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Dr. Bob is Robert Hsiung, MD,
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Posted by banga on March 11, 2005, at 6:57:28
In reply to Re: Luvox and caffeine » banga, posted by ed_uk on March 10, 2005, at 8:58:29
Hi Ed,
I am taking
Adderall 20
desipramine 75
luvox 50
lamictal 100and it is doing ok for now, I think there is some difference RE anxiety with the Abilify gone, but I will see if I can increase the luvox a tad and get by without the Abilify. We will see.....
I am a little reluctant to push out the Lamictal immediately, though I douubt it is doing anything--but want to stabilize first completely and understand the amounts I need with the other meds.
Posted by ed_uk on March 11, 2005, at 8:18:33
In reply to Re: Luvox and caffeine, posted by banga on March 11, 2005, at 6:57:28
Hi B!
>I am a little reluctant to push out the Lamictal immediately, though I douubt it is doing anything--but want to stabilize first completely and understand the amounts I need with the other meds.
Perhaps you could wait a couple of months, until you're getting more out of the fluvoxamine, then you could gradually taper the Lamictal.
Ed :-)
Posted by banga on March 13, 2005, at 4:40:59
In reply to Re: Luvox and caffeine » banga, posted by ed_uk on March 11, 2005, at 8:18:33
I felt my mood and anxiety worsening on day 3 off of Abilify. Oh well. I will try 2.5mg every other day. I took some last night and woke up feeling much better already--didnt think it would be so quick. If it were possible to split these pills into thirds or fourths, Id take even less--but they are already tiny....the only option is to smash it and take rather imprecise amounts. this medication being so powerful, I wonder why they have not come up with even smaller doses. Dont suppose it comes in a liquid--?
But I am not happy about it. Because I've noticed that even at this amount I feel a slight tick of having trouble maintaining eye contact in one position--feel my eyes wanting to go left if only slightly and briefly. Is this akasthisia -or worse?
My other option is to try and find a different source of a 5ht2a antagonist. I am quite sure this is key for me. Any ideas that dont mean instant weight gain? Very tiny amounts of Remeron?? Of tricyclics, do you know which has the most potent 5ht2a action, to get away with the smallest amounts?
Posted by ed_uk on March 13, 2005, at 10:15:00
In reply to Re: Back on Abilify? » ed_uk, posted by banga on March 13, 2005, at 4:40:59
Hi Banga!!!!
>I will try 2.5mg every other day.
I think that is a good idea. Once you have been on the fluvoxamine for a few months you could attempt a gradual taper of the Abilify.
>I wonder why they have not come up with even smaller doses.
I suppose it's because Abilify's not approved for anxiety, where low doses are the norm. You're lucky - the smallest tablet available in the UK is 10mg!
>Because I've noticed that even at this amount I feel a slight tick of having trouble maintaining eye contact in one position--feel my eyes wanting to go left if only slightly and briefly. Is this akasthisia -or worse?
It sounds like a dystonia, same as you had with your tongue.
>Any ideas that dont mean instant weight gain?
I must admit, I don't have any great ideas.
>Of tricyclics, do you know which has the most potent 5ht2a action, to get away with the smallest amounts?
The ones that cause the most weight gain! Amitriptyline and trimipramine - I expect you'd gain weight, even with a low dose. I'm hoping that you won't need any additional medication once you've been on fluvoxamine for a few weeks.
Ed xx
Posted by banga on March 13, 2005, at 10:52:23
In reply to Re: Back on Abilify? » banga, posted by ed_uk on March 13, 2005, at 10:15:00
>You're lucky - the smallest tablet available in the UK is 10mg!
Now that seems ridiculous...I cannot imagine the side effects I would have on that amount....maybe I will try crushing them....>I'm hoping that you won't need any additional medication once you've been on fluvoxamine for a few weeks.
I certainly hope not to have to add more...my goal was a little of 2 or 3 medications, not 5!!
Posted by ed_uk on March 13, 2005, at 11:02:01
In reply to Re: Back on Abilify?, posted by banga on March 13, 2005, at 10:52:23
Hi!
>maybe I will try crushing them....
