Posted by SLS on March 16, 2012, at 5:51:07
In reply to Re: What do you think of abilify at a low dose for Uni, posted by papillon2 on March 15, 2012, at 22:09:24
> > What do you need a drug to do for you such that you are considering taking Abilify to do it?
> >
> > - Scott
> To remove residual depression that seems stubborn as a mule. I'm a lot better than I was last year, when I spent 4 months in hospital, but I still have a ways to go.I know the feeling. Despite feeling better, it is not enough for me to socialize effectively and return to work.
> - low motivation, lack of care about a lot of things
Abilify helped me with energy and motivation.
> - some residual anhedonia, I have more mood reactivity these days and occasionally find myself enjoying something, which is nice!
I will be very curious to see if Abilify helps with anhedonia.
> - still unable to work
Frustrating. Employment is my goal.
> - still have days / moments where I feel depressed as hell and it's obvious to those around me (better at hiding it when I'm less depressed).
I HATE that. Being quiet and having nothing to say along with having a depressed expression on my face leads some people to approach me and ask what's wrong. I feel that my depression is obvious to everyone, even when it's not. It is embarassing.
> - still struggle majorly with diurnal mood variation, it's one of the major barriers to working
What does your diurnal pattern look like? Do you feel worse in the mornings? If so, then you might have a classic endogenous melancholic depression. This would indicate that you are probably be more apt to respond to tricyclics.
> - cognitively better but still not all there
Me, too.
> - still some psychomotor retardation / leaden paralysis but no where near the same extent (was in a freaking wheelchair and unable to talk)
OMG. I am SO sorry. You were very sick. It angers me to hear this.
Psychomotor retardation would be sufficient to explain this, though. Classic leaden paralysis might not apply to you. If it does, then I would entertain the idea that there might be some bipolarity going on.
> Currently:
> Nortriptyline 100mg (blood level 0.5, I suspect any higher would just make me miserable from side effects)Give it a try anyway. You might be VERY surprised. I suspect that you are an extensive metabolizer and that you will need 150 mg/day to reach full remission. Get closer to 150 ng/ml than to 50 ng/ml. For me, side effects are no greater at 150 mg/day than at 75 mg/day. Side effects might get worse immediately upon a dosage increase, but they should decrease over time. After being on nortriptyline for an extended period of time (months), you might not even know that you are taking it. I hope this is the case for you. Even if side effects linger, they should be reduced. I am SURE you will find it to be a worthwhile trade-off if increasing the dosage works.
> Lamictal 200mg
> Lithium 125mg (blood level 0.2, can't go higher as super sensitive)
> And melatonin 3mgThat is a sufficient blood level of lithium for it to exert an antidepressant effect when used as an adjunct to antidepressants. It is far too low to address bipolar mania. For me, lithium at 300 mg/day results in the same blood level as yours. Going higher in dosage does not produce an increased therapeutic effect. It just brings on apathy and amotivation.
> My psychiatrist suggested Epilim (a valproate) but has forgotten that she took me off it as I was shaking all the time.
Combining lithium and valproate acts synergistically to produce shaking. Valproate by itself might not be so bad.
> Her colleague, who specializes in melancholic depression, has suggested Doxepin and/or a course of ultra brief right unilateral ECT. I have refused the latter at present.
Ah, so you are melancholic after all? That was an easy guess to make.
You might profit from adding a MAOI to bring you to full remission if your depression is a hybrid between melancholic and atypical. Actually, this is what bipolar depression looks like; with symptomology looking more atypical. How is you appetite / body weight? What time of day do you feel worst? Is it a regular cycle? My mood was actually worst at 2:00 PM. This is not terribly common.
My illness lies somewhere along the bipolar spectrum. This is what I am currently taking:
Parnate 80 mg
nortriptyline 150 mg
Lamictal 200 mg
Abilify 10 mg
lithium 300 mg
prazosin 6 mg
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1012966
URL: http://www.dr-bob.org/babble/20120316/msgs/1013230.html