Ritalin and Focalin). Its high-potency (each mg packs a punch, more so than, say, seroquel), so each up or downward adjustment can make a big difference. I ended up just feeling zoned out of my mind. I also got in a bad situation where the amphetamine kick-started some EPS from the Abilify and the Abilify gave me more amphetamine-induced jerks...probably a dosing issue.
One of my friends now takes Seroquel and Adderall for her issues. She's been on all kinds of stuff, this combo really works for her,and she's only had minimal weight gain. I personally think it'd be easier to use seroquel with adderall than abilify, since seroquel is lower potency and doesn't bind to d2 receptors as strongly. Just a suggestion.
Good luck.
Posted by plusfours on November 16, 2010, at 9:30:47
In reply to Re: Abilify, Adderall, and Zoloft. Dosage issues., posted by Christ_empowered on November 16, 2010, at 9:19:04
>
> One of my friends now takes Seroquel and Adderall for her issues. She's been on all kinds of stuff, this combo really works for her,and she's only had minimal weight gain. I personally think it'd be easier to use seroquel with adderall than abilify, since seroquel is lower potency and doesn't bind to d2 receptors as strongly. Just a suggestion.Thank you for your advice! The reason my pdoc said that I should try Abilify instead of Seroquel was because he said there was a higher chance of weight gain on the 'quel than there was on Abilify. I'm about 50 lbs overweight as it is, and so far Abilify has been weight neutral, so I'd be hesitant to take something that would make me balloon up again.
Do you know how much weight people usually gain with a low dose of Seroquel?
Thanks a bunch!
Posted by Christ_empowered on November 17, 2010, at 0:52:03
In reply to Re: Abilify, Adderall, and Zoloft. Dosage issues. » Christ_empowered, posted by plusfours on November 16, 2010, at 9:30:47
I think the amount of weight gained (if any) varies considerably, but I did find a table here:
http://www.psycheducation.org/depression/meds/quetiapine.htm#badFor 600mgs/day, after 8 weeks there was a little over 3.5lbs gained. 300mgs, about 1 pound. Some people have found taking metformin along with atypical neuroleptics can help prevent/reduce weight gain.
Posted by Hombre on November 21, 2010, at 21:28:33
In reply to Re: Abilify, Adderall, and Zoloft. Dosage issues. » Christ_empowered, posted by plusfours on November 16, 2010, at 9:30:47
Have you tried exercising in the morning? I find that a brief but intense workout wakes me up and gets my mind going. I take 100mg Seroquel at night, and it hits me like a ton of bricks.
It might also help with being more alert in class. In fact, in Naperville, IL they use this strategy for kids struggling with math and reading. After doing a specially designed, fitness-oriented (not sport) PE class before school, all test scores went up. So much so, that one year Naperville out-ranked even Japan, Korea, Singapore, etc. in an international test of science. They call it "zero hour" PE.
I feel that exercise should be prescribed with atypical antipsychotics - they slow down the metabolism and do make you feel sort of spaced-out or foggy-headed. I swear a hard run or weight session, no more than 20-30 minutes (once you've worked up to it) clears the head and also helps with weight issues.
A short, intense workout also stimulates you body to secrete fat-burning hormones, like testosterone and growth hormone. Intense, not necessarily fatiguing, seems to be the key.
This is the end of the thread.
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