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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by BethM on February 17, 2003, at 19:16:30
I started abilify in December and at first it made me feel wonderful. The schizoaffective fog disappeared after eleven days and I thought it was a miracle drug. But then it made me crazy manic and delusional. I don't know what to do now. That medication was my last chance at sanity. Advice, anyone?
Posted by Thomas123 on February 17, 2003, at 21:14:20
In reply to Re: Abilify, posted by BethM on February 17, 2003, at 19:16:30
I think I would up the dosage.
Posted by BethM on February 17, 2003, at 21:33:52
In reply to Re: Abilify, posted by Thomas123 on February 17, 2003, at 21:14:20
The dose was already raised. That made me even more hyper-aware. Can anyone recommend a drug that might complement abilify?
Posted by SLS on February 17, 2003, at 23:01:48
In reply to Re: Abilify, posted by BethM on February 17, 2003, at 19:16:30
> I started abilify in December and at first it made me feel wonderful. The schizoaffective fog disappeared after eleven days and I thought it was a miracle drug. But then it made me crazy manic and delusional. I don't know what to do now. That medication was my last chance at sanity. Advice, anyone?
Hi Beth.Have you ever tried Klonopin (clonazepam)? Combining an antipsychotic with Klonopin can be a potent antimanic treatment. What you might need is something that addresses the manic part of schizoaffective disorder (Depakote, Neurontin). It seems to me that mania is triggered first, followed by schizoid delusions and hallucinations. Which other antipsychotics have you taken? Zyprexa and Risperdal are good for this disorder. How much anxiety do you experience?
Some of the antipsychotics are known to produce mania. I've seen it happen with Zyprexa and Geodon. Abilify might be even more likely to do so because of its combined agonisms of 5-HT1a and DA2 receptors.
You might consider adding Klonopin or Ativan (both benzodiazepines) temporarily to reduce the manic psychosis. It should act quickly. I would like to note that someone I know who has schizoaffective disorder did poorly on Klonopin. She might be an exception, though. She does better on Ativan. Right now, she is taking Neurontin, Risperdal, and Effexor.
If you haven't tried Zyprexa yet, it might be best to switch over to it now. A last resort would be Clozaril (clozapine). You would need to take blood tests every two weeks, but it is often used successfully when other antipsychotics have failed.
Good luck.
- Scott
Posted by xjs7 on February 18, 2003, at 0:01:32
In reply to Re: Abilify » BethM, posted by SLS on February 17, 2003, at 23:01:48
Hi Beth,
SLS's advice is good. After trials with the newer antypical antipsychotics, refractory patients sometimes try conventional antipsychotics (like Haldol or Thorazine). As SLS said, Clozaril is also helpful for many people with treatment-resistant symptoms. I suspect your best bet it with an antipsychotic agent rather than a mood stabilizing agent, but I do not know the specifics of your disorder. I have schizophrenia and have had success with Geodon. I hope this helps.
xjs7
Posted by BethM on February 18, 2003, at 0:17:11
In reply to Re: Abilify » BethM, posted by SLS on February 17, 2003, at 23:01:48
Thank you guys so much for the advice. I've tried every atypical and thorazine, haldol, navane, etc. I've even tried clozaril. Nothing worked like abilify did. I'm afraid to add a mood stabilizer because I need my mind to be sharp for my work. Perhaps there is a drug out there that's good for manic delusions, but that lets you keep your mind?
Posted by missinglynxx on February 18, 2003, at 5:20:26
In reply to Re: Abilify, posted by BethM on February 17, 2003, at 19:16:30
> I started abilify in December and at first it made me feel wonderful. The schizoaffective fog disappeared after eleven days and I thought it was a miracle drug. But then it made me crazy manic and delusional. I don't know what to do now. That medication was my last chance at sanity. Advice, anyone?
Beth, I take Abilify for some time. Im confused by what you mean by Delusional? How does it Manifest itself. I would stick with Abilify,or try Geodon///
GOOD Luck on your treatment.///
Posted by BethM on February 18, 2003, at 6:26:19
In reply to Re: Abilify, posted by missinglynxx on February 18, 2003, at 5:20:26
I have beliefs that aren't real. Plus, the abilify awakened my senses and my mind to the point where I don't know if my awareness is "normal" or some form of paranoia.
