Psycho-Babble Medication Thread 1015304

Shown: posts 1 to 22 of 22. This is the beginning of the thread.

 

Saphris/asenapine

Posted by tensor on April 10, 2012, at 1:58:59

Is Saphris worth trying for treatment-resistant unipolar depression? I haven't done well on other AAPs.

 

Re: Saphris/asenapine tensor

Posted by phidippus on April 10, 2012, at 16:33:47

In reply to Saphris/asenapine, posted by tensor on April 10, 2012, at 1:58:59

Latuda or Abilify would be better choices, Saphris has no mechanism of action that would treat depression.

Eric

 

Re: Saphris/asenapine phidippus

Posted by tensor on April 11, 2012, at 3:50:02

In reply to Re: Saphris/asenapine tensor, posted by phidippus on April 10, 2012, at 16:33:47

> Latuda or Abilify would be better choices, Saphris has no mechanism of action that would treat depression.
>
> Eric

I don't really agree, well I agree that the aforementioned meds are better options due to other reasons, but pharmacologically Saphris looks like Remeron + clozapine or something.
It has to be the most hitting med of all.

/t

 

Anyone on Saphris for depression? (nm)

Posted by tensor on April 11, 2012, at 4:44:35

In reply to Saphris/asenapine, posted by tensor on April 10, 2012, at 1:58:59

 

Have a look at this

Posted by tensor on April 11, 2012, at 4:47:34

In reply to Saphris/asenapine, posted by tensor on April 10, 2012, at 1:58:59

http://books.google.se/books?id=Z99enarUwZIC&pg=PA140&lpg=PA140&dq=asenapine+stahl&source=bl&ots=NoiqO0UJqt&sig=-1yA60f04RNl7m7CLwLF9i5kCtE&hl=sv&sa=X&ei=zlKFT6iQCuin4gStwMXFBw&ved=0CFQQ6AEwBQ#v=onepage&q&f=false

 

Re: Saphris/asenapine tensor

Posted by SLS on April 11, 2012, at 6:43:25

In reply to Re: Saphris/asenapine phidippus, posted by tensor on April 11, 2012, at 3:50:02

> > Latuda or Abilify would be better choices, Saphris has no mechanism of action that would treat depression.
> >
> > Eric
>
> I don't really agree, well I agree that the aforementioned meds are better options due to other reasons, but pharmacologically Saphris looks like Remeron + clozapine or something.
> It has to be the most hitting med of all.


I won't comment on mechanisms of action as predictors here. I tend to work in reverse when the opportunity presents itself. I will observe an effect and research possible mechanisms for that effect. Stahl's conclusions are interesting. However, some of the drugs that helped me had 5-HT1a partial agonism as a property. On the contrary, asenapine is a full antagonist at that receptor. I did not find asenapine offensive, but neither was it helpful for *me*. I was not on it for very long, though. I probably gave it two weeks. I have not had an AAP produce an antidepressant effect that didn't do so during the first week. I like your comparison of asenapine to mirtazapine. Of course, asenapine doesn't have the NE alpha-2 antagonism of mirtazapine. I keep reading that Seroquel monotherapy has antidepressant properties at medium dosages (300 mg). I haven't seen it for myself, though. I would think it better to combine Seroquel with Prozac to enhance PFC activity for depression.


- Scott

 

Re: Saphris/asenapine tensor

Posted by herpills on April 11, 2012, at 8:44:14

In reply to Re: Saphris/asenapine phidippus, posted by tensor on April 11, 2012, at 3:50:02

> > Latuda or Abilify would be better choices, Saphris has no mechanism of action that would treat depression.
> >
> > Eric
>
> I don't really agree, well I agree that the aforementioned meds are better options due to other reasons, but pharmacologically Saphris looks like Remeron + clozapine or something.
> It has to be the most hitting med of all.
>
> /t

I have used Saphris in the past for depression and it helped me. The other AP I tried were Geodon and Abilify, which did not help. Abilify maybe a little bit, Geodon did nothing for me and depression.

My pdoc thinks Saphris can help depression.

It's FDA approved for mixed episodes...depression is part of a mixed episode, so...

I don't take Saphris right now becuase I'm doing fine on my maintenance combo and don't need it. However Saphris is definitely my go to drug when things get rough for me. Sometimes I'll just take it for a couple weeks. At one point I did stay on it for about 9 months.

