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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 30 to 54 of 164. Go back in thread:
Posted by andys on January 20, 2003, at 14:52:32
In reply to Re:sleep and physical anxiety, posted by Vanidosa on January 20, 2003, at 9:47:01
I just quit abilify after 4 weeks, because the insomnia just got worse and worse, down to 4 hours a night. I have done lots of reaearch on abilify, which I have cut and pasted into a document, which I can send to you if you ask: andys@gotnet.net. But don't ask for it unless you're really serious, I've been really low energy lately. Also for the real "techies", I have an article called "dopamine system stabilizers" which goes into the philosophy behind this new class of meds, that abilify has started.
Remember, keep requests to a minimum, but glad to do it for those really in need. Thanks.
Posted by River1924 on January 20, 2003, at 17:25:36
In reply to Re:sleep and physical anxiety, posted by andys on January 20, 2003, at 14:52:32
I'm trying a low dose (7.5mg) every other day. (It has a half-life of about 3 or 4 days.) I stopped my SSRI and TCA in case I was getting too much serotonin. (That can cause restlessness.) Wish me luck. Abilify has good qualities. River.
Posted by Vanidosa on January 22, 2003, at 19:00:56
In reply to Re: Abilify, posted by sebastian on January 20, 2003, at 12:50:39
Sebastian & Andy,
Thanks so much for the info. It makes me feel better to know that other people have experienced the same thing with abilify. My doctor had told me that it's very rare for people to have those side effects. It helps to hear what you guys have to say. Thanks a lot.
Vanidosa
Posted by ShelliR on January 22, 2003, at 21:17:06
In reply to Re: Abilify, posted by Vanidosa on January 22, 2003, at 19:00:56
I quit both abilify and lexapro because one was making me feel so shakey inside. It's been two weeks since lexapro and over a week since abilify and today was the first day with considerably less shaking. (more like hard to stay inside my skin type symptom). I was starting to think it didn't have to do with the drugs, but it was unusual for me to feel like this. I'm curious how long it will take for your symptoms to go away. I think abilify must have a long half life.
Shelli
Posted by andys on January 23, 2003, at 6:19:05
In reply to Re: Abilify » Vanidosa , posted by ShelliR on January 22, 2003, at 21:17:06
Yes, Abilify has a HUGE half-life. It's over 70 hours! (I don't have the energy to look it up right now, but I believe it's 76 hours). I just quit it, due to side effects, and am getting side effects 2 days later (to be expected). I assume it's going to take 4-5 days for the side effects to calm down. Hang in there...
Posted by River1924 on January 23, 2003, at 6:59:33
In reply to Re: Abilify » ShelliR, posted by andys on January 23, 2003, at 6:19:05
Akathisia: the desire to move and inner restlessness as a side-effect of psychotropic drugs. (In my case, the inability on abilify to sit still and read more than 2 pages of a book.)
Abilify's ability to cause restlessness (and it seemed to get worse after a few weeks) has made me give up on it.
Plus, I've gained 10 lbs at the same time without eating more. Ug.
Posted by Surly on January 23, 2003, at 12:46:49
In reply to Re: Abilify: I give up (for now), posted by River1924 on January 23, 2003, at 6:59:33
Did anybody notice that their muscles were tired and sore? I too gained a few pounds, even though i work out regularly (5 days a week). My workouts suffered drastically because my muscles hurt so bad.
Posted by sebastian on January 24, 2003, at 14:57:37
In reply to Re: Abilify » ShelliR, posted by andys on January 23, 2003, at 6:19:05
It took me a little over 2 weeks for the Abilify side effects to go away, mainly the anxiety.
Sebastian
Posted by ShelliR on January 24, 2003, at 15:43:34
In reply to Re: Abilify, posted by sebastian on January 24, 2003, at 14:57:37
> It took me a little over 2 weeks for the Abilify side effects to go away, mainly the anxiety.
>
> SebastianWas it anxiety, or was it an internal shakiness? Did it all stop? What are the positive effects of abilify for you?
Shelli
Posted by River1924 on January 24, 2003, at 19:54:17
In reply to Re: Abilify » sebastian, posted by ShelliR on January 24, 2003, at 15:43:34
Although your message was directed to sebastian, I want to point out some of Abilify's positive benefits for me (even though I stopped it due to the really annoying almost painful restlessness(akathisia) ...plus some weight gain.)
I don't have schizophrenia but my anxiety and depression manifests like the negative symptoms of schizophrenia ...negative symptoms in schizophrenia are affective flattening (blahness, boredom, lack of emotional response to situations), alogia (difficulty putting words together, muteness), apathy, avolition (lack of interest or motivation (in my case, that includes sex)), social withdrawal, and underachievement.
Abilify really helped all those things. Each of the negative symptoms has its opposite and those good qualities manifested to some degree (in only 4 weeks!) I was quite a different person.
So, ultimately, I'm very disappointed now that I have to stop.
Posted by ShelliR on January 24, 2003, at 20:22:53
In reply to Re: Abilify, posted by River1924 on January 24, 2003, at 19:54:17
I'm sorry; it must be such a disappointment. Valium didn't help with me, so I don't suppose mixing it with an anti-anxiety drug would do much good.