Posted by SLS on February 18, 2003, at 7:06:03
In reply to Re: Abilify » SLS, posted by BethM on February 18, 2003, at 0:17:11
> Thank you guys so much for the advice. I've tried every atypical and thorazine, haldol, navane, etc. I've even tried clozaril. Nothing worked like abilify did. I'm afraid to add a mood stabilizer because I need my mind to be sharp for my work. Perhaps there is a drug out there that's good for manic delusions, but that lets you keep your mind?
I think it is imperative that you employ a mood-stabilizer. The cycle of mania -> schizo -> depression must be interrupted. Depakote should work. Neurontin might. I did not find it to be cognitively disruptive at 3000mg. Of course, everyone has a unique psychobiological structure. Some people find that Depakote somewhat depressing, but not everybody. You won't know until you try. You can always stop taking it, with the side-effects to disappear almost immediately.If I were me (and I can assure you that I am) I would try Klonopin immediately. If it doesn't agree with you, there are Ativan and Xanax as alternatives.
You must avoid unecessary stress. Even after remission is achieved, stress can cause a "medication breakthrough" relapse, despite the continuation of treatment.
My friend claims that adding Effexor made an incredible difference, but I didn't ask her for details. I'll try to find out for you if it helped with depression only or schizoid features. Remember, interruption of the cycle is critical. To remove depression from the loop might help to accomplish this. I don't know. She says that her episodes have been less frequent, so it appears that Effexor has not triggered mania or accelerated her cycling.
Don't give up. I am sure there are alternatives that you have not yet explored. Perhaps adding Risperdal to Abilify is an option. You could take Abilify early in the day and Risperdal at night.
This is probably a good order to try things:1. Klonopin (first choice - anticonvulsant properties; Ativan
2. Mood stabilizer: Depakote; Neurontin; Lamictal; Trileptal
3. Add Risperdal or Seroquel, or whichever AP helped most.
4. Take a look at molindone (Moban). It is a pharmacologically unique AP.I wish I had a more definitive suggestion for you. These are my best guesses.
Please remain optimistic.
- Scott
Posted by utopizen on February 18, 2003, at 10:52:48
In reply to Re: Abilify » BethM, posted by SLS on February 18, 2003, at 7:06:03
No effects at 7.5mg for my social anxiety. I don't feel any differently. Arrgggg!!!!
Doctor avoiding Nardil because of its interaction with stims. So I guess my next stop is Klonopin, although I was hoping for a long term, re-wiring type solution... lol
Posted by whitman on February 18, 2003, at 10:57:28
In reply to Re: Abilify - Day 11, no effects, posted by utopizen on February 18, 2003, at 10:52:48
My doctor just started me on Abilify today at 15mg. Mabey you should go higher in your dose?
Posted by BethM on February 18, 2003, at 11:46:47
In reply to Re: Abilify » BethM, posted by SLS on February 18, 2003, at 7:06:03
I took your advice and talked to my doctor about a mood stabilizer. He is putting me on lithium. Thanks for the help!
Posted by Thomas123 on February 18, 2003, at 13:31:59
In reply to Re: Abilify » Thomas123, posted by BethM on February 17, 2003, at 21:33:52
The drug may be fine. You may be suffering from intense restlessness or akathisia. Doctors see you sitting in the chair and think everything is fine, but perhaps what you need is a benzo rather than stopping the Abilify.
If you just cannot sit still seem anxious but have no positive symptoms you may have akathisia. I think you should work with the Abilify given it helped so much. Try a benzo. Unless of course, you are hallucinating or some such.
Posted by SLS on February 18, 2003, at 16:41:57
In reply to Re: Abilify » SLS, posted by BethM on February 18, 2003, at 11:46:47
> I took your advice and talked to my doctor about a mood stabilizer. He is putting me on lithium. Thanks for the help!
I'll cross my fingers for you. If you don't end up liking lithium for some reason, don't neglect the other mood stabilizers. For your condition, I really don't know which are used most successfully.
Good luck!
- Scott
Posted by whitman on February 18, 2003, at 17:57:44
In reply to Re: Abilify » BethM, posted by SLS on February 18, 2003, at 16:41:57
I took my first 15mg. dose this morning and have had a wicked headache all day since. Has anyone else experienced this and if so does it go away??
Posted by missinglynxx on February 18, 2003, at 18:18:56
In reply to Abilify headache, posted by whitman on February 18, 2003, at 17:57:44
> I took my first 15mg. dose this morning and have had a wicked headache all day since. Has anyone else experienced this and if so does it go away??
Sorry about the head pain Whitman
The first 2 days of Abilify are difficult.. dont give up!
The good moods and happiness happen around the 14th day....
