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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 26. This is the beginning of the thread.
Posted by Noa on May 23, 2018, at 11:37:22
Hi all. Oldtimer here who hasn't posted in ages.
I'm wondering if anyone has had success going off of Abilify.
I started taking it about 3 years ago, started at 2 mg once a day, eventually increased to twice a day (total 4 mg). For a while it did exactly what I had hoped for---mobilized me and activated me so I was able to face day to day life tasks better. But the effect has worn off a lot.
Further, the side effects are troublesome. I have gained a lot of wait, putting me in what I consider the 'unimaginable' weight range. And my blood sugar has not been good--been diagnosed with diabetes II.
So, I'm thinking I might go off of the Abilify but am terrified of a huge rebound of depression. Plus whatever other withdrawal effects there might be.
So I'm looking for experiences and advice.
Thank you in advance.
Noa
Posted by Lamdage22 on May 23, 2018, at 12:51:20
In reply to going off of Abilify, posted by Noa on May 23, 2018, at 11:37:22
You may want to look into Metformin.
Posted by ed_uk2010 on May 23, 2018, at 13:44:35
In reply to going off of Abilify, posted by Noa on May 23, 2018, at 11:37:22
Hi Noa,
Welcome back to p-babble.
You might want to talk with SLS. He has just come off Abilify for related reasons.
Posted by Noa on May 23, 2018, at 14:06:02
In reply to Re: going off of Abilify, posted by Lamdage22 on May 23, 2018, at 12:51:20
> You may want to look into Metformin.
Thanks. I've been on Metformin for a while.
Posted by Noa on May 23, 2018, at 14:07:32
In reply to Re: going off of Abilify » Noa, posted by ed_uk2010 on May 23, 2018, at 13:44:35
> Hi Noa,
>
> Welcome back to p-babble.
>
> You might want to talk with SLS. He has just come off Abilify for related reasons.
>Thanks, Ed. I'll look forward to reading what Scott has to say---he's helped me a lot before.
Posted by SLS on May 23, 2018, at 20:00:54
In reply to Re: going off of Abilify » ed_uk2010, posted by Noa on May 23, 2018, at 14:07:32
Hi, Noa.
It's nice to see you again.
I'm afraid I can't guide you at this juncture. First of all, I switched directly from Abilify to Saphris - mainly because of weight gain and high triglycerides produced by Abilify. Any rebound depression resulting from Abilify discontinuation might be masked by Saphris. A friend of mine has tried to discontinue Abilify a few times, but found herself wanting to restart it because of the appearance of anxiety after two weeks. I suffered a hell of a crash into depression yesterday. It might not be an unrelated coincidence that it occurred at the two-week mark post-discontinuation.
You might want to taper Abilify slowly and methodically. Abilify has a half-life of 72 hours or more. You can work your way down such that you can space your doses 2-3 days apart at the end of the taper period. If anxiety should appear, you could use an anxiolytic as a temporary bridge to help you get through withdrawal. Are there any benzodiazepines that you had success with in the past? I would suggest looking at Ativan or Xanax XR.
Saphris has some interesting antidepressant properties.
What are you taking now?
Maybe you can help me. Have you ever taken Trintellix (vortioxetine)? If so, how did you react to it?
I hope you don't have a difficult time discontinuing Abilify.
- Scott
Posted by SLS on May 23, 2018, at 21:00:29
In reply to going off of Abilify, posted by Noa on May 23, 2018, at 11:37:22
You could perhaps use hydroxyzine to deal with rebound anxiety.
- Scott
Posted by Noa on May 24, 2018, at 6:55:37
In reply to Re: going off of Abilify » Noa, posted by SLS on May 23, 2018, at 21:00:29
Thanks, Scott. I hope your crash resolves quickly.
I haven't taken the meds you mentioned.
As for benzos, I take ativan now--for the restless legs I get from one or more of my antidepressants.
