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Dr. Bob is Robert Hsiung, MD,
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Posted by phidippus on April 25, 2016, at 12:45:35
In reply to Re: Vraylar (Cariprazine) » phidippus, posted by MuseMemento on April 25, 2016, at 10:36:09
I have ADHD, OCD and Bipolar disorders. Hopefully Vraylar will augment my Lithium and Mirtazapine and benefit my mood and anxiety.
Eric
Posted by MuseMemento on April 25, 2016, at 16:15:56
In reply to Re: Vraylar (Cariprazine) » MuseMemento, posted by phidippus on April 25, 2016, at 12:45:35
Thanks! I absolutely hope so, too!
Posted by crabcakebenny on April 25, 2016, at 19:46:27
In reply to Re: Vraylar (Cariprazine) » phidippus, posted by MuseMemento on April 25, 2016, at 10:36:09
How does Vraylar fare on the EPS/Tardive Dyskinesia side of things? I had akathisia real bad on Abilify and Latuda, do not want to repeat that experience again.
Posted by phidippus on April 25, 2016, at 20:15:13
In reply to Re: Vraylar (Cariprazine), posted by crabcakebenny on April 25, 2016, at 19:46:27
Ive experienced no EPS so far on the Vraylar at 6 mg.
Eric
Posted by phidippus on April 27, 2016, at 1:24:57
In reply to Re: Vraylar (Cariprazine) » phidippus, posted by MuseMemento on April 25, 2016, at 16:15:56
Much of my depressive symptoms have abated and my libido is returning. Day 4.
Eric
Posted by MuseMemento on April 27, 2016, at 9:44:41
In reply to Re: Vraylar (Cariprazine) » MuseMemento, posted by phidippus on April 27, 2016, at 1:24:57
Awesome! Keep up the good work!
Posted by SLS on May 5, 2016, at 8:19:45
In reply to Vraylar (Cariprazine), posted by phidippus on April 24, 2016, at 3:10:52
Hi Eric.
What's up with Vraylar?
Are you less satisfied with Vraylar as time progresses?
I have been taking 3.0 mg/day of Vraylar for 4 days. So far, I don't like how I feel. I feel drugged up, a tad dysphoric, and somewhat slowed-down. Of course, I am hoping that these are startup side effects that will disappear with continued treatment. I am still taking Abilify 10 mg/day, but plan to reduce it starting tomorrow.
I was very encouraged by your description of the effects Vraylar had on you after 4 days. I was looking forward to a more potent antidepressant effect than is seen with Abilify. I also liked your report of feeling less drugged on Vraylar.
Rexulti (brexpiprazole) offers an alternative. It may be that I was in error thinking that Vraylar would be more effective than Rexulti, simply because I liked the differences in the D3/D2 ratio of binding affinities. I think my doctor prefers Rexulti to Vraylar for depression, but I expressed a desire to try Vraylar first.
* I just got done speaking with my doctor. I described my experience with the addition of Vraylar. He said that I should reduce the dosage of Abilify from 10 mg/day to 5 mg/day. Let's hope that this works.
I wish for us both nothing but good things from Vraylar.
- Scott
Posted by phidippus on May 5, 2016, at 19:15:35
In reply to Re: Vraylar (Cariprazine), posted by SLS on May 5, 2016, at 8:19:45
Scott,
The Vraylar is working out just fine.
It was as if a wet blanket were lifted from me when I switched to Vraylar from Abilify. My emotions are brighter and cognitive functioning is improved.
I never felt drugged up or dysphoric when starting the Vraylar-much of the improvements I experienced were in the first few days.
What's the max dose of Vraylar? I'm at 6 mg right now.
Eric
Posted by SLS on May 5, 2016, at 22:27:08
In reply to Re: Vraylar (Cariprazine) » SLS, posted by phidippus on May 5, 2016, at 19:15:35
Hi Eric.
Thanks for replying.
> The Vraylar is working out just fine.
Woohoo! I'm glad that you found some magic in those pills.
:-)
> It was as if a wet blanket were lifted from me when I switched to Vraylar from Abilify. My emotions are brighter and cognitive functioning is improved.
I can imagine how that must feel. I haven't been there in a very long time, but I remember the feeling well.
> I never felt drugged up or dysphoric when starting the Vraylar-much of the improvements I experienced were in the first few days.
What dosage did you start at? It can take several weeks to reach steady-state. It takes time for Vraylar to build up in the body. It is very much like Prozac in this regard. The combined half-life of Vraylar and its active metabolites is 1-3 weeks. Perhaps you have effectively used 6 mg/day as a loading dose. At some point, you may find it necessary to reduce the dosage to 3.0 mg/day. Of course, if it ain't broke, don't fix it.
> What's the max dose of Vraylar? I'm at 6 mg right now.
6 mg/day is considered the maximum for Vraylar. This is equivalent to approximately 20 mg/day of Abilify. However, clinical trials tested dosages as high as 12 mg/day.
