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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 Christ_empowered on October 26, 2011, at 2:10:02
Its been a little while since I stopped my 15 Abilify. I thought I'd give an update, since you all have been supportive and helpful.
I feel SO MUCH BETTER. Sorry for the screaming caps, but seriously: the improvement is awesome. I'm a little bit more introspective, a bit more intense emotionally, more active, I eat less, my thinking is clearer, and my concentration has improved. The voices, surprisingly, are less of an issue now (or have been for the past couple days) than when I was on an effective dose of Abilify. I think maybe its a psychological thing; since I'm reading more, thinking more, talking to people more, doing more, my mind isn't stuck on the same events in the past or the same recurrent themes of my low-grade auditory hallucinations. Also, my mood is better overall (although obviously I have more minor ups and downs now that I'm off the tranquilizer), so I think maybe pushing my mood up above a tranquilized melancholy has done wonders for reducing the frequency and intensity of my voices.
Sleep is good. Weirdly enough, although Lamictal is definitely not sedating, it prevents me from going days without sleep. My sleep is heavy, restorative, and filled with vivid dreams with complicated plots.
My anxiety seems improved. I don't know if getting rid of the whole dopamine-blocking, deactivation effect corrected anxiety that was caused by low-grade Parkinson's, or if I'm just having a good week, or if getting rid of the neuroleptic lets the mood elevating effects of the Lamictal 200 shine through, or what, but I'm feeling much, much better.
I think maybe Abilify had outlived its usefulness for me.
Posted by SLS on October 26, 2011, at 7:24:29
In reply to No more Abilify: progress notes, posted by Christ_empowered on October 26, 2011, at 2:10:02
Hi.
> I think maybe Abilify had outlived its usefulness for me.
Haven't you been here before?
- Scott
Posted by Phillipa on October 26, 2011, at 10:29:45
In reply to No more Abilify: progress notes, posted by Christ_empowered on October 26, 2011, at 2:10:02
CE definitely getting out and interracting more with people will distract your mind from voices. Could the voices have been from lonliness and no one to talk with? If so that is great to hear. What's this about low grade Parkinson's? Phillipa
Posted by Christ_empowered on October 26, 2011, at 17:06:26
In reply to Re: No more Abilify: progress notes » Christ_empowered, posted by Phillipa on October 26, 2011, at 10:29:45
Hey Phillipa. Yeah, I think intense social isolation and stress and regret over the past, plus being soundly rejected and ridiculed really took their toll. I may have to go back on Abilify, or take it occasionally, or take a lower dose, but for now I think I can make a go of it with the 200 Lamictal and my supplements.
Posted by Phillipa on October 26, 2011, at 20:58:15
In reply to Re: No more Abilify: progress notes, posted by Christ_empowered on October 26, 2011, at 17:06:26
CE how will you know if you need to go back on abilify? What will you be looking for and most importantly will you recognize them and take action? Phillipa
Posted by floatingbridge on October 26, 2011, at 21:45:43
In reply to Re: No more Abilify: progress notes » Christ_empowered, posted by SLS on October 26, 2011, at 7:24:29
> Hi.
>
> > I think maybe Abilify had outlived its usefulness for me.
>
>
> Haven't you been here before?
>
>
> - ScottI don't recall. Not with lamictal. So maybe this monotherapy is going to work. I hope so. Or klonipin as needed for stressful times?
Posted by SLS on October 26, 2011, at 22:15:53
In reply to Re: No more Abilify: progress notes » SLS, posted by floatingbridge on October 26, 2011, at 21:45:43
> > Hi.
> >
> > > I think maybe Abilify had outlived its usefulness for me.
> >
> >
> > Haven't you been here before?
> >
> >
> > - Scott
>
> I don't recall. Not with lamictal. So maybe this monotherapy is going to work. I hope so. Or klonipin as needed for stressful times?
Lamictal makes a poor anti-manic agent. I don't see how it could exert anti-psychotic effects. Maybe it would be of help in a case of rapid-cycling schizoaffective disorder, bipolar type. It is probably of little help in schizophrenia.Sometimes, a person will feel better transiently when the dosage of a psychotropic medication is changed abruptly. Perhaps another AP would produce better results. I think it would have made sense to reduce the dosage of Abilify to 10mg in an attempt to retain AP effects while eliminating cognitive side effects.
Of course, I would like to see C_E feel well without any treatment at all. However, I am concerned that history will repeat itself.
