![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 61. This is the beginning of the thread.
Posted by SLS on December 4, 2013, at 4:27:42
I am thinking of swapping out Abilify for Latuda to treat bipolar depression so that I can avoid and reverse weight-gain. Has anyone had success with this drug for treating depression?
Thanks.
- Scott
Posted by Bob on December 4, 2013, at 20:43:35
In reply to Does anyone take Latuda for depression?, posted by SLS on December 4, 2013, at 4:27:42
> I am thinking of swapping out Abilify for Latuda to treat bipolar depression so that I can avoid and reverse weight-gain. Has anyone had success with this drug for treating depression?
>
> Thanks.
>
>
> - ScottI'm taking it now Scott. Have been for a little over 3 weeks I think, and now I'm at 20mg twice per day. The reason for trying this med was basically the same as what you stated - an adjunct AP that doesn't destroy my body with unwanted metabolic side effects. So far it doesn't seem to be causing the outrageous weight gain that I have experienced on almost all other APs, such as Zyprexa, Abilify, Seroquel etc. I think it's toofffffffffffffffff early to tell if it will evenutally cause an insidious creeping weight gain but so far it hasn't.
I'm adding it to a liberal amount of nortriptyline (225mg) and about 75mg per day of sertraline. I added it initially for an energizing/brightening effect which it initially did but that quickly faded. In the last few days I've added some bupropion to try to get rid of flat affect problems but that has not been a long term solution in the past and probably won't be this time either.
Bob
Posted by SLS on December 4, 2013, at 22:23:04
In reply to Re: Does anyone take Latuda for depression?, posted by Bob on December 4, 2013, at 20:43:35
> > I am thinking of swapping out Abilify for Latuda to treat bipolar depression so that I can avoid and reverse weight-gain. Has anyone had success with this drug for treating depression?
> >
> > Thanks.> I'm taking it now Scott. Have been for a little over 3 weeks I think, and now I'm at 20mg twice per day. The reason for trying this med was basically the same as what you stated - an adjunct AP that doesn't destroy my body with unwanted metabolic side effects. So far it doesn't seem to be causing the outrageous weight gain that I have experienced on almost all other APs, such as Zyprexa, Abilify, Seroquel etc. I think it's toofffffffffffffffff early to tell if it will evenutally cause an insidious creeping weight gain but so far it hasn't.
> I'm adding it to a liberal amount of nortriptyline (225mg) and about 75mg per day of sertraline. I added it initially for an energizing/brightening effect which it initially did but that quickly faded. In the last few days I've added some bupropion to try to get rid of flat affect problems but that has not been a long term solution in the past and probably won't be this time either.Focalin maybe?
I haven't looked at the clinical trials of Latuda when used for bipolar depression, so I don't have a good feel for how quickly it works.
Gosh. I'm sorry that you find yourself in such a frustrating situation. You don't sound hopeless, though. That is a gift.
Which AP acted as the best antidepressant for you? How long were you on it for?
- Scott
Posted by bob on December 5, 2013, at 1:46:02
In reply to Re: Does anyone take Latuda for depression? » Bob, posted by SLS on December 4, 2013, at 22:23:04
> > > I am thinking of swapping out Abilify for Latuda to treat bipolar depression so that I can avoid and reverse weight-gain. Has anyone had success with this drug for treating depression?
> > >
> > > Thanks.
>
> > I'm taking it now Scott. Have been for a little over 3 weeks I think, and now I'm at 20mg twice per day. The reason for trying this med was basically the same as what you stated - an adjunct AP that doesn't destroy my body with unwanted metabolic side effects. So far it doesn't seem to be causing the outrageous weight gain that I have experienced on almost all other APs, such as Zyprexa, Abilify, Seroquel etc. I think it's too early to tell if it will evenutally cause an insidious creeping weight gain but so far it hasn't.
>
> > I'm adding it to a liberal amount of nortriptyline (225mg) and about 75mg per day of sertraline. I added it initially for an energizing/brightening effect which it initially did but that quickly faded. In the last few days I've added some bupropion to try to get rid of flat affect problems but that has not been a long term solution in the past and probably won't be this time either.