Plus exercising heavy on Abilify is Recommended!
helps the fatigue alot. and its an anti-depressant (heavy exericise) GOOD luck and keep in touch , Whit
Posted by cybercafe on February 18, 2003, at 19:30:16
In reply to Re: Abilify, posted by Thomas123 on February 18, 2003, at 13:31:59
> The drug may be fine. You may be suffering from intense restlessness or akathisia. Doctors see you sitting in the chair and think everything is fine, but perhaps what you need is a benzo rather than stopping the Abilify.
>
> If you just cannot sit still seem anxious but have no positive symptoms you may have akathisia. I think you should work with the Abilify given it helped so much. Try a benzo. Unless of course, you are hallucinating or some such.i think someone mentioned propanolol/inderal for akathisia, no?
Posted by canwetalk on February 19, 2003, at 10:37:07
In reply to Re: Abilify, posted by Thomas123 on February 18, 2003, at 13:31:59
My daughter has been on abilify now for just over a month. Her appetite has increased a little, which is good.
I have noticed however that she still talks to herself rapidly and gets agitated at times. Her psdoc prescribed xanax .025mg for this. He instructed to give it to her at bedtime and during the day only as needed. Well yesterday I had to give it to her twice because of the agitation.
My questions is what other med can be given for her agitation other than xanx.
Posted by ayrity on February 19, 2003, at 22:34:00
In reply to Re: Abilify Whitman, posted by missinglynxx on February 18, 2003, at 18:18:56
> > I took my first 15mg. dose this morning and have had a wicked headache all day since. Has anyone else experienced this and if so does it go away??
Yeah. I felt awful after my first dose, had a horrible headache the next day. No further problems since then. I've been on it for a week now.
Posted by whitman on February 21, 2003, at 16:14:37
In reply to Re: Abilify Whitman, posted by ayrity on February 19, 2003, at 22:34:00
It is making me very groggy but yet it won't let me sleep. My mother in law has my kids for a couple of days until I get used to this, so you would think that I should be able to take a good nap but no matter how hard I try I can't sleep. So I am a walking zombie. I wonder if the seroquel I take at night has anything to do with this. I only take 50mg. at bedtime but I always feel completely drained and now it is worse. Has anyone else had this combo? At least the headache is gone. But is it really going to work, I read somebody say to give it 4 weeks so I will do that but it is going to be a rough 4 weeks.
Posted by canwetalk on February 22, 2003, at 9:34:29
In reply to I'm not sure about this Abilify, posted by whitman on February 21, 2003, at 16:14:37
Yes I saw your posted message and wanted to reply to it. How many milligrams of Abilify are you on? What time do you take it?
My daughter is on 15mg. Her psdoc started with 10mg but increased it. We had the same problem about not being able to sleep. I know this is difficult for you. Unfortunately it is one of the side effects of this medication.
My daughter has now been on it for a little over a month. She is now able to fall asleep and sleeps through the night. She takes xanax at bedtime (this is to help her sleep)
I know you were asking about the seroquel. Can't help you there, but your not being able to sleep caught my attention and just wanted to share with you on it. Give it a little more time and your body well adjust to it. I know my daughter is now sleeping. This started only a few days ago.
Posted by kb on February 22, 2003, at 11:15:16
In reply to Re: I'm not sure about this Abilify, posted by canwetalk on February 22, 2003, at 9:34:29
I started Abilify on monday (7.5 to start with) to replace Zyprexa because of weight gain. I"ve noticed that I'm definitely sleeping less and waking up alert rather than groggy. Both of these are good since on Zyprexa I slept 12 hours a night and then was groggy when I woke up and reluctant to get out of bed.
Posted by whitman on February 23, 2003, at 11:15:46
In reply to Re: I'm not sure about this Abilify, posted by canwetalk on February 22, 2003, at 9:34:29
I take 15mg. every morning. I am now on my 5th day and I am going to skip today and tomorrows doses. My 5 yr. old son has been begging me for a week to go to dinner out where he can play and I keep telling him when I feel better, and that is just not happening with this. I feel extremely sedated. So I figure if I skip these 2 days by tomorrow night I should feel better since this has such a long half life. I take Seroquel at night so I do sleep then but I am not functioning at all during the day because I feel so sedated. So I am not sure this is going to work. This is worse than the depression(almost) I am happy that this is working well for your daughter, this seems like a good med if you can get through the first few weeks, but with 2 kids(5 & 2 1/2)That is going to be hard.
This is the end of the thread.
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