I'd say you've got nothing to lose at least try it if you aren't feeling well. Good luck.

 

Re: Saphris/asenapine herpills

Posted by SLS on April 11, 2012, at 9:13:32

In reply to Re: Saphris/asenapine tensor, posted by herpills on April 11, 2012, at 8:44:14

Hi Herpills.

> I have used Saphris in the past for depression and it helped me

How many days does it take for Saphris to begin working?


- Scott

 

Re: Saphris/asenapine SLS

Posted by tensor on April 11, 2012, at 10:26:38

In reply to Re: Saphris/asenapine tensor, posted by SLS on April 11, 2012, at 6:43:25

> I won't comment on mechanisms of action as predictors here. I tend to work in reverse when the opportunity presents itself. I will observe an effect and research possible mechanisms for that effect. Stahl's conclusions are interesting. However, some of the drugs that helped me had 5-HT1a partial agonism as a property. On the contrary, asenapine is a full antagonist at that receptor. I did not find asenapine offensive, but neither was it helpful for *me*. I was not on it for very long, though. I probably gave it two weeks. I have not had an AAP produce an antidepressant effect that didn't do so during the first week. I like your comparison of asenapine to mirtazapine. Of course, asenapine doesn't have the NE alpha-2 antagonism of mirtazapine. I keep reading that Seroquel monotherapy has antidepressant properties at medium dosages (300 mg). I haven't seen it for myself, though. I would think it better to combine Seroquel with Prozac to enhance PFC activity for depression.
>
>
> - Scott

I don't who is right but wikipedia contradicts what you are saying about 5HT1A and NE alpha 2.
http://en.wikipedia.org/wiki/Asenapine

/t

 

Re: Saphris/asenapine herpills

Posted by tensor on April 11, 2012, at 10:29:33

In reply to Re: Saphris/asenapine tensor, posted by herpills on April 11, 2012, at 8:44:14

> I have used Saphris in the past for depression and it helped me. The other AP I tried were Geodon and Abilify, which did not help. Abilify maybe a little bit, Geodon did nothing for me and depression.
>
> My pdoc thinks Saphris can help depression.
>
> It's FDA approved for mixed episodes...depression is part of a mixed episode, so...
>
> I don't take Saphris right now becuase I'm doing fine on my maintenance combo and don't need it. However Saphris is definitely my go to drug when things get rough for me. Sometimes I'll just take it for a couple weeks. At one point I did stay on it for about 9 months.
>
> I'd say you've got nothing to lose at least try it if you aren't feeling well. Good luck.

What is your maintenance combo? What dose of Saphris do/did you take?

/t

 

Re: Saphris/asenapine tensor

Posted by Beckett on April 11, 2012, at 12:04:06

In reply to Saphris/asenapine, posted by tensor on April 10, 2012, at 1:58:59

> Is Saphris worth trying for treatment-resistant unipolar depression? I haven't done well on other AAPs.

I can't comment on the mechanisms of action, but I have found Saphris helpful. It seems to have an antidepressant and anxiolytic effect on me. It helps me sleep as well. I take it at bedtime. I have not done well on other AAP's with the exception of low dose risperidone as a mood stabilizer.

 

Re: Saphris/asenapine tensor

Posted by SLS on April 11, 2012, at 12:56:37

In reply to Re: Saphris/asenapine SLS, posted by tensor on April 11, 2012, at 10:26:38

> > I won't comment on mechanisms of action as predictors here. I tend to work in reverse when the opportunity presents itself. I will observe an effect and research possible mechanisms for that effect. Stahl's conclusions are interesting. However, some of the drugs that helped me had 5-HT1a partial agonism as a property. On the contrary, asenapine is a full antagonist at that receptor. I did not find asenapine offensive, but neither was it helpful for *me*. I was not on it for very long, though. I probably gave it two weeks. I have not had an AAP produce an antidepressant effect that didn't do so during the first week. I like your comparison of asenapine to mirtazapine. Of course, asenapine doesn't have the NE alpha-2 antagonism of mirtazapine. I keep reading that Seroquel monotherapy has antidepressant properties at medium dosages (300 mg). I haven't seen it for myself, though. I would think it better to combine Seroquel with Prozac to enhance PFC activity for depression.
> >
> >
> > - Scott
>
> I don't who is right but wikipedia contradicts what you are saying about 5HT1A and NE alpha 2.
> http://en.wikipedia.org/wiki/Asenapine


I apologize. You are right.

