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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by SLS on January 17, 2014, at 9:01:31
I have bipolar depression that is partially responsive to Abilify. I would like to:
1. Add Latuda or Saphris to convert a partial response to a more robust response or remission.
2. Switch from Abilify to either Latuda or Saphris to avoid the weight gain and high triglycerides that Abilify produces.
Thanks.
- Scott
Posted by Phillipa on January 17, 2014, at 9:07:46
In reply to Latuda or Saphris for depression? - Any updates?, posted by SLS on January 17, 2014, at 9:01:31
Scott what happens if you don't take an antipsychotic? Relapse? PJ
Posted by SLS on January 17, 2014, at 9:49:12
In reply to Re: Latuda or Saphris for depression? - Any updates? » SLS, posted by Phillipa on January 17, 2014, at 9:07:46
> Scott what happens if you don't take an antipsychotic? Relapse? PJ
I really don't need an antipsychotic per se. I seem to need a drug that is pro-dopaminergic and/or anti-serotonergic. I have tried lowering the dosage of Abilify and discontinuing it altogether. I relapse in both cases. Abilify is pro-dopaminergic in cases where synaptic dopamine is too low. Latuda does not do this, but it is anti-serotonergic in that it blocks 5-HT7 receptors along with 5-HT2a receptors. Saphris does a whole bunch of stuff. I have seen it activate a friend of mine. This person is now energetic, sharp of mind, and very functional.
- Scott
Posted by Christ_empowered on January 17, 2014, at 10:39:58
In reply to Re: Latuda or Saphris for depression? - Any updates? » Phillipa, posted by SLS on January 17, 2014, at 9:49:12
Low(ish) dose Seroquel (maybe xr), plus an xr stimulant AM?
Posted by SLS on January 17, 2014, at 11:02:18
In reply to Re: Latuda or Saphris for depression? - Any updates?, posted by Christ_empowered on January 17, 2014, at 10:39:58
>
> Low(ish) dose Seroquel (maybe xr), plus an xr stimulant AM?Hi C_E.
I hope you are feeling as well as you sound.
Seroquel, even at low dosages, leaves me feeling dysphoric. It is a good idea, though. I have just been prescribed Focalin. We'll see if that can give me enough mental energy to function better.
Thanks for the suggestions.
- Scott
Posted by sigismund on January 17, 2014, at 15:06:36
In reply to Re: Latuda or Saphris for depression? - Any updates? » Phillipa, posted by SLS on January 17, 2014, at 9:49:12
> I seem to need a drug that is pro-dopaminergic and/or anti-serotonergic.
I suppose you have not had access to tianeptine?
Not that I understand how it works in different parts of the brain
It's not very strong anyway, but is of some use to me.
Posted by SLS on January 17, 2014, at 15:24:38
In reply to Re: Latuda or Saphris for depression? - Any updates? » SLS, posted by sigismund on January 17, 2014, at 15:06:36
> > I seem to need a drug that is pro-dopaminergic and/or anti-serotonergic.
>
> I suppose you have not had access to tianeptine?
>
> Not that I understand how it works in different parts of the brain
>
> It's not very strong anyway, but is of some use to me.Thanks, Sigi.
I'll keep tianeptine on my list.
- Scott
Posted by Phillipa on January 17, 2014, at 17:57:50
In reply to Re: Latuda or Saphris for depression? - Any updates? » Phillipa, posted by SLS on January 17, 2014, at 9:49:12
Sounds like Saphris might be a good choice for you then? Would you eliminate the abilify? Or do a gradual taper? PJ
Posted by baseball55 on January 17, 2014, at 20:02:43
In reply to Re: Latuda or Saphris for depression? - Any updates? » sigismund, posted by SLS on January 17, 2014, at 15:24:38
Scott - I had a really good response to ability, risperdal and zyprexa. All made me gain weight like crazy. I'm talking 2-3 pounds per week, even though my diet was unchanged. I was told about some version of zyprexa (?), that is sub-lingual and is supposed to not cause weight gain? Is that saphris?
I never took it, because parnate turned out to work fine.
Posted by SLS on January 17, 2014, at 22:34:49
In reply to Re: Latuda or Saphris for depression? - Any updates? » SLS, posted by baseball55 on January 17, 2014, at 20:02:43
> Scott - I had a really good response to ability, risperdal and zyprexa. All made me gain weight like crazy. I'm talking 2-3 pounds per week, even though my diet was unchanged. I was told about some version of zyprexa (?), that is sub-lingual and is supposed to not cause weight gain? Is that saphris?
>
> I never took it, because parnate turned out to work fine.One of the reasons I am looking at Latuda is that it has a reputation for being weight neutral. Also, a friend of mine is losing weight on Saphris as her dosage of Seroquel is being tapered.
- Scott
Posted by SLS on January 17, 2014, at 22:35:53
In reply to Re: Latuda or Saphris for depression? - Any updates? » SLS, posted by Phillipa on January 17, 2014, at 17:57:50
> Sounds like Saphris might be a good choice for you then? Would you eliminate the abilify? Or do a gradual taper? PJ
I would add the Saphris or Latuda first, and then attempt to discontinue the Abilify.