Here's what I take:
adderall xr
synthroid
cytomel
metformin ER
venlafaxine ER
abilify
nefazodone
atorvastatin (my cholesterol also got worse after taking abilify)
ativan
Posted by SLS on May 24, 2018, at 11:56:20
In reply to Re: going off of Abilify » SLS, posted by Noa on May 24, 2018, at 6:55:37
So.
What's the plan?
- Scott
Posted by Noa on May 24, 2018, at 16:19:56
In reply to Re: going off of Abilify » Noa, posted by SLS on May 24, 2018, at 11:56:20
I don't know for sure. Maybe I'll do a very slow taper. I'll have to talk to my pharmacologist. I would like it if the abilify comes in 1 mg tabs so I can taper by .5 mg every couple of weeks, but I have a feeling the smallest is 2 mgs, which could be easily cut into 1 mg, but not so easily into .5mg. The generic version I'm taking now can't be cut at all--it's a tiny round, nearly spherical pill. But one of the other generics I have taken in the past were oblong and had a split line through the center. Still, cutting it further to .5 would be hard.
I am wary of asking to use ativan to ward off any withdrawal effects because I've habituated somewhat to the ativan. When I first started taking it, I could tolerate only about an eighth of a mg and that was enough to calm my restless legs and allow me to sleep. That was many years ago, so the habituation was very gradual, but now I need 2 mg each night and when I really can't sleep I am tempted to take an extra one, but usually don't because then I'll run out of them before I can get a refill.
Posted by Christ_empowered on May 25, 2018, at 1:27:14
In reply to Re: going off of Abilify » Noa, posted by SLS on May 23, 2018, at 21:00:29
gabapentin helped me reduce my abilify dosage. im not a big gabapentin fan, but...for maybe a month or so, dosing up w/ gabapentin evened things out after the abilify dosage was cut by 10mgs.
i seem to recall reading a shrink's website in which she wrote about switching patients on higher potency neuroleptics over to lower potency drugs and tapering slowly off the lower potency drug. i don't know if id go for it, personally, but itd probably be easier to do a slow taper off, say, seroquel or even a low(ish) dose of good ole Thorazine than it would be to step down slowly off Abilify.
Posted by SLS on May 25, 2018, at 13:31:09
In reply to Re: going off of Abilify, posted by Christ_empowered on May 25, 2018, at 1:27:14
For me, I think taking Saphris acted as a bridge to buffer the withdrawal effects of Abilify when I discontinued it.
I have discontinued Saphris as an experiment. I would like to prove that continuing Saphris treatment will be of enough therapeutic value to commit to taking it indefinitely. So far, I'm not feeling significantly worse. I suppose that there are some adjustments that the brain has yet to make to fully accommodate the loss of Abilify. I am tempted to restart the Saprhis occasionally, but I wouldn't have an answer to my question.
- Scott
Posted by Lamdage22 on May 26, 2018, at 4:07:40
In reply to Re: going off of Abilify, posted by SLS on May 25, 2018, at 13:31:09
You never know in advance what will happen.
Posted by Noa on May 26, 2018, at 8:12:31
In reply to Re: going off of Abilify, posted by Lamdage22 on May 26, 2018, at 4:07:40
Yes, thats one of the problemsnot knowing.
Posted by Noa on May 26, 2018, at 8:16:52
In reply to Re: going off of Abilify, posted by SLS on May 25, 2018, at 13:31:09
Scott, I can relate to the quandary. Its frustrating that we have to use so much trial and error on our brains.
Posted by SLS on May 31, 2018, at 14:10:35
In reply to Re: going off of Abilify » SLS, posted by Noa on May 26, 2018, at 8:16:52
How are you doing today?
I felt it necessary to restart Saphris two days ago. I fell pretty hard without it. I really didn't expect that to happen, but...
I am doing a bit better today.
- Scott
Posted by Noa on May 31, 2018, at 17:19:48
In reply to Re: going off of Abilify » Noa, posted by SLS on May 31, 2018, at 14:10:35
> How are you doing today?
