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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 tensor on December 26, 2011, at 11:10:33
My Seroquel trial is coming to an end. No improvement in energy and motivation. I'm now looking at the above. Do you favor one over the other?
Posted by SLS on December 26, 2011, at 11:37:51
In reply to Abilify vs. Geodon for MDD, posted by tensor on December 26, 2011, at 11:10:33
> My Seroquel trial is coming to an end. No improvement in energy and motivation. I'm now looking at the above. Do you favor one over the other?
I would consider both as possible therapeutic agents to treat depression. I would choose Abilify first because it is more predictable than Geodon in therapeutic effect. Both drugs can help with increasing energy and motivation. You will find success stories with the use of either of these drugs.
Antidepressant properties:
Abilify: D2/D3 partial agonist
Geodon: NE and 5-HT reuptake inhibition; 5-HT7 receptor antagonist
Both: 5-HT2a antagonist; 5-HT1a receptor partial agonist.
- Scott
Posted by tensor on December 26, 2011, at 12:06:48
In reply to Re: Abilify vs. Geodon for MDD, posted by SLS on December 26, 2011, at 11:37:51
> I would consider both as possible therapeutic agents to treat depression. I would choose Abilify first because it is more predictable than Geodon in therapeutic effect. Both drugs can help with increasing energy and motivation. You will find success stories with the use of either of these drugs.
>
> Antidepressant properties:
>
> Abilify: D2/D3 partial agonist
>
> Geodon: NE and 5-HT reuptake inhibition; 5-HT7 receptor antagonist
>
> Both: 5-HT2a antagonist; 5-HT1a receptor partial agonist.
>
>
> - ScottThanks Scott! Will try Abilify.
Posted by Phillipa on December 26, 2011, at 15:21:34
In reply to Re: Abilify vs. Geodon for MDD » SLS, posted by tensor on December 26, 2011, at 12:06:48
I heard higher doses of abilify up energy? Phillipa
Posted by Christ_empowered on December 26, 2011, at 18:47:05
In reply to Abilify vs. Geodon for MDD, posted by tensor on December 26, 2011, at 11:10:33
I find it kind of odd that a doctor thought seroquel would be good for energy and motivation. Its helpful for anxious, agitated states (and obviously psychosis), but I can't imagine it putting any pep in your step.
I take 15-30 Abilify daily, depending on how crazed I feel. Its not an upper or anything, but it seems clean enough and it doesn't sedate me or turn me into a zombie. I've heard that lower doses are good for some people with depression...something like 2-10 milligrams or something. Keep in mind that 10 is where its effective against schizophrenia and bipolar, so that might be a little high for you. Or not.
Do you have any other options? Provigil, ritalin, something like that? Antipsychotics obviously help a lot of people, but they're expensive and can cause lots of problems. Speaking as someone on Abilify, I'd say avoid it unless you have...you know...psychosis.
Posted by SLS on December 26, 2011, at 19:47:14
In reply to Re: Abilify vs. Geodon for MDD, posted by Christ_empowered on December 26, 2011, at 18:47:05
> I find it kind of odd that a doctor thought seroquel would be good for energy and motivation. Its helpful for anxious, agitated states (and obviously psychosis), but I can't imagine it putting any pep in your step.
Recall that the metabolite of quetiapine (Seroquel), norquetiapine, inhibits the reuptake of NE. Perhaps Seroquel is energizing for some people at higher dosages.
- Scott
Posted by Phillipa on December 26, 2011, at 20:04:42
In reply to Re: Abilify vs. Geodon for MDD » Christ_empowered, posted by SLS on December 26, 2011, at 19:47:14
Was once put on it for one day in hospital and taken off by the doc. I couldn't speak wanted to no words would come out and almost fainted. I'd hate to need this med. Phillipa
Posted by Christ_empowered on December 26, 2011, at 20:16:40
In reply to Re: Abilify vs. Geodon for MDD, posted by Phillipa on December 26, 2011, at 20:04:42
I've only had docs offer it to me/push it one me when I was in an agitated state. I couldn't tolerate it at 100 daily, so after that I always said no when it came up again.
Posted by tensor on December 27, 2011, at 2:32:37
In reply to Re: Abilify vs. Geodon for MDD, posted by Christ_empowered on December 26, 2011, at 18:47:05
> I find it kind of odd that a doctor thought seroquel would be good for energy and motivation. Its helpful for anxious, agitated states (and obviously psychosis), but I can't imagine it putting any pep in your step.
>
> I take 15-30 Abilify daily, depending on how crazed I feel. Its not an upper or anything, but it seems clean enough and it doesn't sedate me or turn me into a zombie. I've heard that lower doses are good for some people with depression...something like 2-10 milligrams or something. Keep in mind that 10 is where its effective against schizophrenia and bipolar, so that might be a little high for you. Or not.
