Psycho-Babble Medication Thread 1098631

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Re: Switching from Abililfy to Saphris. » SLS

Posted by ed_uk2010 on June 4, 2018, at 16:38:07

In reply to Re: Switching from Abililfy to Saphris., posted by SLS on June 3, 2018, at 20:55:58

Hi Scott,

Sorry to hear that asenapine didn't suit you.

How quickly do you plan to stop Parnate?

 

Re: Switching from Abililfy to Saphris. » SLS

Posted by sigismund on June 4, 2018, at 18:52:59

In reply to Re: Switching from Abililfy to Saphris., posted by SLS on June 3, 2018, at 20:55:58

>Things have turned foul on me. Not only did I lose the improvement that I enjoyed during the first week or two on Saphris, but I am feeling decidedly worse.

The effects of Saphris change with the dosage?

How can you know what dose might be helpful if the effect is not linear?

Just a thought.

 

Re: Switching from Abililfy to Saphris.

Posted by sigismund on June 4, 2018, at 19:00:00

In reply to Re: Switching from Abililfy to Saphris. » SLS, posted by sigismund on June 4, 2018, at 18:52:59

There's a lot of 1s and 5s for Saphris on askapatient and not too many 3s. Doses from 5 to 20.

 

Re: Switching from Abililfy to Saphris. » sigismund

Posted by SLS on June 4, 2018, at 20:04:40

In reply to Re: Switching from Abililfy to Saphris. » SLS, posted by sigismund on June 4, 2018, at 18:52:59

> >Things have turned foul on me. Not only did I lose the improvement that I enjoyed during the first week or two on Saphris, but I am feeling decidedly worse.
>
> The effects of Saphris change with the dosage?
>
> How can you know what dose might be helpful if the effect is not linear?
>
> Just a thought.

That's a very good thought!

Thank you.


- Scott

 

Re: Switching from Abililfy to Saphris. » ed_uk2010

Posted by SLS on June 4, 2018, at 20:15:08

In reply to Re: Switching from Abililfy to Saphris. » SLS, posted by ed_uk2010 on June 4, 2018, at 16:38:07

> Hi Scott,
>
> Sorry to hear that asenapine didn't suit you.
>
> How quickly do you plan to stop Parnate?

I have begun to taper the dosage of Parnate as of today. I've done this before, of course. One of the most prominent withdrawal symptoms has been profound fatigue. I guess it is similar to coming off of amphetamine. I might use Focalin judiciously to help create a bridge for the worst of it. Similarly, I can use Abilify as a bridge as was suggested by my doctor. I will try not to do this, though. One day at a time.


- Scott

 

Re: Switching from Abililfy to Saphris.

Posted by Lamdage22 on June 4, 2018, at 21:42:11

In reply to Re: Switching from Abililfy to Saphris. » ed_uk2010, posted by SLS on June 4, 2018, at 20:15:08

That is why i have become more careful with med changes. I hope it turns out ok for you.

 

Re: Switching from Abililfy to Saphris.

Posted by Lamdage22 on June 4, 2018, at 21:54:42

In reply to Re: Switching from Abililfy to Saphris. » ed_uk2010, posted by SLS on June 4, 2018, at 20:15:08

So what is the plan now? You are changing two parameters at the same time?

 

Re: Switching from Abililfy to Saphris.

Posted by SLS on June 5, 2018, at 13:06:11

In reply to Re: Switching from Abililfy to Saphris., posted by Lamdage22 on June 4, 2018, at 21:54:42

Hi, Lamdage.

> So what is the plan now? You are changing two parameters at the same time?

The plan is to switch from Parnate to Trintellix. Right now, I am not taking Abilify or Saphris. Having already gone through the bulk of Abilify and Saphris withdrawals, I am reluctant to return to either one of them. My doctor suggested that I could go back to Abilify and use it as a temporary bridge if necessary as I taper Parnate and wait 7-10 days before beginning Trintellix.


