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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by tensor on December 30, 2011, at 6:49:48
Taking it as an AD augmentor, two days on 7.5mg. How can one tell if dosage is too high or too low? Am nauseous and apathetic, really early in treatment, I know.
Thanks.
Posted by SLS on December 30, 2011, at 7:30:21
In reply to Swapped Seroquel for Abilify, posted by tensor on December 30, 2011, at 6:49:48
> Taking it as an AD augmentor, two days on 7.5mg. How can one tell if dosage is too high or too low? Am nauseous and apathetic, really early in treatment, I know.
>
> Thanks.
I had restlessness as a startup side effect. It disappeared within a week.The nausea is probably due to the dopamine D2 agonism. It should pass. The apathy, I don't like to hear, but it could also be a startup effect. I hope so.
Good luck.
- Scott
Posted by tensor on December 30, 2011, at 7:40:35
In reply to Re: Swapped Seroquel for Abilify » tensor, posted by SLS on December 30, 2011, at 7:30:21
> I had restlessness as a startup side effect. It disappeared within a week.
>
> The nausea is probably due to the dopamine D2 agonism. It should pass. The apathy, I don't like to hear, but it could also be a startup effect. I hope so.
>
> Good luck.
>
> - ScottThanks. The apathy is nothing new though so it shouldn't be attributed to APZ.
Posted by Christ_empowered on December 30, 2011, at 8:38:13
In reply to Re: Swapped Seroquel for Abilify » SLS, posted by tensor on December 30, 2011, at 7:40:35
I think you could try a lower dose. I started on 7.5 for psychotic depression, so I'd think 5 or even lower might be good for non-psychotic, non-agitated depression. Just guessing.
Posted by SLS on December 30, 2011, at 8:47:29
In reply to Re: Swapped Seroquel for Abilify, posted by Christ_empowered on December 30, 2011, at 8:38:13
> I think you could try a lower dose. I started on 7.5 for psychotic depression, so I'd think 5 or even lower might be good for non-psychotic, non-agitated depression. Just guessing.
Yeah. 5 mg seems to be the sweet-spot for treating depression.
- Scott
Posted by tensor on December 30, 2011, at 9:12:14
In reply to Re: Swapped Seroquel for Abilify, posted by SLS on December 30, 2011, at 8:47:29
What would the symptoms be if one is dosing above (vs. below) what is "needed"? Is it rational with Abilify, because of its long halflife, to titrate with a higher dosage in the first two weeks and then lower as needed?
Thanks.
Posted by tensor on December 30, 2011, at 9:25:29
In reply to Re: Swapped Seroquel for Abilify, posted by SLS on December 30, 2011, at 8:47:29
Some interesting reading.
http://www.biomedsearch.com/attachments/00/21/65/53/21655344/ndt-7-303.pdf
http://www.benthamscience.com/cds/samples/cds3-3.tar/0010CDS.pdf
Posted by Phillipa on December 30, 2011, at 9:38:37
In reply to Re: Swapped Seroquel for Abilify, posted by tensor on December 30, 2011, at 9:12:14
Tensor I did read 2.5-5mg for depression think was a newsletter? Phillipa
Posted by SLS on December 30, 2011, at 9:49:25
In reply to Re: Swapped Seroquel for Abilify, posted by tensor on December 30, 2011, at 9:12:14
> What would the symptoms be if one is dosing above (vs. below) what is "needed"? Is it rational with Abilify, because of its long halflife, to titrate with a higher dosage in the first two weeks and then lower as needed?
Exactly.
It's called a loading dose. I started off with Abilify by taking 20 mg. You don't want to take 20 mg for an entire week, though. Maybe only one dose to be followed up with your target dosage.
- Scott
Posted by ed_uk2010 on December 30, 2011, at 17:46:43
In reply to Re: Swapped Seroquel for Abilify » tensor, posted by SLS on December 30, 2011, at 9:49:25
I don't think a loading dose would be a good idea for someone who has never taken Abilfy before. A low initial dose should allow the body to become accustomed to the medication and reduce adverse effects.
Apathy suggests that the dose could be too high. 5mg seems sensible initially.
Posted by SLS on December 30, 2011, at 20:51:04
In reply to Re: Swapped Seroquel for Abilify, posted by ed_uk2010 on December 30, 2011, at 17:46:43
> I don't think a loading dose would be a good idea for someone who has never taken Abilfy before.
I don't know about that. I was a virgin when I took my first 20 mg dose. Some people seem to be very sensitive to low dosages, though.