They're not enteric-coated or film-coated are they? I don't think they are, just check the package insert.
Will you try 1.25mg/day, or maybe 0.625mg!
Ed xx
Posted by banga on March 13, 2005, at 15:36:56
In reply to Re: Back on Abilify? » banga, posted by ed_uk on March 13, 2005, at 11:02:01
I really dont know what to do....even at this dose today (Abilify), I feel the dystonia and shaky--really difficult to bear as I dont feel great and I think my sister-in-law and brother may notice this and its embarrassing. It is unclear to me why it is actually worse today than yesterday (I didn't take the Abilify last night)....
It's like a tease, feeling good one day, able to deal with life and actually envision a future, and then distressed and almost devastated the next. For no reason.I will have to try without the Abilify somehow. I think with the long half-life and interactions with desipramine and Luvox it is too much--too unpredictable that is. I will have to work with the other pieces.
Hm. An angle I haven't considered--I take the LUvox 1x/day (at night). Maybe mood swings could be due to Luvox levels swinging? I unfortunately have not made a note of the pattern...but maybe I do better in the am than pm--when perhaps Luvox is at its lowest?
Sorry, just thinking out loud here--
Posted by banga on March 13, 2005, at 15:40:02
In reply to Re: Back on Abilify?, posted by banga on March 13, 2005, at 15:36:56
Maybe that is what is logical at this moment--try and alter (space out) dosages? Right now I take all but the Adderall at night.
Posted by ed_uk on March 13, 2005, at 15:48:08
In reply to Re: Back on Abilify?, posted by banga on March 13, 2005, at 15:36:56
Hello,
>I will have to try without the Abilify somehow.
I can't remember why you discontinued Risperdal, did it cause weight gain? Risperdal has the advantage of coming in very low doses, half-scored 0.5mg tablets. Perhaps you could replace the Abilify with a low dose of Risperdal.
>but maybe I do better in the am than pm--when perhaps Luvox is at its lowest?
I think you should try taking 25mg every 12 hours, a steady level is usually best in the long run.
I don't feel well today either, I feel very fatigued. My body is aching and so are my eyes, even though I had plenty of sleep.
Ed xx
Posted by banga on March 13, 2005, at 15:53:04
In reply to Re: Back on Abilify? » banga, posted by ed_uk on March 13, 2005, at 15:48:08
Thanks Ed!
How are things going for you in general? YOu comment and help others so much, I rarely hear how things are on your end...
Posted by banga on March 13, 2005, at 16:06:10
In reply to Re: Back on Abilify? » ed_uk, posted by banga on March 13, 2005, at 15:53:04
...And do you have an amazing memory or do you take notes?? I took risperdal--I can't remember the dose--but stopped due to fatigue and dislike with how it affects hormonal systems. But I dont recall having dystonia....Perhaps`you are right--a low dose may do OK. If I don't restabilize with these other meds I will perhaps try it out when I get home...
Posted by ed_uk on March 13, 2005, at 16:18:09
In reply to Re: Back on Abilify? » ed_uk, posted by banga on March 13, 2005, at 15:53:04
Hi B!
I'm not doing too bad thanks, I've got exams in June, not sure how I'm gonna do. The pharmacy course is so dull, it's sad really because it could have been interesting - we'd need a whole new set of lecturers for that to happen though! It's essentially a course in pharmaceutical science, it's not a clinical course at all. We don't learn that much relevent stuff to be honest, most of the lecturers are chemists. In many cases, they've got no idea what drugs are even available at the moment.
I never wanted to do pharmacy really, I wanted to do medicine but my personality got in the way, I would have had a breakdown if I'd done medicine.
So, as ever, I'm addicted to the internet and not doing as much work as I should. This semester's gone a lot better than last semester though - which was a disaster. I have to do the January exams in August, it's not going to be fun, I don't know how I'm going to motivate myself to revise. I'm gonna try to get another job in a pharmacy over the summer, I liked it last summer, it was better than being at university. The people you work with make all the difference, if they're nice it's fun but if they're not it's horrible. I worked in a few different pharmacies last summer, some I enjoyed but others were a nightmare. Not sure what I'm gonna do about the sweating, last summer I was dripping sweat over the counter thanks to the ADs I was on. Tried Inderal but it didn't help, I hate Inderal anyway, it makes me feel cr*p and it doesnt do anything for my anxiety.