>
> Do you have any other options? Provigil, ritalin, something like that? Antipsychotics obviously help a lot of people, but they're expensive and can cause lots of problems. Speaking as someone on Abilify, I'd say avoid it unless you have...you know...psychosis.I actually had no problems with sedation and I went up to 600mg, I do also have anxiety issues but I have to say Seroquel did not do much in that regard. Provigil did work once but does nothing for me anymore except makes me more focused.
I'm doing a little trial now with bupropion to see if I respond to dopaminergic meds. I have worked through so many meds I can't really afford being picky about side effects anymore, I need something that works.
Posted by SLS on December 27, 2011, at 7:17:11
In reply to Re: Abilify vs. Geodon for MDD, posted by tensor on December 27, 2011, at 2:32:37
> Speaking as someone on Abilify, I'd say avoid it unless you have...you know...psychosis.
What would you say to those people for whom Abilify is a necessary component to their treatment of depression? Is depression any less deserving of treatment than psychosis?
- Scott
Posted by SLS on December 27, 2011, at 7:21:34
In reply to Re: Abilify vs. Geodon for MDD, posted by Christ_empowered on December 26, 2011, at 20:16:40
> Speaking as someone on Abilify, I'd say avoid it unless you have...you know...psychosis.
What would you say to those people for whom Abilify is a necessary component to their treatment of depression? Is depression any less deserving of treatment than psychosis?
- Scott
Posted by linkadge on December 27, 2011, at 8:15:44
In reply to Re: Abilify vs. Geodon for MDD » SLS, posted by tensor on December 26, 2011, at 12:06:48
I assume you've tried regular antidepressants?
Antipsychotics are poor antidepressants IMHO, unless its more of a stress induced depression.
Linkadge
Posted by SLS on December 27, 2011, at 8:20:06
In reply to Re: Abilify vs. Geodon for MDD, posted by linkadge on December 27, 2011, at 8:15:44
> I assume you've tried regular antidepressants?
>
> Antipsychotics are poor antidepressants IMHO, unless its more of a stress induce
I didn't know that there were any good antidepressants.;-)
- Scott
Posted by Emme-V2 on December 27, 2011, at 8:24:32
In reply to Re: Abilify vs. Geodon for MDD, posted by linkadge on December 27, 2011, at 8:15:44
I have treatment resistant MDD, and a combination of Lamictal and a very low dose of Abilify has been far more effective for me over the long haul than the antidepressants have been.
Abilify also helps anxiety for me.
There is, of course, only one real way to find out if a med is a good match for you....
Good luck.
emme
Posted by ed_uk2010 on December 27, 2011, at 11:51:54
In reply to Re: Abilify vs. Geodon for MDD, posted by tensor on December 27, 2011, at 2:32:37
>I'm doing a little trial now with bupropion to see if I respond to dopaminergic meds.
Hi M,
What do you mean by a little trial? Not a proper trial? I'm not sure how dopaminergic bupropion is, and I don't think your response to bupropion will predict your response to anything else. On the other hand, bupropion is an established AD and you might do well on it.
RE Abilify vs. Geodon. I would go for Abilify, probably starting at 5mg then increasing to 10mg if necessary after a few weeks.
Best of luck with whatever you decide!
Posted by emmanuel98 on December 27, 2011, at 19:31:58
In reply to Re: Abilify vs. Geodon for MDD » tensor, posted by SLS on December 27, 2011, at 7:17:11
Abilify was like magic for me for major depression. But I gained weight on it so fast that I had to keep staring and stopping and tryng other AAP's. Risperdal and zyprexa also worked for me but made me gain 2-3 pounds a week. I finally had to give up on AAPs.
Posted by sleepygirl2 on December 27, 2011, at 21:31:39
In reply to Re: Abilify vs. Geodon for MDD, posted by emmanuel98 on December 27, 2011, at 19:31:58
Abilify was a weird drug for me. When I started it on a low dose I found it a bit mood brightening. I might have even had some motivation.
But, I had an acid like feeling at the back of my throat while I was on the higher doses, and was more anxious on the higher doses.
Posted by SLS on December 31, 2011, at 5:50:32
In reply to Re: Abilify vs. Geodon for MDD » tensor, posted by Phillipa on December 26, 2011, at 15:21:34
> I heard higher doses of abilify up energy? Phillipa
After a certain dosage, some people experience a mild-to-moderate "brain fog" and other changes in cognition. These things occur with me once I reach 20 mg.
Geodon produced major brain fog for me at a dosage of 80 mg. It feels almost like dissociation.
- Scott
Posted by Phillipa on December 31, 2011, at 19:06:25
In reply to Re: Abilify vs. Geodon for MDD » Phillipa, posted by SLS on December 31, 2011, at 5:50:32
Scott and to think that pdoc I saw when moved here basically told me to take 120mg of geodon. BTW after he fell asleep on patients he was diagnosed with narcolepsy. New pdoc told me. Phillipa
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