- Scott
Posted by Christ_empowered on December 30, 2011, at 22:20:30
In reply to Re: Swapped Seroquel for Abilify » ed_uk2010, posted by SLS on December 30, 2011, at 20:51:04
What else are you on? If you're not on a benzo and/or benzos aren't an option, then starting a bit higher and then going lower makes sense---lower doses, according to my ex-shrink, are stimulating and they become more "calming" as you move up the dosage. At 30 I didn't notice a whole lot of "calming," but then again my problems are a bit different from yours.
Personally, I'd rather start low, go slow if I were you, especially if stimulation is what you're after. Drug-induced anxiety would be a concern, but that could be addressed.
Posted by tensor on December 31, 2011, at 3:03:38
In reply to Re: Swapped Seroquel for Abilify, posted by Christ_empowered on December 30, 2011, at 22:20:30
> What else are you on? If you're not on a benzo and/or benzos aren't an option, then starting a bit higher and then going lower makes sense---lower doses, according to my ex-shrink, are stimulating and they become more "calming" as you move up the dosage. At 30 I didn't notice a whole lot of "calming," but then again my problems are a bit different from yours.
>
> Personally, I'd rather start low, go slow if I were you, especially if stimulation is what you're after. Drug-induced anxiety would be a concern, but that could be addressed.Actually, it would be great if it was both anxiolytic and activating, but those attributes are for me almost mutually exclusive. But I do take clonazepam which works good. Anyway, it's the energizing effect I so desperately need.
The idea was to start at 5mg, or even 2.5mg, but the authorities only cover for 15mg and 30mg, hence the 7.5mg. I rather pay 1.50 than some 300, I do have insurance but then I would have to put up money for the entire cost and wait two-three weeks to get it back :-)
Posted by tensor on December 31, 2011, at 3:05:14
In reply to Re: Swapped Seroquel for Abilify, posted by ed_uk2010 on December 30, 2011, at 17:46:43
> Apathy suggests that the dose could be too high. 5mg seems sensible initially.
>Hi Ed :-)
http://www.dr-bob.org/babble/20111226/msgs/1005948.html
Regards.
Posted by Emme-V2 on December 31, 2011, at 6:05:29
In reply to Re: Swapped Seroquel for Abilify » Christ_empowered, posted by tensor on December 31, 2011, at 3:03:38
> Actually, it would be great if it was both anxiolytic and activating, but those attributes are for me almost mutually exclusive.I find a very low dose of Abilify (2.5 mg) does help with both anxiety and motivation. It can make me a bit logy energy-wise (not really sedated per se), but it does help with getting things done. I have a very low dose of a stimulant that I titrate carefully to help combat fatigue from the Abilify. I think with the right combination, you can combat both anxiety and apathy.
> The idea was to start at 5mg, or even 2.5mg, but the authorities only cover for 15mg and 30mg, hence the 7.5mg.If you have the 15 mg tabs and a nice small pill splitter, you can cut into quarters and get 3.25 mg. I can cut 5 mg tabs into quarters. I don't know what's special about the binding agents they use, but Abilify doesn't crumble much when you cut it into tiny pieces.
Good luck.
emme
Posted by SLS on December 31, 2011, at 6:14:49
In reply to Re: Swapped Seroquel for Abilify » tensor, posted by Emme-V2 on December 31, 2011, at 6:05:29
Hi Emme-V2.
It is always nice to have you drop in for a visit.
:-)
- Scott
Posted by tensor on December 31, 2011, at 6:45:36
In reply to Re: Swapped Seroquel for Abilify » tensor, posted by Emme-V2 on December 31, 2011, at 6:05:29
> I find a very low dose of Abilify (2.5 mg) does help with both anxiety and motivation. It can make me a bit logy energy-wise (not really sedated per se), but it does help with getting things done. I have a very low dose of a stimulant that I titrate carefully to help combat fatigue from the Abilify. I think with the right combination, you can combat both anxiety and apathy.
May I ask what stimulant and what dosage?
> If you have the 15 mg tabs and a nice small pill splitter, you can cut into quarters and get 3.25 mg. I can cut 5 mg tabs into quarters. I don't know what's special about the binding agents they use, but Abilify doesn't crumble much when you cut it into tiny pieces.
3.75mg, right? Just kidding. I have a really good splitter but when I saw those ridiculously small pills I thought it would be a just a pile of crumbs, but no, nice halves every time. I'm not really sure what to do here, but I think I will stay at 7.5mg for awhile, actually got some things done today which was nice.
> Good luck.
Thanks. Good luck to you too.
Posted by Emme-V2 on December 31, 2011, at 6:59:40
In reply to Re: Swapped Seroquel for Abilify » Emme-V2, posted by tensor on December 31, 2011, at 6:45:36
> > I find a very low dose of Abilify (2.5 mg) does help with both anxiety and motivation. It can make me a bit logy energy-wise (not really sedated per se), but it does help with getting things done. I have a very low dose of a stimulant that I titrate carefully to help combat fatigue from the Abilify. I think with the right combination, you can combat both anxiety and apathy.