I have been waiting for Vraylar for quite awhile. The FDA first denied Forest/Alergan approval of their compound because they were not happy with the lack of data regarding dosing recommendations. This delayed approval by 2 years.
- Scott
Posted by phidippus on May 6, 2016, at 2:08:53
In reply to Re: Vraylar (Cariprazine) » phidippus, posted by SLS on May 5, 2016, at 22:27:08
Scott,
> Woohoo! I'm glad that you found some magic in those pills.
Its called science!
> What dosage did you start at?
I started at 3 mg.
>you have effectively used 6 mg/day as a loading dose.
I was on 3 mg for a week before titrating to 6 mg.
> 6 mg/day is considered the maximum for Vraylar. This is equivalent to approximately 20 mg/day of Abilify.
I dont care for equivalencies ;)
Eric
Posted by SLS on May 7, 2016, at 10:29:21
In reply to Re: Vraylar (Cariprazine) » SLS, posted by phidippus on May 6, 2016, at 2:08:53
I had to stop taking Vraylar. The "drugged-up" feeling has become worse, not better. It reminds me of the old antipsychotics. In addition, I developed significant dysphoria and a worsening of depression, including slowed thinking, slowed speech, memory recall impairments, loss of interest and motivation, and more anhedonia. If I'm lucky, I will feel better within 7 days. Vraylar has a half-life of 2-4 days, but the two active metabolites have half-lives of 1-3 weeks.
I hope you continue to do well with Vraylar.
- Scott
Posted by phidippus on May 7, 2016, at 21:41:14
In reply to Re: Vraylar (Cariprazine) » phidippus, posted by SLS on May 7, 2016, at 10:29:21
I don't think its the Vraylar causing the dysphoria-I believe its your withdrawal from Abilify. This has happened in the past, where you tried to get off the Abilify and were left dysphoric.
Eric
Posted by SLS on May 8, 2016, at 3:50:23
In reply to Re: Vraylar (Cariprazine) » SLS, posted by phidippus on May 7, 2016, at 21:41:14
Hi Eric.
I never stopped taking nor reduced the dosage of Abilify. However, your conclusion is logical. I began to deteriorate before calling my doctor and receiving his advice to reduce the Abilify. That is information I did not provide you with. Thankfully, I am beginning to feel better after two days without Vraylar. I am very disappointed that my reaction to Vraylar was not identical to yours. I'll give Abilify more time before possibly switching to Rexulti (brexpiprazole). My guess is that my current treatment would take a year or more to bring me to a state of near-remission. I might become employable before that, though. I can be patient as long as I am convinced that I am on the right stuff at the right dosages, and that there aren't any better alternatives available in my case. We shall see what new treatments emerge in the future.
- Scott
Posted by uncouth on May 9, 2016, at 0:10:05
In reply to Re: Vraylar (Cariprazine) » phidippus, posted by SLS on May 8, 2016, at 3:50:23
I have been taking Vraylar for a little over two weeks. Most of that time was at 1.5mg, the last two days have been 3.0. I am hoping to improve abilify's response but without the weight gain and appetite increase. Abilify always would work within a few days, 1-3, I would feel a dramatic difference in the depression. I had been off of Abilify for 1-2 weeks after 1 week on it, before I switched to Vraylar. So far, couldn't feel much at 1.5mg. Hopefully 3.0mg kicks in. I am unfortunately also transitioning from desipramine to strattera (which I have been on before) at the same time so there will be confounding data.
I would say so far, Vraylar is not superior to abilify, but unclear that it is much worse as my mood is relatively stable, though I was hoping for some differential efficacy with respect to the d3 partial agonism. I have not seen any benefit with respect to craving aspects or addivtive/obsessive behaviors, if anything they have worsened, but again I am also transitioning.
Crossing fingers vraylar kicks in soon and perhaps it just may need to build up given its absurdly long half life.
Posted by uncouth on May 9, 2016, at 0:12:33
In reply to Re: Vraylar (Cariprazine), posted by uncouth on May 9, 2016, at 0:10:05
Also I will mention I am not as mentally stimulated...i'm not getting the creative ideation and motivation I usually get when I start on a dopamine agonist like drug or abilify. If anything thus far feel a bit amotivated and slowed down as to echo Scott. Hopefully things upregulate soon.
Posted by SLS on May 9, 2016, at 6:53:34
In reply to Re: Vraylar (Cariprazine), posted by uncouth on May 9, 2016, at 0:10:05
> Crossing fingers vraylar kicks in soon and perhaps it just may need to build up given its absurdly long half life.
Absolutely. Vraylar takes 1-2 weeks for any one dosage to reach equilibrium. Still, I started to feel worse after 3 days at 3.0 mg/day.