- Scott

 

Re: Switching from Abililfy to Saphris. » SLS

Posted by ed_uk2010 on June 5, 2018, at 15:09:45

In reply to Re: Switching from Abililfy to Saphris. » ed_uk2010, posted by SLS on June 4, 2018, at 20:15:08

>I have begun to taper the dosage of Parnate as of today.

How long do you think it will take Scott?

 

Re: Switching from Abililfy to Saphris. » ed_uk2010

Posted by SLS on June 5, 2018, at 18:03:44

In reply to Re: Switching from Abililfy to Saphris. » SLS, posted by ed_uk2010 on June 5, 2018, at 15:09:45

> >I have begun to taper the dosage of Parnate as of today.
>
> How long do you think it will take Scott?

I am hoping to discontinue Parnate in 10 days. I'll be pushing it. However, I am allowing myself flexibility in the taper period. I don't know what to expect with respect to the severity of depression. I am expecting profound fatigue, though. This is what I've experienced in the past. I'm guessing it is similar to amphetamine withdrawal.

My doctor will let me go with a 7-10 day washout period. Serotonin syndrome is a concern as I prepare to begin Trintellix treatment.


- Scott

 

Re: Switching from Abililfy to Saphris. » SLS

Posted by ed_uk2010 on June 6, 2018, at 0:45:00

In reply to Re: Switching from Abililfy to Saphris. » ed_uk2010, posted by SLS on June 5, 2018, at 18:03:44

Hi Scott,

That is a fast withdrawal! But if you allow yourself flexibility it should be ok.

I can see why you would be keen to start something new, so it makes sense.

Hope it works out well. Let me know.

 

Re: Switching from Abililfy to Saphris. » ed_uk2010

Posted by SLS on June 6, 2018, at 8:32:28

In reply to Re: Switching from Abililfy to Saphris. » SLS, posted by ed_uk2010 on June 6, 2018, at 0:45:00

> Hi Scott,
>
> That is a fast withdrawal! But if you allow yourself flexibility it should be ok.
>
> I can see why you would be keen to start something new, so it makes sense.
>
> Hope it works out well. Let me know.

Thanks, Ed.

:-)


- Scott

 

Re: Switching from Abililfy to Saphris.

Posted by Lamdage22 on June 25, 2018, at 10:27:06

In reply to Re: Switching from Abililfy to Saphris. » ed_uk2010, posted by SLS on June 6, 2018, at 8:32:28

Hey Scott,

how you doing? You are brave. Are you fully withdrawn from Neuroleptics? Just watch out before you get another destructive Mania/Psychosis phase. I think you have lost enough relationships to Psychosis. Me too :(

Keep us posted.

 

Re: Switching from Abililfy to Saphris. » Lamdage22

Posted by SLS on June 25, 2018, at 13:02:46

In reply to Re: Switching from Abililfy to Saphris., posted by Lamdage22 on June 25, 2018, at 10:27:06

Hi Lamdage.

> Hey Scott,
>
> how you doing? You are brave.

:-)

> Are you fully withdrawn from Neuroleptics?

Yes.

> Just watch out before you get another destructive Mania/Psychosis phase.

That's great advice. Thank you. I'll try to be careful. I am relying on family members to recognize the emergence of mania. They know what to look for. I can only hope that I am receptive to their advice. So far, the only manic episodes I've had have been in association with MAOIs. It is likely that Abilify acted as a prophylactic against manic reactions to both Nardil and Parnate. Latuda maybe?

I have mostly recovered from withdrawal effects for having discontinued Abilify and Parnate. I didn't expect that I would be hit so hard. There is some residual anxiety, but the depression has stabilized. I am on day 4 of Trintellix treatment. I'm taking 5.0 mg/day. I felt numb and slowed-down initially, but that seems to be subsiding.

I needed to do something. I was stuck for too many years.

Thanks again.


