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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by chinaboy on January 2, 2014, at 0:10:54
My psychiatrist (the one who suspects me that i might have psychosis) also mentioned Abilify is an effective add-on to antidepressants to boost their efficacy.
Is this true? If true, why? Why can Abilify boost antidepressants' efficacy?
Posted by Jeroen on January 2, 2014, at 7:18:46
In reply to Abilify as an add-on to antidepressants?, posted by chinaboy on January 2, 2014, at 0:10:54
i'm taking abilify 6 years for psychosis, it has a slight anti depressant effect, but it varies from person to person, it might work very good for you
Posted by SLS on January 2, 2014, at 11:47:13
In reply to Abilify as an add-on to antidepressants?, posted by chinaboy on January 2, 2014, at 0:10:54
> My psychiatrist (the one who suspects me that i might have psychosis) also mentioned Abilify is an effective add-on to antidepressants to boost their efficacy.
> Is this true?Yes.
> If true, why? Why can Abilify boost antidepressants' efficacy?
Abilify does a few things that promote dopamine (DA) and serotonin (5-HT) balance. It is a partial agonist of D2 and D3 receptors and also of 5-HT1a receptors. As to which of these properties contributes to its antidepressant effects is nothing more than an educated guess at this point.
Sometimes the only way of finding the right drugs for a given individual is through experimentation. Since doctors do NOT understand enough about how these drugs work, their treatment practices are often reduced to trial and error. This becomes particularly true of cases that are difficult to treat. Actually, empirical observations using trial and error becomes necessary in many more fields of medicine, even with cardiac illness. The practice of medicine is as much an art as it is a science.
I take Abilify 10 mg/day to treat bipolar depression. However, the dosage necessary for a therapeutic response in unipolar depression is generally lower (2 - 5 mg/day).
Good luck with the Abilify. Just know that the first week might include some uncomfortable feelings of restlessness. This usually dissipates quickly. On the other hand, a much more severe side effect called akathisia can occur. It is not dangerous. If you discontinue the medication, the akathisia disappears. Under some circumstances, it makes sense to remain on the Abilify and treat the akathisia.
- Scott
Posted by baseball55 on January 2, 2014, at 19:20:42
In reply to Re: Abilify as an add-on to antidepressants? » chinaboy, posted by SLS on January 2, 2014, at 11:47:13
I still don't understand. What is your diagnosis? Do you have a mental illness or do you just worry you have a mental illness? What are your symptoms, beyond worrying and self-medicating?
Posted by chinaboy on January 2, 2014, at 19:21:28
In reply to Re: Abilify as an add-on to antidepressants? » chinaboy, posted by SLS on January 2, 2014, at 11:47:13
I once took Abilify with Fluoxetine for four days,the first day was 5mg,and the next three days was 10mg.(Because Fluoxetine can double the plasma level of abilify, I actually took 10-20mg)
I felt brain fog,agitation,zombie-like effects on the second to fourth days,so i decided to stop it altogether. A strange thing happened for the next two days---I felt happy again!I could find pleasure from everything I saw.
I know Abilify has a long half-life, could this happy feeling be due to Abilify?What do you think?
Posted by chinaboy on January 2, 2014, at 19:29:22
In reply to Re: Abilify as an add-on to antidepressants?, posted by baseball55 on January 2, 2014, at 19:20:42
Excuse my bad English,I'll try to make it clear.
1I cannot feel pleasure from supposed pleasurable activities,nor can I feel sad, as if I'm completely emotionless.
2 There is a constant restlessness and agitated feeling in me.
3 Lack of motivation,I'm very,very lazy,unable to work full-time.
4 I pay no attention to personal hygienic condition,and I cannot take good care of myself(one psychiatrist once diagnosed me as schizoid personality disorder for this reason)
5 Social Anxiety
6 Suspecting that I have schizophrenia and self-medicating.
What do you think my diagnose is?
Posted by Tomatheus on January 2, 2014, at 21:10:07
In reply to My symptoms:, posted by chinaboy on January 2, 2014, at 19:29:22
Chinaboy,
As I understand things, even medical professionals can have trouble distinguishing between the "negative" symptoms of a psychotic disorder and the symptoms of other disorders, particularly mood disorders. Basically, the symptoms of psychotic disorders are divided into those that are considered to be "positive" (phenomena that are present in symptomatic individuals but typically absent in unaffected individuals) and those that are considered to be "negative" (phenomena that are absent in symptomatic individuals but typically present in unaffected individuals). Examples of "positive" symptoms include hallucinations, delusions, and disorganized speech, and some examples of "negative" symptoms are avolition (reduction in goal-oriented behavior), alogia (poverty speech), affective flattening, and social withdrawal. As I understand things, some "positive" symptoms must be observed in an affected individual for that individual to be diagnosed with schizophrenia under the diagnostic manual in the U.S., but I'm not sure if diagnostic manuals used outside of the U.S. follow the same criteria.