Shelli
Posted by 1313 on January 24, 2003, at 22:23:30
In reply to Re: Abilify » River1924, posted by ShelliR on January 24, 2003, at 20:22:53
this is my fouth week on abilify and we have just lowerd the dose to 10mgs today I don't know anyone else to talk to but when I lay down to sleep I can feel my heartbeat. It makes it very hard to fall asleep. It is 11:00pm. At 10:00 I was exausted because I did not sleep the night before but now I can't rest. I tried ativan last night... it didn't help. I know there is a long half-life to abilify so I am going to wait four days to judge the new dose. sometimes I feel anxious but other times I feel calm. I hope the calm will primarily prevail on 10 mg. Is there anybody out there on 10mg what is it like for you?is anyone GLAD they are on abilify???!!!
thank you for your response!!!!
Posted by andys on January 25, 2003, at 5:49:47
In reply to Re:abilify, posted by 1313 on January 24, 2003, at 22:23:30
We can see a pattern emerging from these postings. I too had intolerable insomnia, which, combined with sedation and restlessness, made me quit, after 4 weeks at only 1/2 pill (7.5 mg.). But I wanted to warn you insomniacs, that although zyprexa and seroquel would help sleep immenseley, they shouldn't be taken with abilify. Since all three have strong Dopamine D2 antagonism, they really shouldn't be used together. Just a reminder.
Posted by 1313 on January 25, 2003, at 7:19:40
In reply to Re:abilify » 1313, posted by andys on January 25, 2003, at 5:49:47
HI! Andy so far i have no akathesia and am sleeping 6 hours per night. on zyprexa I was sleeping 12 hours a night and didn't want to wake up. now I am up without an alarm clock! My problem is by 2:00 I am exhausted and I become increasingly anxious so I cant drive...my problem isnt exactly sleeping but my intense fear that feeling my heartbeat is not a good thing!which keeps me awake till i do or dont fall asleep!
Posted by angeliz02 on January 25, 2003, at 8:22:09
In reply to Re: Abilify, posted by River1924 on January 24, 2003, at 19:54:17
My 16 year old son was put on abilify 4 days ago for to control rages. I have noticed several mentioning insomnia. When did that start? He is sleeping alot more than he use to and seems to get wore out much faster. He takes 7.5mg a day. He has been on several meds including the zyprexa which made him much worse and seroquel which worked for a while.
Posted by River1924 on January 25, 2003, at 10:35:31
In reply to Re:abilify, posted by 1313 on January 25, 2003, at 7:19:40
Although abilify has a long half-life, maybe it might make a difference what time a day you take the med. Maybe there is an unknown short acting metabolite. I'm just talking out the top of my head.
I don't tolerate benadryl but for most people, it helps people with side-effects (according to my doctor.)
Posted by ShelliR on January 25, 2003, at 13:41:10
In reply to Re:abilify » 1313, posted by River1924 on January 25, 2003, at 10:35:31
> Although abilify has a long half-life, maybe it might make a difference what time a day you take the med. Maybe there is an unknown short acting metabolite. I'm just talking out the top of my head.
>
> I don't tolerate benadryl but for most people, it helps people with side-effects (according to my doctor.)
I can't tolerate benadryl either, but it never occurred to me to try abilify with aterex, a similar antihistimine type prescription without benedryl's side effects.
Posted by andys on January 25, 2003, at 14:15:40
In reply to Re:abilify » 1313, posted by River1924 on January 25, 2003, at 10:35:31
I tried taking it at all different times of the day, with no help. But with a 76 hour half-life, it makes sense that time of day wouldn't matter.
Posted by sebastian on January 25, 2003, at 18:34:23
In reply to Re: Abilify » sebastian, posted by ShelliR on January 24, 2003, at 15:43:34
ShelliR
I stoped taking the Abilify and went back the Zyprexa, the anxiety and other effects took over 2 weeks to go away.
Sebastian
Posted by 1313 on January 25, 2003, at 18:48:16
In reply to Re: Abilify » ShelliR, posted by sebastian on January 25, 2003, at 18:34:23
sebastian,
How long did you stay on Abilify before you switched back to Zyprexa?
deb 1313
Posted by River1924 on January 25, 2003, at 21:18:18
In reply to Re: Abilify (sebastian), posted by 1313 on January 25, 2003, at 18:48:16
Found this on the web...
"Potential Problem with Akathisia
According to Larry Ereshefsky, Pharm.D., professor of pharmacy, pharmacology and psychiatry at the University of Texas Health Science Center at San Antonio, the novel partial dopamine agonist mechanism of action augments the 5-HT1a and 5-HT2 effects of aripiprazole."These effects should lead to greater dopaminergic throughput and cortical activity which is good for thinking," says Ereshefsky. "But it also might possibly explain the increased rates of akathisia at [the] middle doses (15 mg/d) in some studies. There is clearly a greater effect on the Barnes akathisia scale than [from] risperidone, and about half the effect of haloperidol."
Ereshefsy adds, "Akathisia is a potential side effect which bares further evaluation in long-term studies to see whether it abates."