>
> Focalin maybe?
>
> I haven't looked at the clinical trials of Latuda when used for bipolar depression, so I don't have a good feel for how quickly it works.
>
> Gosh. I'm sorry that you find yourself in such a frustrating situation. You don't sound hopeless, though. That is a gift.
>
> Which AP acted as the best antidepressant for you? How long were you on it for?
>
>
> - ScottI hate to say it but probably one of the best APs was Zyprexa... At least for a little while. Abilify was very good as well, but soon caused an intolerable akithisia and started to lose the initial positive effects. I didn't get very high in dosing because I was unwilling to go down the massive weight road yet again.
Why do you suggest Focalin in particular?
Bob
I have a feeling that if you make a swap you could find the lurasidone to be somewhat less effective at producing motivation and drive. Of course I could be wrong and don't want to discourage you from trying it.
Posted by SLS on December 5, 2013, at 7:49:29
In reply to Re: Does anyone take Latuda for depression? » SLS, posted by bob on December 5, 2013, at 1:46:02
> > > > I am thinking of swapping out Abilify for Latuda to treat bipolar depression so that I can avoid and reverse weight-gain. Has anyone had success with this drug for treating depression?
> > > >
> > > > Thanks.
> >
> > > I'm taking it now Scott. Have been for a little over 3 weeks I think, and now I'm at 20mg twice per day. The reason for trying this med was basically the same as what you stated - an adjunct AP that doesn't destroy my body with unwanted metabolic side effects. So far it doesn't seem to be causing the outrageous weight gain that I have experienced on almost all other APs, such as Zyprexa, Abilify, Seroquel etc. I think it's too early to tell if it will evenutally cause an insidious creeping weight gain but so far it hasn't.
> >
> > > I'm adding it to a liberal amount of nortriptyline (225mg)Get a blood test to be sure your nortriptyline level does not exceed 150 ng/mL. If you go too high in dosage with nortriptyline, it actually stops working. Most rapid metabolizers of nortriptyline need not go beyond 150 mg/day. It's really an approximation of drug activity. It is not absolute, but if your blood levels of nortriptyline are significantly higher than 150 ng/mL, I would recommend talking to your doctor about lowering the dosage so as to perform a brief experiment. For you, lower might be better.
> and about 75mg per day of sertraline. I added it initially for an energizing/brightening effect which it initially did but that quickly faded. In the last few days I've added some bupropion to try to get rid of flat affect problems but that has not been a long term solution in the past and probably won't be this time either.
What do you attribute the flat affect to?
> > I haven't looked at the clinical trials of Latuda when used for bipolar depression, so I don't have a good feel for how quickly it works.
> >
> > Gosh. I'm sorry that you find yourself in such a frustrating situation. You don't sound hopeless, though. That is a gift.
> >
> > Which AP acted as the best antidepressant for you? How long were you on it for?
> >
> >
> > - Scott
>
> I hate to say it but probably one of the best APs was Zyprexa... At least for a little while. Abilify was very good as well, but soon caused an intolerable akithisia and started to lose the initial positive effects. I didn't get very high in dosing because I was unwilling to go down the massive weight road yet again.
If your flat affect is a side effect of Zoloft (sertraline), which it certainly can be, perhaps you can explore Pristiq (desvenlafaxine) if you can afford it or Effexor (venlafaxine) if you can't.> > Focalin maybe?
> Why do you suggest Focalin in particular?
If your flat affect is a side effect of Zoloft, which it certainly can be, perhaps you can explore Pristiq if you can afford it or Effexor if you can't.
I found that Focalin (dexmethylphenidate) gives me a predictable increase in mental energy and improvements in thought speed and mental clarity. I was more sociable, probably because my mind became more active. You might find that twice-a-day dosing works best - morning and afternoon. In my estimation, Focalin is "smoother" than Ritalin, which felt harsh to me.