- Scott
Posted by SLS on May 9, 2016, at 7:14:25
In reply to Re: Vraylar (Cariprazine), posted by uncouth on May 9, 2016, at 0:12:33
> Also I will mention I am not as mentally stimulated...i'm not getting the creative ideation and motivation I usually get when I start on a dopamine agonist like drug or abilify. If anything thus far feel a bit amotivated and slowed down as to echo Scott. Hopefully things upregulate soon.
It would be difficult for me to draw any comparisons between what you are feeling now with what I felt during week 1. If dysphoria were to emerge, I would then seriously consider aborting the trial. Otherwise, what you feel might be startup side effects that soon will disappear.
I am going to ask my doctor about using Reluxti (brexpiprazole) to treat me. Although it is a sister drug to Abilify, it is skewed more towards binding to D2 than D3 receptors compared to Abilify. Who knows? Reluxti might work well despite what we think about the role of D3 receptors in depression. It may be that the target should be D2 receptors in the striatum and prefrontal cortex rather than D3 receptors in the shell of the nucleus accumbens.
Good luck!
- Scott
Posted by Uncouth on May 18, 2016, at 22:08:25
In reply to Re: Vraylar (Cariprazine) » uncouth, posted by SLS on May 9, 2016, at 7:14:25
Anyone have any updates to share on vraylar?
Posted by phidippus on May 18, 2016, at 22:24:11
In reply to Re: Vraylar (Cariprazine), posted by Uncouth on May 18, 2016, at 22:08:25
Im on my 4th week of Vraylar. My mood has brightened and my cognition remains improved.
Eric
Posted by SLS on May 19, 2016, at 5:21:25
In reply to Re: Vraylar (Cariprazine) » Uncouth, posted by phidippus on May 18, 2016, at 22:24:11
> Im on my 4th week of Vraylar. My mood has brightened and my cognition remains improved.
>
> EricAre you satisfied with your current treatment regime, or do you feel the need to change it?
As you may know, I had a terrible reaction to Vraylar. It exacerbated my depressive symptoms and added to them dysphoria and feelings of cognitive blunting that reminded me of Thorazine or Prolixen. I felt very "drugged-up". This will not, however, prevent me from trying Reluxti. Although it is a sister drug to Abilify, I think its pharmacology is different enough to warrant a trial. It may be that my D3 receptors don't need tweaking. My only concern with Reluxti is that it might act as a NE alpha-2a receptor antagonist, which usually makes me feel worse. Only alpha-2d is listed, though.
- Scott
Posted by phidippus on May 19, 2016, at 13:58:36
In reply to Re: Vraylar (Cariprazine) » phidippus, posted by SLS on May 19, 2016, at 5:21:25
Im very happy with my regimen and see no need to change it at this point.
Lithium 900
Mirtazapine 30 mg
Vraylar 6 mg
Vyvanse 70mg
Ropinirole ER 20 mgEric
Posted by MuseMemento on May 19, 2016, at 14:44:48
In reply to Re: Vraylar (Cariprazine) » SLS, posted by phidippus on May 19, 2016, at 13:58:36
What role does the Ropinirole play in your regimen?
Thanks
Posted by phidippus on May 19, 2016, at 16:29:07
In reply to Re: Vraylar (Cariprazine) » phidippus, posted by MuseMemento on May 19, 2016, at 14:44:48
I have HSDD and the ropinirole Ive been using as a libido enhancer.
Eric
Posted by babbler20 on May 22, 2016, at 21:56:20
In reply to Re: Vraylar (Cariprazine), posted by SLS on May 5, 2016, at 8:19:45
> Hi Eric.
>
> What's up with Vraylar?
>
> Are you less satisfied with Vraylar as time progresses?
>
> I have been taking 3.0 mg/day of Vraylar for 4 days. So far, I don't like how I feel. I feel drugged up, a tad dysphoric, and somewhat slowed-down. Of course, I am hoping that these are startup side effects that will disappear with continued treatment. I am still taking Abilify 10 mg/day, but plan to reduce it starting tomorrow.
>
> I was very encouraged by your description of the effects Vraylar had on you after 4 days. I was looking forward to a more potent antidepressant effect than is seen with Abilify. I also liked your report of feeling less drugged on Vraylar.
>
> Rexulti (brexpiprazole) offers an alternative. It may be that I was in error thinking that Vraylar would be more effective than Rexulti, simply because I liked the differences in the D3/D2 ratio of binding affinities. I think my doctor prefers Rexulti to Vraylar for depression, but I expressed a desire to try Vraylar first.
>
> * I just got done speaking with my doctor. I described my experience with the addition of Vraylar. He said that I should reduce the dosage of Abilify from 10 mg/day to 5 mg/day. Let's hope that this works.
>
> I wish for us both nothing but good things from Vraylar.
>
>
> - Scott
>
Posted by phidippus on May 23, 2016, at 8:35:50
In reply to Re: Vraylar (Cariprazine), posted by babbler20 on May 22, 2016, at 21:56:20
I think we already knew a lot of this.
Eric
This is the end of the thread.
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