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Re: any updates on Abilify to augment antidepressa

Posted by roslynn on April 13, 2008, at 19:57:42

In reply to Re: any updates on Abilify to augment antidepressants?, posted by med_empowered on April 13, 2008, at 18:18:13

> hey. Abilify either got approved or is undergoing FDA approval as an add-on for people on antidepressants with residual symptoms.
> Anyway, Abilify is a weird med...you might get a respose going lower (possibly more activatig? Some people respond @ 2.5mgs or so) or by going higher, possibly up to the antipsychotic-level (10mgs+). The FDA approved dosage for schizophrenia goes from 10-30mgs.
> Sometimes people get "poop out," and sometimes its (unfortunately) rapid. I would think going off of lithium could cause either a crash or a switch into (hypo)mania...lithium's bizarre, too, b/c some people find that if they go off of lithium after stabilizing on it, it doesn't work the same when they re-introduce it.
> You might want to try it for a couple weeks. Or, like I said, change the dose...since Abilify seems pretty safe in terms of tardive dyskinesia and what not, you can experiment w/o having to worry too much. According to my own shrink, higher doses are more "soothing" (read: tranquilizing), so if your prob is more of an agitated and/or bipolar-ish depression, going up might be a good idea...personally, I found 1/2 of 15mgs tab (the old starting dose) to be great for agitation AND depression; I didn't feel like I was "really" on an antipsychotic till I hit 30mgs.
> Have you tried any of the other atypicals? Abilify is arguably the "cleanest," but pretty much all of them are used as add-ons for depression. Geodon might be a good idea; its actually kind of like Tofranil, only also a dopamine-blocker. If your doc wanted to go old-school, Moban is sometimes used...loxapine is also atypical-ish, and amoxapine (Asendin) is a bizzaro antipsychotic/antidepressant hybrid that sometimes helps people with psychotic and/or treatment-resistant depression. Some docs consider it to be an atypical antipsychotic.
> Have you tried BuSpar? Its an anti-anxiety drug thats kind-of-sorta antipsychotic-ish, and it can help non-resposive depressives w/ a low risk of your usual antipsychotic side effects. Dosages vary wildly, from 15mgs/day to 60mgs/day, and I think some docs go above that.
> Have you tried Vistaril (or Atarax...) ? They're different forms of hydroxyzine, both of which can relieve tension...they can also boost antidepressants and long-term use is pretty much safe. You can also use hydroxyzine as a sleeping pill.
> Benzos can also boost antidepressats. Xanax has mild AD properties, and I think Serax does, too...for some patients, Klonopin can also boost AD action.
>
> I wandered way off topic here, but I hope this all helps...Abilify is cool and all, but if it fails you, there are still plenty of drugs that can help (some of which are waaaaaay cheaper and don't carry any antipsychotic risks.).
>
> Good luck, and please keep everybody here posted on how you're doing.


Hi Med,
Thank you so much for your informative post. I'm worried about going above 5mg for Abilify because I've heard about the terrible akithesia (sp?) it can cause, but maybe that is at really high doses? I tend toward "agitated" depression and I don't want to do anything to make it worse.

My other meds: I am on Seroquel 25mg for sleep, lithobid 300mg, prozac 40mg, desipramine 30 mg, ativan up to 2mg per day as needed. total of 6 meds.

I have't tried half the things you've mentioned but my pdoc has not mentioned them either--the next step according to him for me would be the MAOIs.

Thank you for your help and information!...roslynn

 

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