- Scott
Posted by Phillipa on October 26, 2011, at 23:19:14
In reply to Re: No more Abilify: progress notes » floatingbridge, posted by SLS on October 26, 2011, at 22:15:53
I know but I feel CE has a good support system close by that will help guide him back if needed. He's a pretty smart person hoping also he will recognize any decline and add back his meds. Phillipa
Posted by sigismund on October 26, 2011, at 23:54:57
In reply to Re: No more Abilify: progress notes » floatingbridge, posted by SLS on October 26, 2011, at 22:15:53
I worry that he has been a little bit quick.
Posted by floatingbridge on October 27, 2011, at 6:31:22
In reply to Re: No more Abilify: progress notes » floatingbridge, posted by SLS on October 26, 2011, at 22:15:53
Yes, perhaps it was a bit quick. I know you want CE well. We all do.
Posted by morgan miller on October 30, 2011, at 15:28:22
In reply to No more Abilify: progress notes, posted by Christ_empowered on October 26, 2011, at 2:10:02
As much as I have expressed my negative feelings about Lamictal, I would certainly choose it over an Antipsychotic any day.
When I was on Zyprexa, I was stuck on negative thoughts more and felt so much more depressed about them. Sounds like you had a similar reaction to Abilify.
Posted by morgan miller on October 30, 2011, at 15:38:34
In reply to Re: No more Abilify: progress notes, posted by sigismund on October 26, 2011, at 23:54:57
CE will be fine. He's aware that he may have to return to Abilify at a lower dose. I'm sure he will take quick action if or when things start to go down hill in certain ways. I do think just stopping Abilify may be a bit rash, but at least he got an idea of what things feel like without it.
CE, what do you think about a lower dose of Abilify or Zyprexa in the future? What about Depakote instead of an antipsychotic? Sodium Valproate can be helpful as an antipsychotic agent. Or maybe even consider adding some lithium to the mix?
Well, it does not sound like you are full blown schizophrenic, more like bipolar/schizoaffective. Is this the diagnosis that's been given to you?
I have a friend that had full blown psychosis one time and was on an AP for 3 years or so. He no longer takes one. He does not ever experience psychotic symptoms, but he also is not doing very well. I think if he just upped his Depakote dose, took a moderate dose of lithium, and took an SSRI like lexapro or luvox, he would do much better. But he is one stubborn SOB. I can't really blame him, he's been through hell with his illness, finding a decent treatment that provides a considerably amount of relief, and bad hospital experiences.
Morgan
Posted by morgan miller on October 30, 2011, at 15:39:58
In reply to Re: No more Abilify: progress notes, posted by sigismund on October 26, 2011, at 23:54:57
CE will be fine. He's aware that he may have to return to Abilify at a lower dose. I'm sure he will take quick action if or when things start to go down hill in certain ways. I do think just stopping Abilify may be a bit rash, but at least he got an idea of what things feel like without it.
CE, what do you think about a lower dose of Abilify or Zyprexa in the future? What about Depakote instead of an antipsychotic? Sodium Valproate can be helpful as an antipsychotic agent. Or maybe even consider adding some lithium to the mix?
Well, it does not sound like you are full blown schizophrenic, more like bipolar/schizoaffective. Is this the diagnosis that's been given to you?
I have a friend that had full blown psychosis one time and was on an AP for 3 years or so. He no longer takes one. He does not ever experience psychotic symptoms, but he also is not doing very well. I think if he just upped his Depakote dose, took a moderate dose of lithium, and took an SSRI like lexapro or luvox, he would do much better. But he is one stubborn SOB. I can't really blame him, he's been through hell with his illness, finding a decent treatment that provides a considerably amount of relief, and bad hospital experiences.
Morgan
Posted by Phillipa on October 30, 2011, at 19:56:11
In reply to No more Abilify: progress notes, posted by Christ_empowered on October 26, 2011, at 2:10:02
CE you okay? Let us know? Phillipa
Posted by Christ_empowered on October 31, 2011, at 1:42:57
In reply to Re: No more Abilify: progress notes, posted by Phillipa on October 30, 2011, at 19:56:11
I'm doing well. I took 15mgs Abilify today because I'd gotten "stuck in my head"--kind of agitated and unable to focus, but not really anxious. I think this as-needed approach might be the way to go.