> I have a feeling that if you make a swap you could find the lurasidone to be somewhat less effective at producing motivation and drive. Of course I could be wrong and don't want to discourage you from trying it.I appreciate any observations, insights, or theories you would like to share.
Take care and feel better!
- Scott
Posted by Phillipa on December 5, 2013, at 9:56:09
In reply to Re: Does anyone take Latuda for depression? » bob, posted by SLS on December 5, 2013, at 7:49:29
Question if you don't get mania's why do you need the antipsychotics? I don't know? Thanks
Posted by Bob on December 5, 2013, at 12:41:57
In reply to Re: Does anyone take Latuda for depression? » SLS, posted by Phillipa on December 5, 2013, at 9:56:09
> Question if you don't get mania's why do you need the antipsychotics? I don't know? Thanks
If I understand correctly, AP's are sometimes added to an antidepressant - usually an SSRI - as an adjunctive treatment for depressive problems apart from the mood stabilization possibilities.
Bob
Posted by Bob on December 5, 2013, at 12:42:50
In reply to Re: Does anyone take Latuda for depression? » bob, posted by SLS on December 5, 2013, at 7:49:29
Thanks for your opinions Scott.
Posted by phidippus on December 5, 2013, at 17:50:46
In reply to Does anyone take Latuda for depression?, posted by SLS on December 4, 2013, at 4:27:42
I feel Latuda was much more effective at boosting my mood than Abilify.
My honest opinion is that most atypicals do a good job of worsening mood - sacrificing all that dopamine is going to have its consequences.
I'm having a lot of luck with NMDA antagonists. Riluzole really does enhance my mood. here's some suggestions:
Ketamine seems to work, but results fade fast- weekly injections needed.
Tramadol seems to be a very effective antidepressant but so many are weary of its addictive properties (I think it has none)
Memantine seems to help.
Dextromethorphan is being studied as a treatment for depression.
Magnesium is popular with the holistic folks.
Methoxetamine is an nmda antagonist and seratonin reuptake inhibitor.
Neramexane: a memantine analogue with nootropic, antidepressant properties. Also a nicotinic acetylcholine antagonist.
Eric
Posted by Fiat500 on December 5, 2013, at 22:11:17
In reply to Re: Does anyone take Latuda for depression? » SLS, posted by phidippus on December 5, 2013, at 17:50:46
Rilutek is very effective although it takes a while to kick in. Memantine can cause depression so watch out. Works for some though.
Posted by Bob on December 6, 2013, at 11:24:13
In reply to Re: Does anyone take Latuda for depression?, posted by Fiat500 on December 5, 2013, at 22:11:17
> Rilutek is very effective although it takes a while to kick in. Memantine can cause depression so watch out. Works for some though.
You've tried both?
Posted by Bob on December 6, 2013, at 11:26:10
In reply to Re: Does anyone take Latuda for depression? » SLS, posted by phidippus on December 5, 2013, at 17:50:46
> I feel Latuda was much more effective at boosting my mood than Abilify.
>
> My honest opinion is that most atypicals do a good job of worsening mood - sacrificing all that dopamine is going to have its consequences.
>
> I'm having a lot of luck with NMDA antagonists. Riluzole really does enhance my mood. here's some suggestions:
>
> Ketamine seems to work, but results fade fast- weekly injections needed.
>
> Tramadol seems to be a very effective antidepressant but so many are weary of its addictive properties (I think it has none)
>
> Memantine seems to help.
>
> Dextromethorphan is being studied as a treatment for depression.
>
> Magnesium is popular with the holistic folks.
>
> Methoxetamine is an nmda antagonist and seratonin reuptake inhibitor.
>
> Neramexane: a memantine analogue with nootropic, antidepressant properties. Also a nicotinic acetylcholine antagonist.
>
>
> Eric
How many of these meds you mention have you tried? Are you on one currently? If so, are you taking just that or in combo with other meds?Bob
Posted by phidippus on December 7, 2013, at 6:12:19
In reply to Re: Does anyone take Latuda for depression? » phidippus, posted by Bob on December 6, 2013, at 11:26:10
>How many of these meds you mention have you tried?