>
> May I ask what stimulant and what dosage?Focalin. It is one of the isomers of Ritalin. It makes me less jittery than ritalin - feels cleaner. I take a quarter of a 2.5 mg tablet a couple of times during the course of a day as needed. I am a "low dose" person for most meds, hence I am always chopping up pills. You might need more. I do find that with both stimulants and benzos, starting low and titrating carefully helps me find the sweet spot dosage-wise.
> 3.75mg, right?Egad. And I was always an A student in math... :)
> I have a really good splitter but when I saw those ridiculously small pills I thought it would be a just a pile of crumbs, but no, nice halves every time. I'm not really sure what to do here, but I think I will stay at 7.5mg for awhile, actually got some things done today which was nice.
It is nice, isn't it? I knew I had a serious apathy problem when I couldn't get over the hurdle to order someone a present online! Adding Abilify to Lamictal greatly improved things within about 4 days. I think apathy is its own special symptom that can persist even when the worst of the horrid mood is gone. It's insidious and frustrating.
> Thanks. Good luck to you too.Thanks!
Posted by Emme-V2 on December 31, 2011, at 7:25:32
In reply to Re: Swapped Seroquel for Abilify » Emme-V2, posted by SLS on December 31, 2011, at 6:14:49
> Hi Emme-V2.
>
> It is always nice to have you drop in for a visit.
>
> :-)
>
>
> - ScottThanks! :)
Posted by Phidippus on January 1, 2012, at 19:02:02
In reply to Swapped Seroquel for Abilify, posted by tensor on December 30, 2011, at 6:49:48
10 mg is really the most adequate dosage for Abilify.
Eric
Posted by porkpiehat on January 3, 2012, at 12:48:55
In reply to Re: Swapped Seroquel for Abilify » Emme-V2, posted by tensor on December 31, 2011, at 6:45:36
Can I ask why you're dropping the Seroquel? I am using Klonopin to augment my AD and lamictal and I am starting to get suicidally depressed.
A friend suggested seroquel instead. I'm hoping if can help with hypomanic tendencies plus fear/paranoia and obsession.
Was the Seroquel to weight-gainy? Too sedating?
Posted by tensor on January 3, 2012, at 13:16:37
In reply to Re: Swapped Seroquel for Abilify, posted by porkpiehat on January 3, 2012, at 12:48:55
> Can I ask why you're dropping the Seroquel? I am using Klonopin to augment my AD and lamictal and I am starting to get suicidally depressed.
>
> A friend suggested seroquel instead. I'm hoping if can help with hypomanic tendencies plus fear/paranoia and obsession.
>
> Was the Seroquel to weight-gainy? Too sedating?It didn't help with my depression, no drive or energy. Seroquel is great for many though, worth a try. I was on diet so I didn't gain, wasn't sedating although I slept well on it.
Regards.
Posted by JohnLA on January 5, 2012, at 21:43:56
In reply to Swapped Seroquel for Abilify, posted by tensor on December 30, 2011, at 6:49:48
tensor-
hope you are doing ok.
could you let me know how the abilify is working-out for you? my doc just recommended adding 2 to 5 mg to my remeron/klonopin meds. i'm scared to say the least about the side effects of abilify. i also need something to get me motivated. i've literally have been in bed for about 20 months now and need to do something about that. i'm dealing with severe depression/apathy/anhedonia/etc.
thanks for any info.
john
Posted by tensor on January 6, 2012, at 3:21:11
In reply to tensor; Abilify, posted by JohnLA on January 5, 2012, at 21:43:56
> tensor-
>
> hope you are doing ok.
>
> could you let me know how the abilify is working-out for you? my doc just recommended adding 2 to 5 mg to my remeron/klonopin meds. i'm scared to say the least about the side effects of abilify. i also need something to get me motivated. i've literally have been in bed for about 20 months now and need to do something about that. i'm dealing with severe depression/apathy/anhedonia/etc.
>
> thanks for any info.
>
> johnHi!
Seems our situations are about the same. I'm starting to get things done a couple of days ago and it's day 9 now. I have upped the dosage to 15mg just to see how it works. Primary and only notable side effect is nausea, which has been substantial, but seems to abate now. If you're scared to try, begin with 2mg, that won't harm.
Good luck.
Posted by JohnLA on January 7, 2012, at 19:00:21
In reply to Re: tensor; Abilify » JohnLA, posted by tensor on January 6, 2012, at 3:21:11
thanks for the reply tensor.
hope you are doing well.
john
This is the end of the thread.
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