- Scott

 

Re: Switching from Abililfy to Saphris. » SLS

Posted by Robert_Burton_1621 on July 2, 2018, at 4:42:08

In reply to Re: Switching from Abililfy to Saphris. » Lamdage22, posted by SLS on June 25, 2018, at 13:02:46

I do hope the substitution of vortioxetine for parnate does the trick, Scott.

I tried vortioxetine between stopping parnate and then resuming it, unsuccessfully - the main effects were agitation and hyper-sexuality. However, my psychiatrist at the time, a specialist in TRD, had done his own study of the drug with 100 of his own TRD patients, and overall it was successful.

At one point I had looked into the properties of the drug, and it seemed to be rather similar to Abilify *without* the dopamine antagonism. That was only my initial impression.

 

Re: Switching from Abililfy to Saphris. » Robert_Burton_1621

Posted by SLS on July 2, 2018, at 8:26:56

In reply to Re: Switching from Abililfy to Saphris. » SLS, posted by Robert_Burton_1621 on July 2, 2018, at 4:42:08

Hi, Robert.

> I do hope the substitution of vortioxetine for parnate does the trick, Scott.
>
> I tried vortioxetine between stopping parnate and then resuming it, unsuccessfully - the main effects were agitation and hyper-sexuality. However, my psychiatrist at the time, a specialist in TRD, had done his own study of the drug with 100 of his own TRD patients, and overall it was successful.
>
> At one point I had looked into the properties of the drug, and it seemed to be rather similar to Abilify *without* the dopamine antagonism. That was only my initial impression.

Thanks for the information, Robert. It helps to give me hope. I am on day 10 of treatment. I don't know what to think. I have some background anxiety, which isn't normal for me. Maybe this is how I experience the agitation you describe. Yesterday was not a good day, but not the worst. I will continue at 10 mg/day for two weeks until I see my doctor.

What dosage of vortioxetine did you try? How long did you take it for?


- Scott

 

Re: Switching from Abililfy to Saphris. » SLS

Posted by ed_uk2010 on July 2, 2018, at 14:39:09

In reply to Re: Switching from Abililfy to Saphris. » Robert_Burton_1621, posted by SLS on July 2, 2018, at 8:26:56

> I have some background anxiety, which isn't normal for me. Maybe this is how I experience the agitation you describe.

Might it help to have a small dose of a benzodiazepine for a couple of weeks until you get used to the vortioxetine? Eg. lorazepam 0.5mg twice a day.

 

Re: Switching from Abililfy to Saphris. » ed_uk2010

Posted by SLS on July 2, 2018, at 17:16:00

In reply to Re: Switching from Abililfy to Saphris. » SLS, posted by ed_uk2010 on July 2, 2018, at 14:39:09

> > I have some background anxiety, which isn't normal for me. Maybe this is how I experience the agitation you describe.
>
> Might it help to have a small dose of a benzodiazepine for a couple of weeks until you get used to the vortioxetine? Eg. lorazepam 0.5mg twice a day.

Great idea.

I have been taking lorazepam 1.0 mg 2-3 times a day. It helps, but I am reluctant to depend on it. I probably worry too much about that.


- Scott

 

Re: Switching from Abililfy to Saphris. » SLS

Posted by ed_uk2010 on July 3, 2018, at 16:03:05

In reply to Re: Switching from Abililfy to Saphris. » ed_uk2010, posted by SLS on July 2, 2018, at 17:16:00

>I have been taking lorazepam 1.0 mg 2-3 times a day. It helps, but I am reluctant to depend on it. I probably worry too much about that.

I was just thinking of before. You were able to stop it quite easily via careful reduction based on symptoms, right? Just taking a little bit if symptoms occurred.

 

Re: Switching from Abililfy to Saphris.

Posted by Robert_Burton_1621 on July 11, 2018, at 4:40:22

In reply to Re: Switching from Abililfy to Saphris. » Robert_Burton_1621, posted by SLS on July 2, 2018, at 8:26:56

Scott, I went from 10 to 20 mg quite quickly (over a week), and stayed on 20mg for a month. But, for me, there was no improvement. The side-effects were disturbing: particularly the hyper-sexuality. But it was not pleasurbale. It was an *agitated* hyper-activity.