All of them. I am currently taking Riluzole along with Lithium, Lexapro, Vyvanse and Invega.
Eric
Posted by Fiat500 on December 11, 2013, at 23:34:37
In reply to Re: Does anyone take Latuda for depression? » Fiat500, posted by Bob on December 6, 2013, at 11:24:13
Yes I did. Memantine caused depression and Rilutek was excellent but I was mortified as I had to discontinue as after about three months I had difficulty putting sentences together and had difficulty speaking.
Posted by LouisianaSportsman on December 12, 2013, at 19:58:55
In reply to Does anyone take Latuda for depression?, posted by SLS on December 4, 2013, at 4:27:42
> I am thinking of swapping out Abilify for Latuda to treat bipolar depression so that I can avoid and reverse weight-gain. Has anyone had success with this drug for treating depression?
>
> Thanks.
>
>
> - ScottSLS,
I've posted about wanting to switch to Latuda from Abilify for the exact same reason. I did so. I currently take 60mg. of Latuda.
I was a big advocate for Abilify-- it was the most effective psychiatric medication I had taken. It was a difficult choice to switch to Latuda, but something had to be done about the weight gain. I have lost 13 pounds since being initiated on Latuda two months; however, we did begin Topamax at the same time.
Latuda works better than Abilify! It is subtle, but definitely brightens my mood and is the best remedy I have discovered for my bipolar depression. The only downside is that you have to eat ~350 calories with it.
I highly suggest you try it out, Scott.
Posted by SLS on December 12, 2013, at 20:57:29
In reply to Re: Does anyone take Latuda for depression?, posted by LouisianaSportsman on December 12, 2013, at 19:58:55
Thanks!!!
:-)
I'll say a little prayer for you that Latuda continues to improve your depression.
I will definitely try Latuda at some point, perhaps next month. I am beginning to respond more robustly to my current treatment regime. I increased my Parnate from 80 mg/day to 100 mg/day. I would rather not rock the boat just yet, but at some point, the weight gain must be addressed.
Currently:
Parnate (tranylcypromine) 100 mg/day
nortriptyline 150 mg/day
Lamictal 200 mg/day
lithium 450 mg/day
Abilify 10 mg/day
minocycline 200 mg/day
prazosin 25 mg/day
Thanks again.
- Scott
Posted by bob on December 13, 2013, at 23:55:26
In reply to Re: Does anyone take Latuda for depression? » LouisianaSportsman, posted by SLS on December 12, 2013, at 20:57:29
> Thanks!!!
>
> :-)
>
> I'll say a little prayer for you that Latuda continues to improve your depression.
>
> I will definitely try Latuda at some point, perhaps next month. I am beginning to respond more robustly to my current treatment regime. I increased my Parnate from 80 mg/day to 100 mg/day. I would rather not rock the boat just yet, but at some point, the weight gain must be addressed.
>
> Currently:
>
> Parnate (tranylcypromine) 100 mg/day
> nortriptyline 150 mg/day
> Lamictal 200 mg/day
> lithium 450 mg/day
> Abilify 10 mg/day
> minocycline 200 mg/day
> prazosin 25 mg/day
>
>
> Thanks again.
>
>
> - ScottHey Scott... I noticed you replaced your Nardil with Parnate. Are you getting the changes you hoped for from that?
Bob
Posted by SLS on December 14, 2013, at 0:38:25
In reply to Re: Does anyone take Latuda for depression? » SLS, posted by bob on December 13, 2013, at 23:55:26
Hi Bob.
> Hey Scott... I noticed you replaced your Nardil with Parnate. Are you getting the changes you hoped for from that?
I went from Parnate to Nardil, and back to Parnate again. For some reason, Nardil didn't help me as much as it had in the past. I am convinced that Parnate is a better drug for me, so... No more experiments.
I'm starting to feel pretty good.
