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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Alvin on June 12, 2005, at 21:33:49
Hi, after helpful posts from many of you about how abilify has helped you, I took my first 2.5 mg dose last week. Unfortunately, while I think I experienced postive mental improvements, my physical reaction - vomiting and nausea - was so bad that I couldn't take a second dose (even half of 2.5mg) the next day. Does this mean i'm allergic to it, or should I just go slower? Does anyone have suggestions on how to prevent the vomiting/nausea? I'd like to try this drug again, but won't if I can't avoid the physical adverse effects. Thanks for any help/tips you might have.
Posted by Sabina on June 13, 2005, at 17:58:36
In reply to ANYONE-Tips to preventNausea/Vomiting on Abilify??, posted by Alvin on June 12, 2005, at 21:33:49
Hmmmm...I don't really know, as I haven't had any such SE's myself. I did have some headache and general, low grade "trippy" feelings early on. I'm still on a baby dose myself of 5mg every other day and am happier than I've been in years. I will titrate up when/if needs be. Did you take it with food, say maybe a dairy and starch heavy meal? That might be an idea. Or a real ginger ale and saltines? Mostly I just hate to hear that you had a bad time with it. I hope it gets better if you decide to try it again.
Posted by Alvin on June 13, 2005, at 19:43:19
In reply to Re: ANYONE-Tips to preventNausea/Vomiting on Abilify??, posted by Sabina on June 13, 2005, at 17:58:36
Thank you Sabina; I see my pdoc tomorrow to discuss how I might approach trying it again. The encouragement from you is helpful; in fact the encouragement from people on this board who have had success with Abilify helped me immensely. When I try again, I may also cut my 2.5 gms to 1.25 and slowly titrate up....I'm taking it for GAD and soft bipolar with some rapid cycling features. If you don't mind my asking, is that similar to your diagnosis? For close to 2 years, I've "managed" my issues by taking ativan as needed, but that unfortunately, does not seem to be enough right now. Are you on any other meds combined with ABilify? Thanks again.
> Hmmmm...I don't really know, as I haven't had any such SE's myself. I did have some headache and general, low grade "trippy" feelings early on. I'm still on a baby dose myself of 5mg every other day and am happier than I've been in years. I will titrate up when/if needs be. Did you take it with food, say maybe a dairy and starch heavy meal? That might be an idea. Or a real ginger ale and saltines? Mostly I just hate to hear that you had a bad time with it. I hope it gets better if you decide to try it again.
Posted by Sabina on June 13, 2005, at 23:09:55
In reply to Re: ANYONE-Tips to preventNausea/Vomiting on Abilify??, posted by Alvin on June 13, 2005, at 19:43:19
I am Bipolar II with ultra rapid cycling and mixed states. I suppose I've always had anxiety, ever since I was a child, even though that's not part of my official dx. I managed, hid, and covered my symptoms through various crafty means for many years until a complete physical breakdown from Fibromyalgia triggered an exacerbation of my BPII symptoms.
I realize that some people aren't keen on atypicals, but they've been great for me. I tend to hear and see things that aren't there when I don't get enough rest so they're actually a must for me. Seroquel saved my life; but after two years working hard to get through physical recovery mode, I just needed something more activating, as I was simply too sedated yet ready to join the world again. Now I'm more motivated than I could have imagined but without being hypomanic. I was worried about not being able to sleep, but I take the Abilify in the mornings and that seems to do the trick. For those times when I do become anxious, I have .50 Xanax. I'm also on a small (100mg) maintenance dose of Topamax. It keeps me feeling centered and my urge to self medicate with alcohol at bay. Alcohol was never a problem for me, only a med substitution before I had a pdoc and insurance! I'm a believer in taking the bare minimum to get by and I'm doing just that.
Oh yeah, I also take Soma and Hydrocodone as needed for pain, which translates as Miltown and Opiates in the Psych realm, strictly speaking. After more than two years on Soma and one on Hydrocodone, I've never increased my dosage and still experience good effects from that combo. As far as increasing my quality of life (I've also got back pain from surgeries), I cannot underestimate what these two drugs have done for both my physical well being and my mood (due to the fact that I can participate in so many more activities).
That's probably more information than you needed. Sorry. I hope that things go well with your pdoc. Titrating slowly is always a good idea. Find what works for you. When I started Topamax, I didn't think I'd make it; but s-l-o-w titration was the key. Good luck!