>
> I felt it necessary to restart Saphris two days ago. I fell pretty hard without it. I really didn't expect that to happen, but...
>
> I am doing a bit better today.
>
>
> - Scott
>
Sorry to hear you've been having a hard time with it. And thank you for sharing because it gives me pause for trying to going off the Abilify without some sort of back up.Is there a reason you were not wanting to take the Safris? (I know nothing about Safris)
Hope you continue to feel better.
Posted by SLS on June 2, 2018, at 10:46:32
In reply to Re: going off of Abilify » SLS, posted by Noa on May 31, 2018, at 17:19:48
Hi, Noa.
> Sorry to hear you've been having a hard time with it. And thank you for sharing because it gives me pause for trying to going off the Abilify without some sort of back up.Abilify has a half-life of three days or longer. How that figures into rebound depression or anxiety is not clear to me. I don't know the best method for discontinuing Abilify, but for me, the worst time for withdrawal depression was between 2 and 3 weeks after taking the last dose. A friend of mine had a similar experience. Her doctor prescribed hydroxyzine for the rebound anxiety. She was taking only 2 mg/day of Abilfy and had tried on three occasions to discontinue it without success. Using hydroxyzine provided a bridge of sorts to get her through withdrawal. She is now free of Abilify, although her depression has returned to some degree.
> Is there a reason you were not wanting to take the Safris? (I know nothing about Safris)
I discontinued Saphris briefly to see whether or not it was responsible for making me feel less depressed. I thought, perhaps, that Saphris acted only as a bridge to prevent withdrawal from Abilify. After a few days, I relapsed into a severe depression with some anxiety. It seemed pretty clear to me that I was significantly better on Saphris than off it. That's why I restarted it.
I don't know what effect Saphris will have on my body weight I gained 50 pounds over the years while taking Abilify. A good friend of mine had gained weight with Abilify in a way similar to me. She couldn't lose a single pound. Once she crossed-over to Saphris, the pounds melted off; this despite the description of significant weight gain contained in the package label. I experienced some water retention in the beginning of Saphris treatment. My doctor decided to watch what would happen rather than prescribe a diuretic so soon. I lost the water weight and it has not come back.
> Hope you continue to feel better.
Thanks.
- Scott
Posted by jane d on June 2, 2018, at 21:24:34
In reply to going off of Abilify, posted by Noa on May 23, 2018, at 11:37:22
No experience with Abilify. Just want to say hi, Noa.
Posted by Noa on June 3, 2018, at 7:02:32
In reply to Re: going off of Abilify » Noa, posted by jane d on June 2, 2018, at 21:24:34
Hi!
Posted by bleauberry on June 3, 2018, at 17:59:20
In reply to going off of Abilify, posted by Noa on May 23, 2018, at 11:37:22
I've had a lot of experience getting off of meds or switching to other meds. And I was always extra sensitive, so I had to be extra careful and do it as right as possible.
You can customize doses anyway you want. Pills can be crushed to powder and divided into equal piles, or can but cut in half, quarters, whatever, tiny chunks. Capsules can be dumped out, make piles, mix custom doses with apple sauce or yogurt for easy swallow. Even time released beads can be counted out in milligrams.
My general rule for the smoothest ride was to reduce doses in tiny increments and to stay at each new lower dose a few days, and then reduce the dose another little bit and wait, and repeat over and over. If difficulty at any time, go back to the most recent dose and stay there a few days, then try going back down again, sometimes stabilize at a new dose for a week or two, feel it out.
I'm talking tiny doses, like maybe 1/10th of 1mg at a time in your case. But if you find you are not that sensitive then you can always be more aggressive and reduce the dose in larger steps and quicker time.
