Posted by med_empowered on September 13, 2005, at 14:52:52
In reply to Re: Zyprexa 10mg - why does it help me so much?, posted by Sebastian on September 13, 2005, at 11:56:48
hi! I *hated* zyprexa, but I really like (very low dose) Abilify, and I wish I could find a doc who would do it prn (for some reason, Zyprexa is *the* antipsychotic of choice for prn use; no one really seems to understand Abilify well enough to recommend it for such uses). Anyway, although the two meds work differently, I noticed a lot of the same things you all have been talking about...its simply amazing. When I started low-dose (5-7.5mgs) Abilify, I was already on Trileptal and Celexa and Klonopin; still, I was so incredibly anxious that I could barely leave my apartment. I had spirit-crushing anxiety and agitation, and depression with lots of "labile moods"--basically, I was a walking talking nervous breakdown. Anyway, within a couple doses, I could suddenly walk outside and feel...good. Not OK, not better, but flat out, truly *GOOD*. It was amazing. The longer I took the Abilify, and the higher the dosage got (my shrink at the time ramped it up to 30mgs thinking it would control moods and adding more would help with anxiety; it really just screwed everything up). Antipsychotics have been used for these kind of problems for a long time; check out the PDR, and you'll see dosing recommendations for things like Stelazine and Mellaril for anxiety and what not. My guess is that since today's antipsychotics block D2 receptors less intensely, and also block off serotonin and sometimes have antidepressant actions as well (Geodon, for instance, inhibits the reuptake of serotonin, so its kind of a Prozac and antipsychotic combo in one), you can get an immediate anti-anxiety, truly tranquilizing effect without too much cognitive impairment...they also usually don't cause EPS or induce depression (the old drugs were notorious for pushing bipolars into depression). From what I've read, it seems that until about 1964, docs thought Thorazine and other antipsychotics that were around then worked on schizophrenia primarily through some sort of unusual sedation; keep in mind that before Thorazine was used as an anti-psychotic, it was used as a pre-operative sedative...the docs who used it noticed that, at low doses, patients felt a sense of intense calm and contentment that lingered for a couple days. It was then used on schizophrenics. One reason it caused so many problems was probably dosage; used to relieve pre-operative anxiety, a doc might give someone 50mgs...when used for psychosis, dosages were usually at least 300mgs, and often went up to 2,000mgs or more. Stelazine and Mellaril were often used off-label for intense, treatment-resistant anxiety. In addition, there have been some studies showing that Valium and other benzos can act as mild antipsychotic agents; massive doses of Valium have sometimes been shown to work alone against psychosis. Anyway,I guess my point is that maybe the intense agitation and anxiety a lot of us experience isn't all that much different from say, schizophrenia or schizoaffective disorder. There's a definite difference in intensity, and in how the problems present themselves, but I think at the core, some problems of anxiety, agitation, and mood lability may be much more similar to schizophrenia than we usually think. Think about it...excessive anxiety is, by its very nature, illogical, something that defies rationality and causes considerable distress...psychosis is similar, and is often accompanied by unbearable anxiety. Just a thought.
poster:med_empowered
thread:554220
URL: http://www.dr-bob.org/babble/20050909/msgs/554699.html