About you...
What happened with the Risperdal?Ed.
Posted by ed_uk on March 13, 2005, at 16:30:42
In reply to Re: Back on Abilify?, posted by banga on March 13, 2005, at 16:06:10
Hello!
>And do you have an amazing memory or do you take notes??
I have a good memory for medication but a terrible memory for everything else, I kid you not!
>I can't remember the dose.
Can you ask your doc to look in your medical notes?
Side-effects are very dose-dependent with Risperdal, you could try 250mcg/day if your current combination isn't satisfactory.
>If I don't restabilize with these other meds I will perhaps try it out when I get home.
Yes, it's important to wait and see how you do on fluvoxamine. You don't need any more confusion about which meds are helping!
Ed x
Posted by banga on March 13, 2005, at 16:40:21
In reply to Re: Back on Abilify? » banga, posted by ed_uk on March 13, 2005, at 16:18:09
I can truly relate to dropping the med school due to personality interference. It is a shame that school is boring for you at the moment. Any hope that could change soon, some more life-relevant angle in future classes, or with these profs there is no hope?
So are you off all ADs at the moment? How would you characterize your diagnosis?As for the risperdal--I probably did also gain weight on the risperdal, I can't well remember. Was not on it for more than a month. I just remember becoming intensely fatigued, in fact quite ill and dizzy so that I could not exersise though I truly wanted to.
Do you think I should space out all the meds--say 25mg desip., 25mg Luvox, 50mg Lamictal am, the rest in pm?
Posted by banga on March 13, 2005, at 16:49:36
In reply to Re: Back on Abilify? » ed_uk, posted by banga on March 13, 2005, at 16:40:21
LOL it would be a victory for both of us if I stay on one med schedule for more than 24 hours! Though in truth I do think I am struggling more because of the interactions and resultant swings in blood levels....I will make a note on how I feel in the am. vs pm. "see" you tomorrow...
Posted by ed_uk on March 13, 2005, at 17:38:18
In reply to Re: Back on Abilify? » ed_uk, posted by banga on March 13, 2005, at 16:40:21
Hello!
>Any hope that could change soon, some more life-relevant angle in future classes, or with these profs there is no hope?
I think the third year will be a bit better, I'm not that hepeful though.
>So are you off all ADs at the moment?
I'm just on lofepramine 140mg.
How would you characterize your diagnosis?
In the past, lots of things really, mainly anxiety, social anxiety, phobias, conversion disorders, OCD, body dysmorphic disorder, atypical depression, inattentive ADD w/o hyperactivity, fatigue, slight Aspergers traits, maybe some borderline personality traits, general weirdness etc.
At the mo, mainly ADD symptoms and some fatigue.
>Do you think I should space out all the meds
I'd recommend taking the fluvoxamine morning and evening. I don't think it matters too much with your other meds.
Ed xx
Posted by banga on March 14, 2005, at 6:28:42
In reply to Re: Back on Abilify? » banga, posted by ed_uk on March 13, 2005, at 17:38:18
General weirdness is a partial cure for many of the other disorders you listed, you're in luck! Better than any med....
What is lofepramine most similar to in the States?
Feeling better today, at least physically speaking, took Luvox at 12 noon, we'll see how I do tonight. Feel the Abilify leaving my system. Still tough to keep the depression and anxiety at bay. Struggling to keep on track with the dissertation....
Posted by ed_uk on March 15, 2005, at 8:06:06
In reply to Re: Back on Abilify? » ed_uk, posted by banga on March 14, 2005, at 6:28:42
Hi banga!
>What is lofepramine most similar to in the States?
Desipramine.
>Struggling to keep on track with the dissertation....
Lol, I know the feeling!
Ed xx
Posted by anodyne on March 17, 2005, at 15:25:02
In reply to Re: Back on Abilify? » banga, posted by ed_uk on March 15, 2005, at 8:06:06
Hello all. I had to give up on the Nardil due to the side effects. Mainly the general stupidity and a feeling of detachment, it felt like I was on acid. Still much less benign than SSRIs and the diet was not that hard to adjust too.