Sabina
Posted by Mimi on June 14, 2005, at 21:47:19
In reply to ANYONE-Tips to preventNausea/Vomiting on Abilify??, posted by Alvin on June 12, 2005, at 21:33:49
If it doesn't feel good going down, Don't take it. If a med is my friend, it tells me so when it is going down my esophogus. Trust your instincts; they will guide you well. As for side effects diminishing, nary a side effect ever diminished in my 7 years experience on psychotropic drugs. I think they (the pdocs & med companies) just hope you forget how you once were (and felt) in the world.
Mimi
Posted by alvin on June 15, 2005, at 8:10:14
In reply to Re: ANYONE-Tips to preventNausea/Vomiting on Abilify?? » Alvin, posted by Sabina on June 13, 2005, at 23:09:55
Sabina,
Thank you for sharing your personal situation. I spoke to my pdoc, who has suggested that if the nausea persists, even after starting with half of 2.5 mg abilify and following some of the anti-nausea techniques you suggested, I should add .25 mg Haldol to help with nausea. Apparently haldol at such a low dose, is used to help cancer patients with chemo deal with nausea, something I did not realize. I plan to give the abilify another try, by halving my 2.5 mg dose at the beginning, just to see how the nausea goes. Hopefully, it will dissipate and I'll have as successful an experience with abilify as you are having. My best to you and thanks so much for giving me the encouragement of your good experiences ...
> I am Bipolar II with ultra rapid cycling and mixed states. I suppose I've always had anxiety, ever since I was a child, even though that's not part of my official dx. I managed, hid, and covered my symptoms through various crafty means for many years until a complete physical breakdown from Fibromyalgia triggered an exacerbation of my BPII symptoms.
>
> I realize that some people aren't keen on atypicals, but they've been great for me. I tend to hear and see things that aren't there when I don't get enough rest so they're actually a must for me. Seroquel saved my life; but after two years working hard to get through physical recovery mode, I just needed something more activating, as I was simply too sedated yet ready to join the world again. Now I'm more motivated than I could have imagined but without being hypomanic. I was worried about not being able to sleep, but I take the Abilify in the mornings and that seems to do the trick. For those times when I do become anxious, I have .50 Xanax. I'm also on a small (100mg) maintenance dose of Topamax. It keeps me feeling centered and my urge to self medicate with alcohol at bay. Alcohol was never a problem for me, only a med substitution before I had a pdoc and insurance! I'm a believer in taking the bare minimum to get by and I'm doing just that.
>
> Oh yeah, I also take Soma and Hydrocodone as needed for pain, which translates as Miltown and Opiates in the Psych realm, strictly speaking. After more than two years on Soma and one on Hydrocodone, I've never increased my dosage and still experience good effects from that combo. As far as increasing my quality of life (I've also got back pain from surgeries), I cannot underestimate what these two drugs have done for both my physical well being and my mood (due to the fact that I can participate in so many more activities).
>
> That's probably more information than you needed. Sorry. I hope that things go well with your pdoc. Titrating slowly is always a good idea. Find what works for you. When I started Topamax, I didn't think I'd make it; but s-l-o-w titration was the key. Good luck!
>
> Sabina
Posted by yxibow on June 15, 2005, at 15:47:31
In reply to Re: ANYONE-Tips to preventNausea/Vomiting on Abilify?? » Sabina, posted by alvin on June 15, 2005, at 8:10:14
> Sabina,
> Thank you for sharing your personal situation. I spoke to my pdoc, who has suggested that if the nausea persists, even after starting with half of 2.5 mg abilify and following some of the anti-nausea techniques you suggested, I should add .25 mg Haldol to help with nausea. Apparently haldol at such a low dose, is used to help cancer patients with chemo deal with nausea, something I did not realize. I plan to give the abilify another try, by halving my 2.5 mg dose at the beginning, just to see how the nausea goes.
I was going to add that nausea strikes me as counterintuitive on a neuroleptic because some serve dual purposes, for psychosis and other dx, and for uncontrollable nausea (I can attest to this, I was given Compazine for nausea for a flu, and had horrible akathisia.. but that's neither here nor there.) But perhaps this is not so much the case with new neuroleptics, I'm not sure.The touch of Haldol or something like Compazine would work; also less risky (EPS, TD) would be the newer anti-emetic 5HT3 drugs such as Ondansetron, Granisetron, and Dolasetron.
And then there's always raw ginger (an acquired taste), but does hit the tummy nice sometimes, or Australian crystallized ginger, equally.
