Posted by SLS on December 6, 2017, at 8:34:04
In reply to Re: what is being treated?, posted by Christ_empowered on December 6, 2017, at 7:24:08
1. If Wellbutrin necessitates an increase in your dosage of Abilify, then something about it is counterproductive. Does it help so much with depression that it's worth the trade-off? Is it possible that pro-dopaminergic drugs worsen your condition i.e. Wellbutrin and Abilify (through partial agonism)? You might want to switch from Abilify (aripiprazole) to Rexulti (brexpiprazole). Rexulti is less potent at the D3 receptor and more potent at the D2 receptor. Rexulti *should* be less likely to produce akathisia, and I doubt you would need higher dosages to offset Wellbutrin to the point where you experience mood and cognitive side effects. I have seen the introduction of Abilify require increases in Seroquel from 300 mg/day to 900 mg/day in order to maintain the antipsychotic effects of Seroquel. I think this gives evidence to the pro-dopaminergic effects of Abilify that probably occurs in some circumstances. So, You might want to consider switching from Abilify to Rexulti and retain the Wellbutrin if necessary. Personally, I received less improvement in depression from Rexulti than I do with Abilify.
2. You can try switching from Abilify to Saphris, a drug that I happen to like for both psychosis (especially for paranoia) and depression. You should probably bring in the Saphris before reducing the Abilify just to make sure you have antipsychotic coverage. The two ways to accomplish this are to 1) cross-titrate and 2) Reach a target therapeutic dosage of Rexulti before beginning to taper the Abilify.
3. What has been your experience with Lamictal?
4. You should consider adding N-acetylcysteine (NAC). It is good for both depression and psychosis.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3044191/
It can take several months for NAC to provide maximal effect, so having patience is necessary - as long as there are no adverse side effects.
- 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:1096185
URL: http://www.dr-bob.org/babble/20161215/msgs/1096221.html