I saw my Pdoc the other day and he decided to give an atypical anti-psychotic a try for my social anxiety (I guess because nothing else has worked).
I was wondering what the side effects starting this usually are. The first night I took it I woke up covered in sweat and feeling nauseous but it passed after a minute or two. Last night I woke up very early and could not go back to sleep. I am currently taking Xanax XR .5mg at night to help me sleep.
What has been your experience starting Abilify? Do the symptoms pass? I really hope this works.
Has anyone else taken Abilify as a mono therapy of social anxiety with any success?
Thanks!
-Dan
Posted by Basia on March 21, 2005, at 23:55:46
In reply to New to Abilify, posted by anodyne on March 17, 2005, at 15:25:02
Hi,
Just to say I became pretty psychotic on Abilify, feeling really panicky, hallucinating as if I was on acid and having insomnia, as well as total social withdrawal. I was terrified and went back on my usual Sulpiride after three weeks. It may have been withdrawal from the Sulpiride but it was tapered so I don't see why that should happen.
Good luck anyway,
L
Posted by ed_uk on March 22, 2005, at 8:12:07
In reply to Re: New to Abilify, posted by Basia on March 21, 2005, at 23:55:46
Hi L,
What do you take sulpiride for? Depression? Psychosis?
How effective is it for you? Are you having any side effects? I suppose there must be a problem since you decided to try a new medication!
Regards,
Ed.PS. You don't live in the UK by any chance do you? Sulpiride is quite popular here, it's not available in the US.
Posted by Basia on March 23, 2005, at 1:23:10
In reply to Re: Sulpiride » Basia, posted by ed_uk on March 22, 2005, at 8:12:07
Hi Ed,
I take Sulpiride for bipolar II and generally suffer from a mixture of depression and psychosis (the latter only if i am off the meds).
It's really good for psychosis i find - i don't trip out at all, although it didn't do anything for my depression. I use Lamictal for that - life saver!
Side effects have varied from non-existent periods and low libido to some weight gain but these things bother me less nowadays. I tried so many meds in the beginning and this one really cuts the hell of madness out so I am grateful for it.And yes! I am a Brit on my way back to the UK after spending six months in Nairobi.
cheers, L
> Hi L,
>
> What do you take sulpiride for? Depression? Psychosis?
>
> How effective is it for you? Are you having any side effects? I suppose there must be a problem since you decided to try a new medication!
>
> Regards,
> Ed.
>
> PS. You don't live in the UK by any chance do you? Sulpiride is quite popular here, it's not available in the US.
>
>
Posted by ed_uk on March 23, 2005, at 6:44:51
In reply to Re: Sulpiride, posted by Basia on March 23, 2005, at 1:23:10
Hi L!
Thanks for your reply :-)
>It's really good for psychosis i find - i don't trip out at all...
What dose do you take? Have you ever tried amisulpride (Solian)? It's quite similar to sulpiride, I wondered whether you'd tried them both and could compare.
>weight gain
Have you gained a lot of weight on sulpiride? I get the impression that people don't seem to gain as much weight on sulpiride as they do on some other antipsychotics, especially olanzapine (Zyprexa)!
> I am a Brit on my way back to the UK after spending six months in Nairobi.
LOL Welcome Home :-)
Ed.
Posted by SLS on March 23, 2005, at 7:46:58
In reply to Re: Sulpiride » Basia, posted by ed_uk on March 23, 2005, at 6:44:51
> Have you gained a lot of weight on sulpiride? I get the impression that people don't seem to gain as much weight on sulpiride as they do on some other antipsychotics, especially olanzapine (Zyprexa)!Sulpiride can do a hell of job producing hyperprolactinemia. I wouldn't doubt that this is just one of the ways this drug could put weight on someone.
- Scott
Posted by ed_uk on March 23, 2005, at 8:59:23
In reply to Re: Sulpiride, posted by SLS on March 23, 2005, at 7:46:58
Hi Scott!
Hyperprolactinemia often causes sexual dysfunction too. Sulpiride is still a useful AP though!
Ed.
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