- Scott
Posted by Phillipa on January 17, 2014, at 23:04:27
In reply to Re: Latuda or Saphris for depression? - Any updates? » Phillipa, posted by SLS on January 17, 2014, at 22:35:53
Can you take both at one time? PJ
Posted by Christ_empowered on January 18, 2014, at 13:59:43
In reply to Re: Latuda or Saphris for depression? - Any updates? » SLS, posted by Phillipa on January 17, 2014, at 23:04:27
sometimes, people need more than 1 AP. Ideally, one should only take 2+ during a taper, when one is introduced while the other is discontinued.
Posted by SLS on January 18, 2014, at 15:12:05
In reply to Re: Latuda or Saphris for depression? - Any updates?, posted by Christ_empowered on January 18, 2014, at 13:59:43
Thanks, C_E.
That seems sensible.
- Scott
Posted by mogger on January 19, 2014, at 13:07:03
In reply to Latuda or Saphris for depression? - Any updates?, posted by SLS on January 17, 2014, at 9:01:31
Scott,
Sorry to hear Abilify is causing you heavy weight gain. I thought it was supposed to be weight neutral. Is it more likely to cause weight gain than Zyprexa? Does Abilify help your anxiety at all if you have any?
Posted by LouisianaSportsman on January 19, 2014, at 21:28:00
In reply to Re: Latuda or Saphris for depression? - Any updates? » SLS, posted by mogger on January 19, 2014, at 13:07:03
Scott,
I decided to changeover from Abilify to Latuda because of the weight problem and because I also thought it was a better drug due to its pharmacology. So clean.
We added topiramate 100mg. at the same time to help with the weight loss so that may be what it is, but I am losing the Abilify weight since being on Latuda, and my life has changed. Strongly consider Latuda.
Posted by SLS on January 19, 2014, at 22:33:42
In reply to Re: Latuda or Saphris for depression? - Any updates? » SLS, posted by mogger on January 19, 2014, at 13:07:03
> Scott,
>
> Sorry to hear Abilify is causing you heavy weight gain. I thought it was supposed to be weight neutral. Is it more likely to cause weight gain than Zyprexa? Does Abilify help your anxiety at all if you have any?Abilify is sneaky. With me, it was several months before I began to gain weight. The gain was gradual in comparison to the immediate gain seen with Zyprexa. I couldn't guess as to which of the two drugs ultimately causes the most weight gain, but I suspect that Zyprexa does.
Some people find Abilify to help anxiety. However, anxiety can get worse early in treatment.
- Scott
Posted by SLS on January 19, 2014, at 22:36:08
In reply to Re: Latuda or Saphris for depression? - Any updates?, posted by LouisianaSportsman on January 19, 2014, at 21:28:00
> Scott,
>
> I decided to changeover from Abilify to Latuda because of the weight problem and because I also thought it was a better drug due to its pharmacology. So clean.
>
> We added topiramate 100mg. at the same time to help with the weight loss so that may be what it is, but I am losing the Abilify weight since being on Latuda, and my life has changed. Strongly consider Latuda.I will probably do trial Latuda 20 mg/day in two weeks if I feel no better.
- Scott
Posted by mogger on January 19, 2014, at 22:36:32
In reply to Re: Latuda or Saphris for depression? - Any updates? » mogger, posted by SLS on January 19, 2014, at 22:33:42
Thanks for the feedback Scott.
Posted by LouisianaSportsman on January 20, 2014, at 0:05:28
In reply to Re: Latuda or Saphris for depression? - Any updates? » LouisianaSportsman, posted by SLS on January 19, 2014, at 22:36:08
>
> I will probably do trial Latuda 20 mg/day in two weeks if I feel no better.
>
>
> - ScottReal advice: Go ahead and start with 40mg. One of the selling points is that it is an effective therapeutic dose for many patients; therefore, no more titration is required. The PI does say for bipolar depression to start at 20mg., but this is very low and most patients require 40mg. Schizophrenics start at 40mg.-- definitely in the effective range for bipolar depression-- go ahead and start it in the effective range. That's what I did, and it worked.
I know earlier I talked about the fear I got, but I think now that it was caused by the discontinuation of Abilify with no taper.
Posted by mogger on January 28, 2014, at 11:26:04
In reply to Re: Latuda or Saphris for depression? - Any updates?, posted by LouisianaSportsman on January 20, 2014, at 0:05:28
Louisianasportsman,
I am at 40mgs of Latuda (doing a switch tapering off 300mgs of Seroquel and adding 60mgs of Latuda in 10 days which is a bit rough but I am determined to make it happen). I see you are at 60mgs of Latuda and I saw another poster that said he tried 60mgs but found blunting so 40mgs was the dose for him. My question is do you find dulling at 60mgs? I know 60mgs is working for you so I would imagine not hopefully. Are you Schizophrenic or are you taking Latuda for bipolar depression or both? Hope you are continuing to benefit from Latuda,
mogger
This is the end of the thread.
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