- Scott
Posted by mogger on December 14, 2013, at 0:43:04
In reply to Re: Does anyone take Latuda for depression? » bob, posted by SLS on December 14, 2013, at 0:38:25
Good to hear Scott!
Posted by Bob on December 14, 2013, at 14:18:38
In reply to Re: Does anyone take Latuda for depression? » bob, posted by SLS on December 14, 2013, at 0:38:25
> Hi Bob.
>
> > Hey Scott... I noticed you replaced your Nardil with Parnate. Are you getting the changes you hoped for from that?
>
> I went from Parnate to Nardil, and back to Parnate again. For some reason, Nardil didn't help me as much as it had in the past. I am convinced that Parnate is a better drug for me, so... No more experiments.
>
> I'm starting to feel pretty good.
>
>
> - Scott
How long after starting Parnate did it take to get to this point? What do you like about Parnate?Bob
Posted by SLS on December 14, 2013, at 17:56:37
In reply to Re: Does anyone take Latuda for depression? » SLS, posted by Bob on December 14, 2013, at 14:18:38
> How long after starting Parnate did it take to get to this point?
When I do respond properly to Parnate, it usually takes 4 - 8 weeks to see an improvement. I sometimes get a false response in week 2 that disappears after 3 days - tachyphylaxis.
> What do you like about Parnate?
Parnate keeps me normothymic steadily. Nardil seems to foster a hyperthymic temperament or a more unstable acute hypomania. These mental states can be exciting, but not very realistic. I feel "cleaner" and can function better with Parnate. I feel more grounded and better able to construct a life with Parnate than I do with Nardil. Of course, others will describe different scenarios with these two drugs. Some people will fail to respond to Parnate whom will respond to Nardil.
- Scott
Posted by stargazer2 on January 1, 2014, at 12:20:16
In reply to Re: Does anyone take Latuda for depression? » Bob, posted by SLS on December 14, 2013, at 17:56:37
Yes, I think it has been about a week now and I do believe it is helping my suicidal depression.
I'm on 20 mg only, split the pill...in addition take 75 mg Nardil and 900 Lithium.
Star
Posted by SLS on January 1, 2014, at 13:12:03
In reply to Re: Does anyone take Latuda for depression?YES, posted by stargazer2 on January 1, 2014, at 12:20:16
> Yes, I think it has been about a week now and I do believe it is helping my suicidal depression.
> I'm on 20 mg only, split the pill...in addition take 75 mg Nardil and 900 Lithium.
> StarHi Star.
Thanks for chiming in. Your input is greatly appreciated and extremely valuable. I might try Latuda in a month or two. I will probably take your lead and start at 20 mg/day.
Do you find Latuda at all energizing?
Thanks in advance.
- Scott
Posted by Phillipa on January 1, 2014, at 20:10:04
In reply to Re: Does anyone take Latuda for depression?YES » stargazer2, posted by SLS on January 1, 2014, at 13:12:03
Scott are you switching out abilify? PJ
Posted by stargazer2 on January 1, 2014, at 20:10:46
In reply to Re: Does anyone take Latuda for depression?YES » stargazer2, posted by SLS on January 1, 2014, at 13:12:03
I find Latuda not so much energizing, although I have made it to the gym more than normally, but it
has reduced my depressive symptoms to the point where my affect is less internally focused and more externally focused, which for me is critical. As it is my constant self examination that causes my symptoms of depression to become ruminative and paralyzing, resulting in suicidality.I would never have thought it would have done anything as MAO's have been the only meds that have worked to some degree for me, although lately MAOS have not worked to the degree they did years ago as monotherapy. Abilify didn't really make a difference at a low dose and the cost was prohititive. I have no idea of the cost of Latuda yet. I have samples from my doc to try out so still in the trial phase.
I'll keep posting for others to see my response. I also am scheuled to receive low flow magnetic stim in the next few weeks so that will be another attempt to normalize my life but I'm seeing a good response with Latuda at the 8 day point.
Star
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.