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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by maxime on October 8, 2009, at 15:26:04
It's finally here! I always wanted to try it to see if it would help the depression. But since it's a weight gained, I won't be trying it. I can't deal with weight gain.
Posted by Phillipa on October 8, 2009, at 18:44:07
In reply to Abilify now available in Canada, posted by maxime on October 8, 2009, at 15:26:04
Maxie no weight gain on low doses. Know a guy on it. Phillipa
Posted by iforgotmypassword on October 8, 2009, at 19:38:07
In reply to Abilify now available in Canada, posted by maxime on October 8, 2009, at 15:26:04
i don't think lower dose aripiprazole would be much of a problem weight wise; i think it is difficult to know, especially since some people even *lose* weight.
another drug ziprasidone, which we also now have, that i filled an rx for also has lower affinity for H1 receptors. unfortunately i had unbearable akathisia from a single 20mg, it made me remember the terrible difference between acute akathisia and chronic tardive akathisia, and how much worse it can get. i can't see myself taking another dose. my tardive symptoms are just too awful; even now, i can barely move after i stop, i get stuck, my nerves and skin congeal and everything is impossible. i don't know if i have the guts to try abilify, with its 20% rate of akathisia s/e, and the terribly long half-life of the drug and its primary metabolite.
Posted by Zyprexa on October 8, 2009, at 21:31:48
In reply to Abilify now available in Canada, posted by maxime on October 8, 2009, at 15:26:04
I didn't gain any weight on it for the 6 months I took it.
Posted by Netch on October 9, 2009, at 6:27:52
In reply to Re: Abilify now available in Canada » maxime, posted by Zyprexa on October 8, 2009, at 21:31:48
I didn't gain weight on abilify, quite the opposite since I couldn't sit still.
Posted by floatingbridge on October 9, 2009, at 14:35:06
In reply to Abilify now available in Canada, posted by maxime on October 8, 2009, at 15:26:04
Maxime,
It only caused weight gain went I went up to 5. Really. At 2.5 I felt good effects and no weight gain. Really. a little can go a very long way. Try it. You can stop it if it doesn't work. (No discontinuation syndrome I'v heard of.)
fb
Posted by emme on October 9, 2009, at 16:41:03
In reply to Abilify now available in Canada, posted by maxime on October 8, 2009, at 15:26:04
> It's finally here! I always wanted to try it to see if it would help the depression. But since it's a weight gained, I won't be trying it. I can't deal with weight gain.
I suspect the weight gain may be dose dependent. Since dropping to every other day (2.5 mg), my weight gain seems to have halted. And some do not gain weight. I'd encourage you to give a low dose a try. Good luck.
emme
Posted by iforgotmypassword on October 9, 2009, at 22:29:27
In reply to Re: Abilify now available in Canada » maxime, posted by emme on October 9, 2009, at 16:41:03
it wasn't even on the system at the loblaws superstore drugstore pharmacy near me. should i call a hospital pharmacy?
i've decided i am going to try it, but i'm going to find where i put my lorazepam in this messy apartment first.
i think i am likely going to take a dopamine agonist with it, likely pramipexole, as that is covered by the ontario drug benefit. aripiprazole's agonism at dopamine autoreceptors suppresses dopaminergic firing in the VTA significantly, which i think is at the root of its akathisia and EPS issues. with the autoreceptors occupied and little dopamine release, a dopamine agonist may be able to fill in some of the gaps that cause akathisia, since lower dose aripiprazole seems likely to leave some dopamine receptors open, which may also lower the possibility of D2L receptor upregulation, and lower the chance of tardive dyskinesia as well.
Posted by emme on October 10, 2009, at 7:50:49
In reply to what pharmacies are likely to have it in stock?, posted by iforgotmypassword on October 9, 2009, at 22:29:27
You might want to wait and fist see if you experience akathisia before adding a dopamine agonist. I experienced no akithisia at all.
emme
Posted by floatingbridge on October 10, 2009, at 10:47:14
In reply to what pharmacies are likely to have it in stock?, posted by iforgotmypassword on October 9, 2009, at 22:29:27
I'm only intruding to add that I did begin to get mild akathisia at the 5-10 mg dose. My thumbs and hand would twitch, and at ten, I felt like I wasn't able to smile correctly--my mouth would grimace. Is that akathisia? It completely resolved once removed from abilify. You seem incredibly knowledgable--but maybe Emme's advice is sound.
fb
> it wasn't even on the system at the loblaws superstore drugstore pharmacy near me. should i call a hospital pharmacy?
