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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by tensor on November 3, 2011, at 5:52:19
I lack initiative, interest, energy and motivation, am on two antidepressants with clonazepam and Lyrica for anxiety.
Modafinil does not longer work, so I'm looking at Concerta but suspect that any response would fade quickly, which is why I'm also considering the above AAP. Anxiolytic effects are welcome. Any ideas?/Mattias
Posted by SLS on November 3, 2011, at 6:01:01
In reply to Concerta, Abilify or Geodon?, posted by tensor on November 3, 2011, at 5:52:19
> I lack initiative, interest, energy and motivation, am on two antidepressants with clonazepam and Lyrica for anxiety.
> Modafinil does not longer work, so I'm looking at Concerta but suspect that any response would fade quickly, which is why I'm also considering the above AAP. Anxiolytic effects are welcome. Any ideas?
>
> /Mattias
Hi MattiasI would try Abilify first. It has antidepressant and anxiolytic propterties. People often describe an increase in motivation and mental energy when taking Abilify. A friend of mine uses it for depression and anxiety. Whenever she tries to stop taking it, severe anxiety reappears. I think she is taking 5 mg.
Geodon is inconsistent in how it affects people. For some, it hits the target for depression. However, it can also produce anxiety and insomnia.
Good luck.
- Scott
Posted by tensor on November 3, 2011, at 6:05:46
In reply to Re: Concerta, Abilify or Geodon? » tensor, posted by SLS on November 3, 2011, at 6:01:01
>
> Hi Mattias
>
> I would try Abilify first. It has antidepressant and anxiolytic propterties. People often describe an increase in motivation and mental energy when taking Abilify. A friend of mine uses it for depression and anxiety. Whenever she tries to stop taking it, severe anxiety reappears. I think she is taking 5 mg.
>
> Geodon is inconsistent in how it affects people. For some, it hits the target for depression. However, it can also produce anxiety and insomnia.
>
> Good luck.
>
>
> - ScottHi Scott,
thanks for sharing your knowledge. I have been thinking about Abilify for a long time, did not know it was anxiolytic, great. A quick question, how is Risperdal compared to Abilify, pros cons?
Thanks Scott.
Posted by Christ_empowered on November 3, 2011, at 7:22:56
In reply to Re: Concerta, Abilify or Geodon? » SLS, posted by tensor on November 3, 2011, at 6:05:46
I've taken full doses of Risperdal (4mgs) and standard-to-high doses (15 to 30) of Abilify. I prefer the Abilify. Risperdal seemed kinda rough; dysphoria, stiff gait, cognitive dulling, all that fun stuff you associate mostly with older neuroleptics. On the plus side, its available in a lot of places (including the US) as a generic. If you're low-dosing it, then the problems I had might not be an issue for you.
Posted by tensor on November 3, 2011, at 7:29:14
In reply to Re: Concerta, Abilify or Geodon?, posted by Christ_empowered on November 3, 2011, at 7:22:56
> I've taken full doses of Risperdal (4mgs) and standard-to-high doses (15 to 30) of Abilify. I prefer the Abilify. Risperdal seemed kinda rough; dysphoria, stiff gait, cognitive dulling, all that fun stuff you associate mostly with older neuroleptics. On the plus side, its available in a lot of places (including the US) as a generic. If you're low-dosing it, then the problems I had might not be an issue for you.
Hi, and thank for your reply.
If I would start on Risperdal I think it would be in the 1-2mg range. But I have gained weight with Remeron and Lyrica, I now walk for an hour a day (nordic walking, yey!) but it has not had any impact on my weight yet. I'm now discontinuing Lyrica. The weight issue talks in favor of Abilify. Damn, I wish I wasn't so scared about AP side effects.
/Mattias
Posted by Phillipa on November 3, 2011, at 10:46:35
In reply to Re: Concerta, Abilify or Geodon? » Christ_empowered, posted by tensor on November 3, 2011, at 7:29:14
Hi Mattias ever talk to our friend? Good luck with your decision. Phillipa
Posted by tensor on November 3, 2011, at 11:27:22
In reply to Re: Concerta, Abilify or Geodon? » tensor, posted by Phillipa on November 3, 2011, at 10:46:35
> Hi Mattias ever talk to our friend? Good luck with your decision. Phillipa
Hi Phillipa, not in a while. Hugs :-)
Posted by Phidippus on November 3, 2011, at 18:05:03
In reply to Concerta, Abilify or Geodon?, posted by tensor on November 3, 2011, at 5:52:19
You're on two antidepressants is why you're feeling all flat and yucky. Which two antidepressants are you on?
Before you look at an AAP I would take a look at which antidepressants you're on and decide whether you really need two. If you are going to continue with two antidepressantss make sure they have complimentary mechanisms of action...Like Zoloft taken with Wellbutrin - one's an SSRI and the other is an NDRI-both medications work to tackle the problem from unique means.