I poked around, just to be sure. Much to my surprise, it turns out that your Wiki source is accurate. (I like to corroborate Wiki submissions using other sources). The NE alpha-2 antagonism was unexpected.


- Scott

 

Re: Saphris/asenapine Beckett

Posted by tensor on April 11, 2012, at 13:51:14

In reply to Re: Saphris/asenapine tensor, posted by Beckett on April 11, 2012, at 12:04:06

> > Is Saphris worth trying for treatment-resistant unipolar depression? I haven't done well on other AAPs.
>
> I can't comment on the mechanisms of action, but I have found Saphris helpful. It seems to have an antidepressant and anxiolytic effect on me. It helps me sleep as well. I take it at bedtime. I have not done well on other AAP's with the exception of low dose risperidone as a mood stabilizer.

How are the side effects? How do they compare to the other AAPs?

 

Re: Saphris/asenapine SLS

Posted by Solstice on April 11, 2012, at 17:47:49

In reply to Re: Saphris/asenapine herpills, posted by SLS on April 11, 2012, at 9:13:32

> Hi Herpills.
>
> > I have used Saphris in the past for depression and it helped me
>
> How many days does it take for Saphris to begin working?
>
>
> - Scott


For my daughter Moon, there was moderate relief from the hypomania during the 2nd week, but it was probably 4 weeks before I saw the complete turnaround in the extreme irritability and agitation (depression?). She is doing marvelously, truly back to the best of who she is.

Since she simultaneously titrated on lamictal (300mg) it`s hard to say which med has which effect, but I doubt either one alone would be as good as both are together.

Solstice

 

Re: Saphris/asenapine tensor

Posted by Beckett on April 12, 2012, at 9:15:23

In reply to Re: Saphris/asenapine Beckett, posted by tensor on April 11, 2012, at 13:51:14

> > > Is Saphris worth trying for treatment-resistant unipolar depression? I haven't done well on other AAPs.

> How are the side effects? How do they compare to the other AAPs?
>

In my experience, Saphris is sedating, and I need to watch the dose because too much will over-flatten me. It is not brightening like Abilify, but I did not tolerate Abilify nor Latuda. I found both to be agitating. I am treating some kind of depression that has a cyclic nature to it, likely bipolar of some sort. I've corresponded with a couple of people successfully treating schizoaffective disorder with Saphris. Thinking back, I felt the onset fairly quickly, that is, I felt something positive from the beginning, however it took weeks for that to settle into more reliable positive change. Hope this helps....

 

Re: Saphris/asenapine

Posted by Beckett on April 12, 2012, at 9:17:32

In reply to Re: Saphris/asenapine tensor, posted by Beckett on April 12, 2012, at 9:15:23

P.S. I ruminate and have anxiety when unmediated.... Socially avoidance, too....

 

Re: Saphris/asenapine Beckett

Posted by tensor on April 12, 2012, at 9:25:09

In reply to Re: Saphris/asenapine tensor, posted by Beckett on April 12, 2012, at 9:15:23

> In my experience, Saphris is sedating, and I need to watch the dose because too much will over-flatten me. It is not brightening like Abilify, but I did not tolerate Abilify nor Latuda. I found both to be agitating. I am treating some kind of depression that has a cyclic nature to it, likely bipolar of some sort. I've corresponded with a couple of people successfully treating schizoaffective disorder with Saphris. Thinking back, I felt the onset fairly quickly, that is, I felt something positive from the beginning, however it took weeks for that to settle into more reliable positive change. Hope this helps....
>

Thanks for the info. We decided today that we are not going for the Saphris but Lamictal and possibly Abilify instead. Although, I think it's a med with great potential for various disorders so I maybe try it in the future.

/t

 

Re: Saphris/asenapine SLS

Posted by herpills on April 14, 2012, at 13:23:21

In reply to Re: Saphris/asenapine herpills, posted by SLS on April 11, 2012, at 9:13:32

> Hi Herpills.
>
> > I have used Saphris in the past for depression and it helped me
>
> How many days does it take for Saphris to begin working?
>
>
> - Scott

Scott, I would say I start feeling better in a few days. Also, I should mention that if I am having a mood episode, there is usually a sleep disturbance as a component of that. Saphris regulates my sleep very well from the first dose and I think that may be part of why in my view it starts to help rather quickly for me.