Sleep is fine, mood is good (I'm in a much better mood now that I've stopped taking the Abilify everyday), and I'm able to deal with the world. I do, however, have a cold/flu thing going on, which kinda sucks, and is probably one reason I needed the Abilify today (I've been sleeping at odd hours because of the fever and lethargy from my cold/flu).
I'd love to negotiate a much lower daily dose of Abilify with my doctor (I could do it anyway, but it'd be nice to have a doc on board), but I don't think that's possible. Doctors look at my records and see somebody who *needs* to be tranquilized. My shrink even mentioned clozapine the last time I saw her, so I don't think she'd be cool with me micro-dosing the Abilify just yet (or ever). For some reason, shrinks seem to love ramping up antipsychotic doses when they perceive me as mania-prone, and then I've had one doc who saw me as severely depressed (and personality-disordered); he chose to lower my mood stabilizer and give me high dose Cymbalta. Psychiatry, obviously, isn't the most scientific field ever. The sad thing is that if I just went along with what my shrinks said (and I'd have to pick one to listen to), I'd probably either be psychotic and emotionally flat (antidepressants) or suffering from the "tranquilizer psychosis" (apathy, dullness, poor concentration, etc).
Posted by Phillipa on October 31, 2011, at 18:41:53
In reply to Re: No more Abilify: progress notes, posted by Christ_empowered on October 31, 2011, at 1:42:57
CE sorry about you being sick that stinks. Glad you took some abilify though as seriously seems you are so much better when taking it. What do others in your life think when on and off abilify? What do you feel an accurate diagnosis is? I did see miracles happen on clozaril. But I feel the abilify is more benign. Hoping you respond today on how you are doing. Phillipa
Posted by floatingbridge on October 31, 2011, at 19:00:23
In reply to Re: No more Abilify: progress notes, posted by Christ_empowered on October 31, 2011, at 1:42:57
How is Abilify dosed? Would it be easy enough to take 10mg and see how that felt? Or someone (SLS ?) mentioned 7.5mg.
That's not too much. I think a real micro-dose would be under 5mg. That might be activating, but I don't know for you. I don't think Abilify is a bad med to be on if one can find the right dose and it works.
It might be good to stay steady on a lower dose than on and off. My current pdoc was explaining something to me about how it is not good over the long term to bounce too much on AP's. I don't consider him an AP zealot, either. He seems more cautious and conservative about using medications. Passing on his two cents.
Speedy recovery from the flu.
Posted by morgan miller on October 31, 2011, at 20:23:19
In reply to Re: No more Abilify: progress notes, posted by Christ_empowered on October 31, 2011, at 1:42:57
I'm not on an AP, and I'm doing so much better. So many pdocs would have chosen to keep me on an AP. This f*ck*ng field is a massive joke in so many ways. Patients often do a better job at managing meds than doctors do.
Posted by Phillipa on October 31, 2011, at 20:58:58
In reply to Re: No more Abilify: progress notes, posted by morgan miller on October 31, 2011, at 20:23:19
Morgan is true but CE has legitimate reasons for staying on at least a low dose of abilify. He doesn't want to end up back in hospital. He's come so far. Phillipa
Posted by morgan miller on November 1, 2011, at 4:31:26
In reply to Re: No more Abilify: progress notes » morgan miller, posted by Phillipa on October 31, 2011, at 20:58:58
> Morgan is true but CE has legitimate reasons for staying on at least a low dose of abilify. He doesn't want to end up back in hospital. He's come so far. Phillipa
I hear ya..But, he also wants to feel like a human being again. And, I'm do not think a low dose of Abilify, say 5 mg, does a very good job as an antimanic or antipsychotic agent. I think Depakote and Lithium would be much better choices and healthier in the long run. If you take them, you can take l methylfolate to fend against depletion, and l carnitine to fend against depletion caused only by Depakote.
F*ck APs, they are overused and overrated.
One thing I think we need to be more aware of and focus more on resolving is fear. Fear is the real problem here with most of us. Well, fear and not truly loving ourselves, not in a proper way. If you don't think fear and lack of love and nurture are playing a role in your current mental health issues, you are in complete denial.
Not willing to face the painful truth and very sad and hurtful feelings deep inside, then you are not also ever really going to get better. Reality is a bitch, but if you can face it, you are going to be better off.
Medication is necessary, but i swear, in a different world, it would not be for the large majority of us.
This is the end of the thread.
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