If none of the above works, some meds weren't meant to be "forced" on the body, listen to it... but there may be treatment reasons to continue. Thats up to your doctor-patient relationship.
my 2c, and tidings
Posted by ed_uk on June 15, 2005, at 17:04:54
In reply to ANYONE-Tips to preventNausea/Vomiting on Abilify??, posted by Alvin on June 12, 2005, at 21:33:49
Hi Alvin,
>Does this mean i'm allergic to it, or should I just go slower?
Abilify often causes nausea at first, it's not a allergic reaction. I'd recommend starting by taking a tiny piece of a tablet.
Kind regards,
Ed.
Posted by ed_uk on June 15, 2005, at 17:08:49
In reply to Re: ANYONE-Tips to preventNausea/Vomiting on Abili, posted by yxibow on June 15, 2005, at 15:47:31
Hi Yxibow!
>I was going to add that nausea strikes me as counterintuitive on a neuroleptic because some serve dual purposes, for psychosis and other dx, and for uncontrollable nausea (I can attest to this, I was given Compazine for nausea for a flu, and had horrible akathisia.. but that's neither here nor there.) But perhaps this is not so much the case with new neuroleptics, I'm not sure.
I expect Abilify causes nausea because it's a partial agonist at dopamine receptors. Dopamine agonists frequently cause nausea and vomiting........whereas antagonists such as Compazine are anti-emetic. Whatever the reason, Abilify doesn't seem to be anti-emetic. There's a small amount of evidence that some atypicals (eg. Zyprexa) can be used as anti-emetics.
Tidings!
Ed.
Posted by alvin on June 15, 2005, at 18:19:48
In reply to Re: ANYONE-Tips to preventNausea/Vomiting on Abilify?? » Alvin, posted by ed_uk on June 15, 2005, at 17:04:54
Thanks Ed, I appreciate the response you gave to yibow because by understanding the theory of why abilify might cause nausea (versus other different acting neuroleptics that can help abate nausea) I am much more receptive to giving abilify another go round, but as you suggested, on about 1.25 mgs instead of 2.5mgs. Thanks again - did your exams go well?
> Hi Alvin,
>
> >Does this mean i'm allergic to it, or should I just go slower?
>
> Abilify often causes nausea at first, it's not a allergic reaction. I'd recommend starting by taking a tiny piece of a tablet.
>
> Kind regards,
> Ed.
Posted by ed_uk on June 15, 2005, at 18:40:49
In reply to Re: ANYONE-Tips to preventNausea/Vomiting on Abilify?? » ed_uk, posted by alvin on June 15, 2005, at 18:19:48
Hi Alvin!
>I am much more receptive to giving abilify another go round.........
You could take even less than 1.25mg on the first day.
>Thanks again - did your exams go well?
Four of them went ok thank you :-) Chemistry was a disaster though, I'll be resitting that one in August!
Kind regards,
Ed.
Posted by alvin on June 15, 2005, at 18:57:50
In reply to Re: ANYONE-Tips to preventNausea/Vomiting on Abilify?? » alvin, posted by ed_uk on June 15, 2005, at 18:40:49
So you're suggesting just knawing off a little bit and seeing how it goes that way each day until I build up my tolerance - sounds a lot better than meticulously cutting each 5 mg tablet into quarters. Too bad about the chemistry - if it's any consolation, my father is a Phd chemist who believes it is a subject few people teach well, resulting in too many good people turning away from chemistry; anyway, hope your summer will provide you with some fun in addition to studying.....
> Hi Alvin!
>
> >I am much more receptive to giving abilify another go round.........
>
> You could take even less than 1.25mg on the first day.
>
> >Thanks again - did your exams go well?
>
> Four of them went ok thank you :-) Chemistry was a disaster though, I'll be resitting that one in August!
>
> Kind regards,
> Ed.
>
>
Posted by ed_uk on June 15, 2005, at 19:13:35
In reply to Re: ANYONE-Tips to preventNausea/Vomiting on Abilify?? » ed_uk, posted by alvin on June 15, 2005, at 18:57:50
Hi Alvin,
>So you're suggesting just knawing off a little bit and seeing how it goes that way each day until I build up my tolerance - sounds a lot better than meticulously cutting each 5 mg tablet into quarters.
Yes exactly! You don't need to be accurate, a little piece will be fine :-)
Kind regards,
Ed.
Posted by Gabbi-x-2 on June 15, 2005, at 19:55:20
In reply to ANYONE-Tips to preventNausea/Vomiting on Abilify??, posted by Alvin on June 12, 2005, at 21:33:49
I've gotten extremely nauseated while starting up any psychotropic drugs. I hate it! Gingerale is good advice, but my standbye is peppermint oil capsules. It has to be in the capsules though or it doesn't work the same way, it can actually make things worse if you just use tea or drops.
