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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by MuseMemento on April 20, 2016, at 14:29:46
Hi, all. I'm returning to Abilify after a few months off of it and I'm wondering if I can return to my previous dose quicker than initial titration would suggest or if I should still allow two weeks between my starting and final dose. My therapeutic dose in October was 20 mg and that's the dose that I'm aiming for again. I've been on 10 mg for three days now and, according to everything I've seen, should wait two weeks to titrate up. Any thoughts?
Also, I've had a bit of a different response to it than when I was using it before. I always took it in the morning previously but when I tried that first, it made me sleepy and lethargic. If I take it at night, it delays my falling asleep. Is this a passing phase of adjustment to the drug again? Thanks, all.
Posted by SLS on April 20, 2016, at 17:15:34
In reply to Returning to Abilify...quick titration?, posted by MuseMemento on April 20, 2016, at 14:29:46
The half-life of Abilify is quite long. It takes awhile for blood levels to build up at any one dosage. In my experience, you can bring up the dosage up quickly. In fact, I started taking 20 mg/day beginning from the very first day. To be more conservative can't hurt. You should be able to go from 10 mg/day to 15 mg/day now and then to 20 mg/day after 3 days. You may have to go slower if akathisia has been a problem in the past.
Why did you discontinue Abilify?
- Scott
Posted by MuseMemento on April 20, 2016, at 17:50:00
In reply to Re: Returning to Abilify...quick titration? » MuseMemento, posted by SLS on April 20, 2016, at 17:15:34
I discontinued it because of weight gain and, foolishly, convincing myself that I didn't need it. It surprisingly took several months to convince me otherwise. Akathisia has been a problem but the sooner it takes effect, the less it will bother me, I'm sure. Thank you so much. Now to determine when to take it.
Posted by Christ_empowered on April 20, 2016, at 19:42:10
In reply to Re: Returning to Abilify...quick titration? » SLS, posted by MuseMemento on April 20, 2016, at 17:50:00
hey. SLS is right on, as always. My former shrink put me on 20 from day one, with some other stuff...
some of what people think/assume is akathisia from abilify isn't akathisia; its some kind of weird tranquilization mixed with activation. My former shrink said it happened less at higher doses.
Good luck, and please keep us all posted on your progress.
Posted by MuseMemento on April 20, 2016, at 20:05:30
In reply to Re: Returning to Abilify...quick titration?, posted by Christ_empowered on April 20, 2016, at 19:42:10
Thanks so much and that's an interesting take on the perceived akathisia! I think I'll try raising it tomorrow. Thanks again!
Posted by SLS on April 21, 2016, at 0:06:31
In reply to Re: Returning to Abilify...quick titration? » Christ_empowered, posted by MuseMemento on April 20, 2016, at 20:05:30
> Thanks so much and that's an interesting take on the perceived akathisia! I think I'll try raising it tomorrow. Thanks again!
Good luck!
- Scott
Posted by SLS on April 21, 2016, at 0:08:06
In reply to Re: Returning to Abilify...quick titration?, posted by Christ_empowered on April 20, 2016, at 19:42:10
> My former shrink said it happened less at higher doses.
That's very interesting. I had never heard that before.
Thanks.
- Scott
Posted by MuseMemento on April 21, 2016, at 11:17:11
In reply to Re: Returning to Abilify...quick titration? » MuseMemento, posted by SLS on April 21, 2016, at 0:06:31
While I have your attention, how does dosing of abilify affect its properties? I've read that it's more of a dopamine system stabilizer than a true antipsychotic. Does this mean that dopamine activity is more stable at higher doses? Is it a more refined function at higher doses and, therefore, higher doses are needed for psychotic disorders because they presumably have a greater degree of dysfunction with respect to dopamine?
Thanks
Posted by Christ_empowered on April 21, 2016, at 15:09:44
In reply to Returning to Abilify...quick titration?, posted by MuseMemento on April 20, 2016, at 14:29:46
From what I understand...
Low doses are useful in kids and teenagers, and also for milder "issues" in adults. Most people don't achieve control over more serious problems until you hit about 10mgs/day. 15mgs/day was, once upon a time, the standard (and starting) dose. I dunno what it is now...
My former shrinks says lower doses are more stimulating. The stimulating effect is reduced as you go up on dosage. 30mgs is the biggest tablet made and usually the highest daily dose. This is the target dose for mania and I think acute probs with schizophrenia (maybe not...).
To me, 30mgs/day Abilify is...well, its a very tolerable neuroleptic that doesn't make my depression worse or more frequent and doesn't have the side effects of many other options. If I remember correctly, 30mgs/day Abilify is = about 400mgs/Thorazine, 8mgs/Haldol...without the dreadful side effects of both those 2, older meds and many other "atypical" options.
I dunno what's up with low dose Abilify for adults w/MDD. Back in the day, some depressive epsidoes were treated, at least in part, with the older neuroleptics, but side effects and later TD lawsuits made that less common.
When I was on 20mgs/Abilify, I had an easier time of things than off of it. I'm on 30 because I later tapered to 15, freaked out, and doubled the dose...and I'm still on it, lol.
I don't know about this "dopamine stabilizer" business. Abilify takes over D2 receptors and can stimulate them a bit, so EPS and (hopefully) TD are less of an issue. Abilify is farily high potency; if I remember correctly, 30mgs/day occupies over 90% d2 receptors. Usually, once you hit 80ish%, EPS starts kicking in...with abilify, the partial agonism at d2 receptors keeps EPS low (on the aggregate level; individual results may vary).
And...that's about all I know. Abilify is much more tolerable (for me and a lot of other people) than many other options. No probs with prolactin, cardiovascular stuff, heavy sedation, less EPS, less dysphoria, less cognitive blunting.
It is, however, still a neuroleptic. TD is still a very real risk, for instance. I take b vitamins and antioxidants to reduce my TD risk, personally (the orthomolecular people say it helps...so far, so good).
Hope this helps.
Posted by MuseMemento on April 22, 2016, at 10:23:01
In reply to Re: Returning to Abilify...quick titration?, posted by Christ_empowered on April 21, 2016, at 15:09:44
Thank you! I appreciate it very much! Any information is valuable information as far as I' concerned.
This is the end of the thread.
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