Posted by River1924 on January 25, 2003, at 21:31:53
In reply to Re: Abilify and akathisia, posted by River1924 on January 25, 2003, at 21:18:18
http://www.ascp.com/public/pubs/cc/1998/supp4a.shtml
Akathisia
Akathisia may appear within the first few hours of antipsychotic initiation, but usually takes two to three days (and sometimes weeks) to appear and can resolve spontaneously. Akathisia is defined as a feeling of motor restlessness and strong urge to move around. Patients present with agitation, in-creased aggression, jitteriness, in-ability to sit still, tapping of feet, rocking, and sometimes insomnia. Signs and symptoms may resemble dyskinesias (impairment of voluntary movement resulting in incomplete movements), Hunt- ington’s chorea (a hereditary disease characterized by ceaseless occurrence of a variety of rapid, highly complex jerky movements that appear well coordinated but are involuntary and accompanied by mental deterioration), or worsening of psychotic conditions, making diagnosis difficult. Often this may result in an inappropriate increase in the antipsychotic dose, worsening the adverse effect. Illicit drug use, caffeine, and other stimulants may exacerbate akathisia. Iron deficiency may also be associated with akathisia.
Treatment for Akathisia
Although akathisia may resolve spontaneously, it may impede treatment progress and lead to noncompliance, suicidal or assaultive ide-ation, and worsening of psychotic symptoms. If appropriate for the patient, lowering the dose of the causative agent will usually be effective. Other treatment options include anticholinergic agents, benzodiazepines, amantadine, and propranolol. Switching to a low potency or atypical antipsychotic agent is an important option in refractory cases. Anticholinergics, amantadine, and diphenhydramine appear to be less effective in the treatment of akathisia than for other extrapyramidal side effects.
Lipophilic beta-blockers (propranolol, metoprolol, etc.) are more effective in treating akathisia than are benzodiazepines. Since beta-blockers work on the adrenergic system and the effect of the benzodiazepines is mediated through the inhibitory neurotransmitter gamma-aminobutyric acid, their efficacy supports the theory that neurotransmitter systems other than dopamine or acetylcholine are involved in akathisia.
Posted by JohnX2 on January 26, 2003, at 0:53:03
In reply to Re: Abilify and akathisia, posted by River1924 on January 25, 2003, at 21:18:18
Does the potential for akathisia get worse over
15 mg/d?I have been taking this medicine just short of 2 weeks 20 mg/d. The medicine takes 2 weeks to build up in your system.
I get this funny response where I feel akathisia for about 4 hours after a dosing and then it goes away. I seems odd to me because the medicine has such a long 1/2 life (like 90 hrs)?
J
> Found this on the web...
>
> "Potential Problem with Akathisia
> According to Larry Ereshefsky, Pharm.D., professor of pharmacy, pharmacology and psychiatry at the University of Texas Health Science Center at San Antonio, the novel partial dopamine agonist mechanism of action augments the 5-HT1a and 5-HT2 effects of aripiprazole.
>
> "These effects should lead to greater dopaminergic throughput and cortical activity which is good for thinking," says Ereshefsky. "But it also might possibly explain the increased rates of akathisia at [the] middle doses (15 mg/d) in some studies. There is clearly a greater effect on the Barnes akathisia scale than [from] risperidone, and about half the effect of haloperidol."
>
> Ereshefsy adds, "Akathisia is a potential side effect which bares further evaluation in long-term studies to see whether it abates."
Posted by 1313 on January 26, 2003, at 8:10:42
In reply to Re: Abilify and akathisia, posted by JohnX2 on January 26, 2003, at 0:53:03
My doctor asked me to give abilify 6 weeks. I am on week four and two days most of the side effects have gone away. I do not have akathesia. My main concern is my HEART! I feel a tenderness and soreness on the skin above it and at night I can feel my heart beat.This makes it hard to fall asleep. I think my nights and and gym workouts would be better if I could prove to myself I was not at risk! To this end I am going to see my regular doctor and ask if it is necessary to see a cardiologist. I hope he will understand. I had an ekg recently and it came back with good results. Maybe I am carrying my stress in a new place! did anyone else feel this way?!
Posted by River1924 on January 26, 2003, at 9:16:06
In reply to Re: Abilify, posted by 1313 on January 26, 2003, at 8:10:42
Although I'd guess abilify is throwing off your whole system right now (giving a version of panic attacks), it wouldn't hurt to see someone who specializes in cardiology. Maybe take a stress test. It is such a new med. Who knows what it does outside clinical studies???
As for me, my pdoc convinced me to keep going on it...at a tiny dose. Hopefully, I can get him to subscribe a beta-blocker for awhile.On the web:
"Beta blockers.
(B2 blockers). These are the most useful group of drugs in the treatment of akathisia. The mechanism is thought to be antagonism of the adrenergic system which is overactive due to neuroleptic blockade of presynaptic dopamine receptors. The initial use of propranalol is suggested, starting at 10mg three times a day and increasing every few days to a maximum of 90-120 mg. The onset of action is usually fairly rapid (4-40 hours) and it is well tolerated.
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