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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Jeroen on February 23, 2020, at 8:59:08
How to switch from Abilify to Vraylar can take both? because they are the same class
Posted by undopaminergic on February 23, 2020, at 10:57:56
In reply to How to switch from Abilify to Vraylar can take bot, posted by Jeroen on February 23, 2020, at 8:59:08
> How to switch from Abilify to Vraylar can take both? because they are the same class
>Yes, aripiprazole (Ability) and cariprazine (Reagila, Vraylar) have a similar mode of action, and may compete with each other. I would suggest cross-titrating: reduce the aripiprazole a bit and introduce a low dose of cariprazine; repeat the procedure of lowering the dose of the former and elevating that of the latter, until the switch is complete. Alternatively, you could go straight from one to the other, simply terminating aripiprazole and starting the cariprazine at a dose more or less equivalent to the dose you were taking of the aripiprazole.
In general, I recommend always trying to find the minimum effective dose.
-undopaminergic
Posted by Christ_empowered on February 23, 2020, at 22:43:22
In reply to Re: How to switch from Abilify to Vraylar can take bot, posted by undopaminergic on February 23, 2020, at 10:57:56
hey. let us know how it goes, please. my current 'treatment provider' is gung ho about some Vraylar. I'm afraid of EPS, TD, dysphoria...it clamps down on those D2 receptors tight, like Fort Knox. LOL. :-)
but seriously...it seems like it'd be good if there's loads of agitation, active psychosis, mania, etc. involved. I don't know where -I- fit in all that...
but please keep us all posted, OK?
oh, and I think stopping aripiprazole and then going straight over to Vraylar, maybe armed with a PRN sedative, might be a good idea. any time 2+ neuroleptics are used together, adverse effects pop up more frequently than using the equivalent dose of just 1.
how much Abilify do you take? I'm on...15-20. 15 by prescription, 5mgs/samples because I'm 'going thru it,' yet again. blah. :-(
hope things go well for you. :-)
Posted by Jeroen on February 24, 2020, at 2:56:45
In reply to Re: How to switch from Abilify to Vraylar can take bot, posted by Christ_empowered on February 23, 2020, at 22:43:22
So would you discontinue 20 mg abilify what i'm currently taking and take day after just vraylar 1,5 mg?
or lower to 15 mg for a day and then start Vraylar?
Posted by undopaminergic on February 24, 2020, at 3:01:57
In reply to Re: How to switch from Abilify to Vraylar can take bot, posted by Christ_empowered on February 23, 2020, at 22:43:22
> hey. let us know how it goes, please. my current 'treatment provider' is gung ho about some Vraylar. I'm afraid of EPS, TD, dysphoria...it clamps down on those D2 receptors tight, like Fort Knox. LOL. :-)
>I've been in two different hospitals where the majority of patients are on neuroleptics, and never once have I seen TD. It seems to be very rare nowadays.
EPS, well, cariprazine is one of the least likely antipsychotics to cause EPS.
Dysphoria, that is very rare too. I've only had dysphoria from methoxetamine, and I've tried most antidepressants and many neuroleptics.
In low doses, around 1.5--3 mg, cariprazine is slightly stimulating. I'd say 1.5 is better than 3 mg, but the difference is subtle, so I'm not sure.
All neuroleptics are dopamine antagonists, and yet, they have never worsened my anhedonia, and their effect on apathy (ie. motivation) is slight or non-existent. I don't know why. Intuitively, one would expect them to induce a syndrome of dopamine deficiency, ie. parkinsonism.
-undopaminergic
Posted by undopaminergic on February 24, 2020, at 3:06:04
In reply to To Christ empowered, posted by Jeroen on February 24, 2020, at 2:56:45
> So would you discontinue 20 mg abilify what i'm currently taking and take day after just vraylar 1,5 mg?
>Depends on the details of your psychotic disorder. If you are prone to enter psychosis very soon upon discontinuation of neuroleptics, you need to start with a larger dose of cariprazine, maybe 9 mg.
-undopaminergic
This is the end of the thread.
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