I ceased the vortioxetine and resumed parnate.

How are you going now?

 

Re: Switching from Abililfy to Saphris. » Robert_Burton_1621

Posted by SLS on July 11, 2018, at 10:11:22

In reply to Re: Switching from Abililfy to Saphris., posted by Robert_Burton_1621 on July 11, 2018, at 4:40:22

> Scott, I went from 10 to 20 mg quite quickly (over a week), and stayed on 20mg for a month. But, for me, there was no improvement. The side-effects were disturbing: particularly the hyper-sexuality. But it was not pleasurbale. It was an *agitated* hyper-activity.

That sounds unpleasant.

> I ceased the vortioxetine and resumed parnate.

Vortioxetine has a 66 hour half-life. How long are you waiting before resuming Parnate? Serotonin syndrome is a concern. I hope everything goes well for you.

> How are you going now?

It has been over a week since I discontinued vortioxetine, and I am still experiencing some residual adverse effects. They include brain-fog, cognitive slowing, and anxiety. They are improving gradually, though. I began taking Effexor two days ago. I am titrating up to 300 mg/day. Fingers crossed.


- Scott

 

Re: Switching from Abililfy to Saphris. » SLS

Posted by ed_uk2010 on July 11, 2018, at 14:01:33

In reply to Re: Switching from Abililfy to Saphris. » Robert_Burton_1621, posted by SLS on July 11, 2018, at 10:11:22

I forgot you had to stop vortioxetine already.

Will you increase venlafaxine quickly? It seems that very high doses can cause a lot of fatigue for some users, so perhaps it is best not to aim for a really high dose initially.

 

Re: Switching from Abililfy to Saphris. » ed_uk2010

Posted by SLS on July 12, 2018, at 9:16:56

In reply to Re: Switching from Abililfy to Saphris. » SLS, posted by ed_uk2010 on July 11, 2018, at 14:01:33

> I forgot you had to stop vortioxetine already.
>
> Will you increase venlafaxine quickly? It seems that very high doses can cause a lot of fatigue for some users, so perhaps it is best not to aim for a really high dose initially.

Thanks, Ed.

I started at 75 mg/day. I'm now up to 150 mg/day. I'm still experiencing some anxiety, although it is dissipating gradually. I took 0.5 mg of Ativan this morning.

Depression is not as bad as it was last week. I am grateful for that.


- Scott

 

Re: Switching from Abililfy to Saphris. » SLS

Posted by ed_uk2010 on July 12, 2018, at 13:12:41

In reply to Re: Switching from Abililfy to Saphris. » ed_uk2010, posted by SLS on July 12, 2018, at 9:16:56

I wonder whether the dose-response relationship of Effexor is quite flat when on an NRI-type TCA such as nortriptyline?

I was wondering whether you should avoid going above 225mg or so initially, just in case it's counter-productive. Maybe give it a few weeks before pushing too high?

I think the anxiety will improve a lot over the next few days since it seems so clearly related to vortioxetine. Hope lorazepam is helping.

 

Re: Switching from Abililfy to Saphris. » ed_uk2010

Posted by SLS on July 12, 2018, at 14:40:31

In reply to Re: Switching from Abililfy to Saphris. » SLS, posted by ed_uk2010 on July 12, 2018, at 13:12:41

> I wonder whether the dose-response relationship of Effexor is quite flat when on an NRI-type TCA such as nortriptyline?
>
> I was wondering whether you should avoid going above 225mg or so initially, just in case it's counter-productive. Maybe give it a few weeks before pushing too high?
>
> I think the anxiety will improve a lot over the next few days since it seems so clearly related to vortioxetine. Hope lorazepam is helping.

I think you are right about the anxiety. My doctor agrees with you. I'm guessing that the Effexor has made it worse temporarily. There is a trill in my voice and my hands are shaky.

Thanks for your contributions here on Psycho-Babble.


- Scott


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