Another tact would be to drop one of the antidepressants and replace it with Abilify or Latuda - both are 5ht1a agonists, which means they both treat anxiety and depression.
Concerta would be fine, but it could cause anxiety :( Nuvigil might give you more of the effect you want.
How much clonazepam and Lyrica do you take?
Eric
Posted by Chairman_MAO on November 3, 2011, at 19:55:43
In reply to Concerta, Abilify or Geodon?, posted by tensor on November 3, 2011, at 5:52:19
> I lack initiative, interest, energy and motivation, am on two antidepressants with clonazepam and Lyrica for anxiety.
What dose of clonazepam do you take? Which two antidepressants are you on?
Posted by tensor on November 4, 2011, at 4:07:18
In reply to Re: Concerta, Abilify or Geodon? » tensor, posted by Phidippus on November 3, 2011, at 18:05:03
> You're on two antidepressants is why you're feeling all flat and yucky. Which two antidepressants are you on?
>
> Before you look at an AAP I would take a look at which antidepressants you're on and decide whether you really need two. If you are going to continue with two antidepressantss make sure they have complimentary mechanisms of action...Like Zoloft taken with Wellbutrin - one's an SSRI and the other is an NDRI-both medications work to tackle the problem from unique means.
>
> Another tact would be to drop one of the antidepressants and replace it with Abilify or Latuda - both are 5ht1a agonists, which means they both treat anxiety and depression.
>
> Concerta would be fine, but it could cause anxiety :( Nuvigil might give you more of the effect you want.
>
> How much clonazepam and Lyrica do you take?
>
> EricI take 45mg mirtazapine, 20mg escitalopram, 450mg Lyrica, 2mg clonazepam. Escitalopram is good for my mood, makes me less grumpy. Mirtazapine used to be great but I think it still works for my anxiety.
Thanks.
Posted by ed_uk2010 on November 8, 2011, at 10:11:55
In reply to Re: Concerta, Abilify or Geodon?, posted by Christ_empowered on November 3, 2011, at 7:22:56
>Risperdal seemed kinda rough; dysphoria, stiff gait, cognitive dulling, all that fun stuff you associate mostly with older neuroleptics.
I suppose that could be a problem, but at the dose range which tensor might try, it might not be an issue? I believe that risperidone's adverse effects are very dose-dependent.
Posted by psychobot5000 on November 14, 2011, at 13:11:07
In reply to Concerta, Abilify or Geodon?, posted by tensor on November 3, 2011, at 5:52:19
> I lack initiative, interest, energy and motivation, am on two antidepressants with clonazepam and Lyrica for anxiety.
> Modafinil does not longer work, so I'm looking at Concerta but suspect that any response would fade quickly, which is why I'm also considering the above AAP. Anxiolytic effects are welcome. Any ideas?
>
> /MattiasDon't sell the concerta short. Energy and motivation are where methylphenidate (in theory, and in my personal experience) excels in comparison with other medications. It's true that anxiety COULD be a problem, but I also have anxiety and continue to take it on occasion. In my experience, anxiety simply means the dose is too high. Titrate it slowly, and I'll bet you'll be fine.
It's true, its effect will likely fade somewhat after continued use, but you can up the dosage to get a substantial amount of the effect back (if you try to retain 100% of the initial benefit, I think you'll likely end up dosing too high).
Shorter: with the symptoms you describe, concerta is worth a try, but start at low doses, go slowly, and watch for anxiety.
Hell, if that doesn't work, dexedrine is probably worth trying, also, I'd think. It's supposed to be better for mood than concerta/methylphenidate, though in my experience this varies, person to person.
Also: for mood flattening, I'm suspicious of your Lyrica. In my experience, drugs in that class can do that.
Posted by tensor on November 14, 2011, at 13:18:57
In reply to Re: Concerta, Abilify or Geodon?, posted by psychobot5000 on November 14, 2011, at 13:11:07
> Don't sell the concerta short. Energy and motivation are where methylphenidate (in theory, and in my personal experience) excels in comparison with other medications. It's true that anxiety COULD be a problem, but I also have anxiety and continue to take it on occasion. In my experience, anxiety simply means the dose is too high. Titrate it slowly, and I'll bet you'll be fine.
>
> It's true, its effect will likely fade somewhat after continued use, but you can up the dosage to get a substantial amount of the effect back (if you try to retain 100% of the initial benefit, I think you'll likely end up dosing too high).
>
> Shorter: with the symptoms you describe, concerta is worth a try, but start at low doses, go slowly, and watch for anxiety.
>
> Hell, if that doesn't work, dexedrine is probably worth trying, also, I'd think. It's supposed to be better for mood than concerta/methylphenidate, though in my experience this varies, person to person.
>
> Also: for mood flattening, I'm suspicious of your Lyrica. In my experience, drugs in that class can do that.Thanks for your input! I've started Seroquel a few days ago so no Concerta for now. Not unlikely I will try it in the future.
This is the end of the thread.
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