As far as diagnosing is concerned, I think that if you have questions or concerns about your diagnosis that the best person to ask is the professional who diagnosed you. I mentioned above that it can be difficult to distinguish between the symptoms of various disorders, and even though there are a lot of knowledgeable people on this board who may be able to provide you with some valuable insights and information, I think that getting a firm diagnosis requires the expertise of a professional.
Tomatheus
Posted by chinaboy on January 2, 2014, at 23:34:35
In reply to Re: My symptoms: » chinaboy, posted by Tomatheus on January 2, 2014, at 21:10:07
Thank you very much for taking the time to reply my post. Yes,many psychiatrists have found that it is difficult to accurately diagnose my condition.Some say it is purely depressive disorder,while others insist that there must be some negative symptoms of schizophrenia in it.
I think the best way to go is to try both antidepressants and antipsychotics (I mean trying them at different times independently of each other) and see to which class of medications I respond.
What do you think? Now, the psychiatrist removed risperidone because I feel zombie-like on it. Now I'm on 200mg zoloft,30mg remeron,300mg wellbutrin.Is this a reasonable combo?
Posted by Tomatheus on January 3, 2014, at 0:10:23
In reply to Difficulty in diagnosis, posted by chinaboy on January 2, 2014, at 23:34:35
Hi Chinaboy,
Thank you for your reply. It helps to understand that you've received different diagnoses from different psychiatrists, and I think that that can obviously leave patients like us confused as to what's going on with us. I think that it makes sense to go forward with a treatment plan at this point while accepting some uncertainty as far as your diagnosis is concerned and to see if your responses to medications might provide you and your doctors with some clues concerning the nature of your disorder. I can't say that I know enough about medication combos to say whether or not any problems might arise from taking the three medications that you're taking together, but the fact that you at least seem to be tolerating the antidepressants that you're taking, combined with fact that you experienced zombie-like feelings while taking risperidone, has me leaning toward viewing your symptoms more as mood-related symptoms than as symptoms that might be related to a psychotic disorder. Of course, that's just my non-professional opinion as a fellow patient with a mental illness, but that's what I think.
So, how are you doing on the combination of antidepressants that you're taking?
Tomatheus
Posted by chinaboy on January 3, 2014, at 0:21:02
In reply to Re: Difficulty in diagnosis » chinaboy, posted by Tomatheus on January 3, 2014, at 0:10:23
Hi,
Yes,what you said makes great sense! I felt confusion,brain fog,unprovoked anger,and zombie-like feeling while on antipsychotic. But my mind becomes a little bit clear while on antidepressant combinations.
I think that might suggest that my problems are mood-related
Posted by Tomatheus on January 3, 2014, at 0:46:18
In reply to I feel clear-minded on antidepressant's » Tomatheus, posted by chinaboy on January 3, 2014, at 0:21:02
> I think that might suggest that my problems are mood-related
As I said, I tend to lean toward the idea that your symptoms are mood-disorder related, as opposed to being psychotic-disorder related, just based on what I know and on what you've written. Then again, I could be overlooking something that some mental health professionals might be able to see. Although I think you might find it helpful to have a conversation with your psychiatrist about the nature of your symptoms, I think that I would value his (or her) opinion more than I would value my own.
Tomatheus
Posted by chinaboy on January 3, 2014, at 0:56:35
In reply to Re: I feel clear-minded on antidepressant's » chinaboy, posted by Tomatheus on January 3, 2014, at 0:46:18
Thank you, tomatheus,besides, I also had a strange experience with Abilify.
Let me try to recall that day in more detailed words. I took 10mg Abilify(actually 20mg because of Prozac) together with Prozac, and i felt "turbulent mind"(i thought of political things and other stuff that could get me excited) and agitation (I rode a bicycle all the time). Because of the uncomfortable feelings, I decided to stop Abilify on Day 5(probably Day6), and miracle happened on the very day when Abilify was stopped. I felt happiness, which had been absent for almost 20years, again.That wasn't mania, It was a pleasant feeling that was worth dying for. And that happy feeling continued to the next day.Then I visited my psychiatrist after two happy days. But he thought that might be hypomania so he switched me to lamictal and seroquel instead. And that was a horrible experience for me! All the good feelings were gone!
Later I tried Abilify at different doses together with different antidepressants but never felt happy again. It felt like the antidepressants were not working at all (Is it possible that Abilify killed the efficacy of antidepressants?).
I know you guys know more than i do. What can you infer or deduce from the above words?? Any opinion would be appreciated!
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