>
> i've decided i am going to try it, but i'm going to find where i put my lorazepam in this messy apartment first.
>
> i think i am likely going to take a dopamine agonist with it, likely pramipexole, as that is covered by the ontario drug benefit. aripiprazole's agonism at dopamine autoreceptors suppresses dopaminergic firing in the VTA significantly, which i think is at the root of its akathisia and EPS issues. with the autoreceptors occupied and little dopamine release, a dopamine agonist may be able to fill in some of the gaps that cause akathisia, since lower dose aripiprazole seems likely to leave some dopamine receptors open, which may also lower the possibility of D2L receptor upregulation, and lower the chance of tardive dyskinesia as well.
Posted by iforgotmypassword on October 10, 2009, at 16:45:23
In reply to Re: what pharmacies are likely to have it in stock » iforgotmypassword, posted by floatingbridge on October 10, 2009, at 10:47:14
just thought i would pass this along. one pharmacy, while not actually having it in stock yet, confirmed availability of aripiprazole. for 30 2mg pills the cost was approx. 115$ (canadian) at one of the pharmacies where the service charge or whatever tends to be higher. this appears to be a lot cheaper than the 13$+ i hear of people paying per pill in the US. thought i would share this info, in case it is useful to anyone.
thank you both for the advice, i think i will try aripiprazole on its own first. i want to get to the dose of aripiprazole that offers maximum benefit, which for me i think will still be low, but maybe not as low as the 1mg i intend to start at. if say 5mg or even 10mg is the dosage where i get the maximum benefit and where higher dosages aren't helpful, but i am dealing with severe worsening of akathisia or movement symptoms, i think i will then try adding the pramipexole (which thankfully is covered for me.) given that i experienced awful acute akathisia from ziprasidone with only a single dose of 20mg, i am particularly worried i will end up with some problems, perhaps even with the 1mg.
since the pharmacy can only get it in by tuesday (canadian thanksgiving is on monday) i may call my doctor on the same day and ask for a pramipexole rx ahead of time, or at least have the lorazepam handy, but lorazepam tends to be very distorting for me in the long run, also worsening movement issues, so i want to get off of it.
>I'm only intruding to add that I did begin to get
>mild akathisia at the 5-10 mg dose. My thumbs and
>hand would twitch, and at ten, I felt like I
>wasn't able to smile correctly--my mouth would
>grimace. Is that akathisia? It completely
>resolved once removed from abilify.i think all movement symptoms are potentially serious and should be made note of. the problem is, many doctors (at least from my experience in canada) tend to play them down, or not even notice them entirely, especially akathisia, and even more especially when it is SSRI-induced, which i consider to be a tragedy. no one deserves to suffer severe akathisia. in your case, many of the sx you had seem akathitic, and along the lines where akathisia seems more related to dystonia, parkinsonism, and tardive sensory syndrome, and less so to tardive dyskinesia and tardive dysphrenia. the last two seem specifically due to dopaminergic hypersensitivity, though any mix of all of these sx seem capable of occuring together.
the feeling of not being able to smile properly instead feeling like you are grimacing (which i have occurances when i am idle, not even smiling) seems related to dystonia, and if you are experiencing strange pulling sensations (this is what i get in my face all the time) i think that is related to akathisia and dystonia, and what can become tardive sensory syndrome.
i tend not to improve much at all with anticholinergics, only sometimes, whereas lorazepam does help, but with the costs many people seem to experience when taking benzos. i don't think there is any way i can go back to school while taking benzos regularly.
i think the right dose of aripiprazole may actually even help my sx, strangely, but i think it is more likely to happen with a dopamine agonist balancing it. of course tho, i truly have no idea until i try.
This is the end of the thread.
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