Posted by yxibow on July 29, 2008, at 1:58:11
In reply to AAP's comparison, posted by Bob on July 23, 2008, at 13:43:44
> Is anyone here familiar with the pros and cons of the various atypicals as an augmentation to antidepressants?
>
> Here's what I think I know:
>
> Abilify can be somewhat stimulating and there's evidence (quite anecdotal at this point) of a "dose threshold" beyond which the drug becomes more calming and sedating. This drug caused insomnia and anger for me. It seems to be more weight neutral than some of the others.
>
> Zyprexa is more sedating, and is notorius for weight gain and risk of diabetes. I've heard this is the best drug for anti-suicidality, anti-anxiety, and may even offer some anti-obsessional benefits.
>
> Risperdal I don't know much about. It seems to be somewhat depressogenic and sedating, but I've never taken more than one or two doses before quitting.
>
> Geodon I know very little about also, other than it is probably the most stimulating. I once tried a single dose of the med years ago, and within a half hour had entered into an akathisic panic.
>
> If anyone has other insights, I'd love to hear about them.The response varies wildly to them as I've seen in this thread.
Potency can roughly be said to be Risperdal/Invega (at a high enough dose nearly Haldol occupancy), Geodon/Abilify, and Zyprexa/Seroquel.
This will probably show the average, but not necessarily the norm in side effects especially such as akathisia.
But one has to remember that the biochemical makeup of someone with BP I/II is completely different with someone in the Schizophreniform spectrum or various classes of affective disoders.
Personal, and only personal experience:Low dose Risperdal, terrible nightmares, combined with Prozac a mild tic in my right index finger still there years later. I'm very sensitive to APs though.
Abilify I thought would be the cat's pajamas because of its pushme-pullyou activity. Not terribly different from Geodon, akathisia, crawling and holding the carpet.
Zyprexa -- lets not go there --- first round with a low dose, slept like a baby, best antidepressant. Later use, caused some form of tardive dystonia or dystonic reaction which is still here in my legs and arms (stiffness which varies throughout the day).
Seroquel was finally my agent. Yes, people will note the lipid changing qualities of Zyprexa and Seroquel (and even Risperdal for that matter in some cases), but its all I have left. And this is off label. It doesn't work as well as it used to, but since they haven't invented anything as calm and free of EPS as it except for Clozaril, its about the only option I have.
-- tidings
Jay
poster:yxibow
thread:841617
URL: http://www.dr-bob.org/babble/20080727/msgs/842771.html