 

Re: Saphris/asenapine tensor

Posted by herpills on April 14, 2012, at 14:26:47

In reply to Re: Saphris/asenapine herpills, posted by tensor on April 11, 2012, at 10:29:33


>
> What is your maintenance combo? What dose of Saphris do/did you take?
>
> /t

I only took 5mg at night. Apparently it is normally dosed twice a day, but it is so sedating for me I can only tolerate a dose right before bed.

I guess my maintenance combo for me right now is Lamictal 150mg, Lovaza 2g, Klonopin 0.5mg + 0.5mg prn, and metafolin(Deplin) 3.2mg. and some Vitamin C and D.

And then the Saphris is added if needed and I'll usually take it for minimum for about 3 weeks and then go off it, or I've taken it for longer periods, I don't know what the FDA thing is on how long you can take Saphris, does anyone know if it has approval for "maintenance"?? It's certainly possible in the future I may feel like I do need to stay on Saphris for awhile. I have no problem with that if that ends up being the case...

I have had some success with treating depressive episodes with SSRI/SNRI but they don't really seem to help in the long run. They also don't help with anxiety at all for me. I don't have panic attacks, but often severe GAD, which then leads to me getting depressed...herpills

 

Re: Saphris/asenapine herpills

Posted by tensor on April 14, 2012, at 14:35:42

In reply to Re: Saphris/asenapine tensor, posted by herpills on April 14, 2012, at 14:26:47

> I only took 5mg at night. Apparently it is normally dosed twice a day, but it is so sedating for me I can only tolerate a dose right before bed.
>
> I guess my maintenance combo for me right now is Lamictal 150mg, Lovaza 2g, Klonopin 0.5mg + 0.5mg prn, and metafolin(Deplin) 3.2mg. and some Vitamin C and D.
>
> And then the Saphris is added if needed and I'll usually take it for minimum for about 3 weeks and then go off it, or I've taken it for longer periods, I don't know what the FDA thing is on how long you can take Saphris, does anyone know if it has approval for "maintenance"?? It's certainly possible in the future I may feel like I do need to stay on Saphris for awhile. I have no problem with that if that ends up being the case...
>
> I have had some success with treating depressive episodes with SSRI/SNRI but they don't really seem to help in the long run. They also don't help with anxiety at all for me. I don't have panic attacks, but often severe GAD, which then leads to me getting depressed...herpills
>
>

There's surprisingly little information on the internet about Saphris. A comparison to other AAPs would be nice.

 

Re: Saphris/asenapine

Posted by papillon2 on April 15, 2012, at 20:27:04

In reply to Re: Saphris/asenapine SLS, posted by Solstice on April 11, 2012, at 17:47:49

For my daughter Moon, there was moderate relief from the hypomania during the 2nd week, but it was probably 4 weeks before I saw the complete turnaround in the extreme irritability and agitation (depression?). She is doing marvelously, truly back to the best of who she is.
>
> Since she simultaneously titrated on lamictal (300mg) it`s hard to say which med has which effect, but I doubt either one alone would be as good as both are together.
>
> Solstice

I am so glad to hear this.

Papillon

 

Re: Saphris/asenapine papillon2

Posted by SLS on April 16, 2012, at 0:19:31

In reply to Re: Saphris/asenapine, posted by papillon2 on April 15, 2012, at 20:27:04

> For my daughter Moon, there was moderate relief from the hypomania during the 2nd week, but it was probably 4 weeks before I saw the complete turnaround in the extreme irritability and agitation (depression?). She is doing marvelously, truly back to the best of who she is.
> >
> > Since she simultaneously titrated on lamictal (300mg) it`s hard to say which med has which effect, but I doubt either one alone would be as good as both are together.

Good news! I think Moon has become a daughter to many of us.

I think most people tolerate 300 mg of Lamictal well. Others - myself included - suffer memory and cognitive impairments at dosages above 200 mg. If memory impairments and "brain-fog" become issues, don't forget to look at Lamictal as a possible culprit. Other than that, it looks like Moon will now have the life she deserves. You are in no small way directly responsible for this.


- Scott


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