You can get them at the health food store and they are ridiculously expensive compared to what plain peppermint oil actually costs.
If you have an East Indian grocer anywhere in the vicinity though, you can get them by "Pudin Hara" and they are about 1/10th of the cost, or at least that's how it works in Canada.
Posted by alvin on June 15, 2005, at 20:17:43
In reply to Re: ANYONE-Tips to preventNausea/Vomiting on Abilify?? » Alvin, posted by Gabbi-x-2 on June 15, 2005, at 19:55:20
Gabbi, glad you mentioned peppermint oil - where I live in the states, there are plenty of East Indian stores.....thanks for the suggestion!
> I've gotten extremely nauseated while starting up any psychotropic drugs. I hate it! Gingerale is good advice, but my standbye is peppermint oil capsules. It has to be in the capsules though or it doesn't work the same way, it can actually make things worse if you just use tea or drops.
> You can get them at the health food store and they are ridiculously expensive compared to what plain peppermint oil actually costs.
> If you have an East Indian grocer anywhere in the vicinity though, you can get them by "Pudin Hara" and they are about 1/10th of the cost, or at least that's how it works in Canada.
>
Posted by sonhasbp on June 20, 2005, at 15:24:28
In reply to Re: ANYONE-Tips to preventNausea/Vomiting on Abilify?? » Gabbi-x-2, posted by alvin on June 15, 2005, at 20:17:43
When exactly does one take the peppermint oil capsules? My son is having a terrible time adjusting to Abilify. Thanks in advance.
> Gabbi, glad you mentioned peppermint oil - where I live in the states, there are plenty of East Indian stores.....thanks for the suggestion!
> > I've gotten extremely nauseated while starting up any psychotropic drugs. I hate it! Gingerale is good advice, but my standbye is peppermint oil capsules. It has to be in the capsules though or it doesn't work the same way, it can actually make things worse if you just use tea or drops.
> > You can get them at the health food store and they are ridiculously expensive compared to what plain peppermint oil actually costs.
> > If you have an East Indian grocer anywhere in the vicinity though, you can get them by "Pudin Hara" and they are about 1/10th of the cost, or at least that's how it works in Canada.
> >
>
>
Posted by alvin on June 20, 2005, at 16:30:09
In reply to Re: ANYONE-Tips to preventNausea/Vomiting on Abilify??, posted by sonhasbp on June 20, 2005, at 15:24:28
After all the good suggestions for preventing nausea, I ended up doing the following (with approval from my pdoc): Last Wednesday, I started on half the dose my doctor initially started me on, which means I started with 1.25 mgs abilify instead of 2.5; I experienced very mild nausea and knawed on raw ginger once during the day to quell it, but otw, no other problems. AFter day 4, I increased my dose to 2 mgs and experienced no nausea. I will wait a few days and go up to the 2.5 mgs my pdoc initially recommended. So it seems to me very slow titration, (slower than normal) can really help the body adjust. I think abilify is helping me, and certainly, without all the side effects of vomiting, I'm much more likely to proceed and give it a fair trial. THANKS SO MUCH EVERYONE FOR HELPING ME AND GIVING SUCH GREAT SUGGESTIONS - YOUR CARING MADE ME FEEL STRONGER AND ABLE TO TACKLE IT AND GIVE IT FAIR TRIAL.
Posted by ed_uk on June 20, 2005, at 16:38:10
In reply to Re: ANYONE-Tips to preventNausea/Vomiting on Abilify??, posted by alvin on June 20, 2005, at 16:30:09
Hi Alvin!
It's always better when you're not vomiting isn't it?! ;-)
I hope the Abilify works well for you :-)
Keep us updated,
~Ed
Posted by alvin on June 20, 2005, at 17:07:18
In reply to Re: ANYONE-Tips to preventNausea/Vomiting on Abilify?? » alvin, posted by ed_uk on June 20, 2005, at 16:38:10
> Hi Alvin!
>
> It's always better when you're not vomiting isn't it?! ;-) PUZZLING AND MYSTERIOUS, ISN'T IT??
>
> I hope the Abilify works well for you :-)THANKS, I HOPE SO TOO....
>
> Keep us updated, WILL DO, SUCCESSES AS WELL AS "NOT SO" SUCCESSESSES....
>
> ~Ed
This is the end of the thread.
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