It took me 3 months to get off of 5mg Zyprexa after being on it for about 5 years or so. I reduced the dose in tiny steps - literally tiny chunks or bits - over that 3 months. And there are still some noticeable withdrawals even after the final tiny spec is gone. :-)
I think you really need a game plan as to what to do if you stop the med, what next? Try natural? Try replacement? Repeat? Lifestyle changes? Different doctor? Research?
In any case, if you do get off of it, since it is an antipsychotic and it also does have some agonist properties, withdrawals could be challenging. I know Zyprexa was. So go slow and in tiny steps. imo
It might be a time to pause and rethink what else might be going on that is causing all this in the first place. In my case that was an unsuspected longterm lyme thing.
I'm guessing if you asked 10 professionals what to do, most of them would say increase the dose. I'm just not in that camp for a variety of reasons.
Posted by Noa on June 3, 2018, at 19:05:26
In reply to Re: going off of Abilify » Noa, posted by bleauberry on June 3, 2018, at 17:59:20
Thank you so much for your suggestions. My sense, too, is that I should decrease by tiny steps.
Increasing the Abilify is not in the cards. I'm interested in going off of it because of the weight gain (significant) and increase in blood sugar problems.
I don't know yet what I would like to do instead of the Abilify. I haven't raised the issue yet with my psychopharm (nurse practitioner). I'm feeling so hesitant about making a change just yet.
How nice it would be to find out there was something specific and identifiable that causes my depression. It's been with me so long, I doubt anyone could sort that out anyway. So I will go on with some form of med cocktail probably for the rest of my life.
Posted by Lamdage22 on June 4, 2018, at 11:31:31
In reply to Re: going off of Abilify » Noa, posted by bleauberry on June 3, 2018, at 17:59:20
I second what bleauberry said. You can do 10% less every 4-6 weeks
If you want withdrawal guidance you can go on www.survivingantidepressants.org
Posted by Noa on June 4, 2018, at 16:10:18
In reply to Re: going off of Abilify, posted by Lamdage22 on June 4, 2018, at 11:31:31
> I second what bleauberry said. You can do 10% less every 4-6 weeks
>
> If you want withdrawal guidance you can go on www.survivingantidepressants.orgThanks
Posted by bleauberry on June 11, 2018, at 12:34:35
In reply to Re: going off of Abilify » bleauberry, posted by Noa on June 3, 2018, at 19:05:26
> Thank you so much for your suggestions.
You're welcome! Thank you.
>
> I don't know yet what I would like to do instead of the Abilify. I haven't raised the issue yet with my psychopharm (nurse practitioner). I'm feeling so hesitant about making a change just yet.It is a big decision. I think we all stand a better shot at true healing when we are off psych meds not on them. But if we need short term assistance, that is what they are for. If they are not providing short term assistance, or if they are not making a big difference in the longterm, then what's the sense?
>
> How nice it would be to find out there was something specific and identifiable that causes my depression. It's been with me so long, I doubt anyone could sort that out anyway. So I will go on with some form of med cocktail probably for the rest of my life.Well there actually are some ways to identify what the problem is. But that itself is a problem because our medical professionals are not taught to think that way. They don't compute that way. Their primary goal is to develop a relationship with you, to gain trust, and to not rock the boat. Their main job is not healing. It is the relationship. That is where medicine goes wrong.
Here is an example. Let's say a family doctor or psych doc wants to check the thyroid. And he finds there is a problem. At that point he says your depression is because your thyroid is messed up and we need to fix the thyroid. Well, that is a flawed way to look at it, if you ask me. That's because he didn't take it far enough, he skipped the next logical step. And that is, what messed up the thyroid? It didn't just decide to do it for grins. Something made it happen.
Lyme does that. An LLMD probably would have done prescriptions to support the thyroid, maybe some herbal support too, but they would have also started antibiotics and/or herbs to address the actual underlying problem which wasn't they thyroid.
Make sense?
So if you scan my posts going back a few months, you will see that in my opinion that primary cause of depression - especially when it is not responding well to treatment - is tick born disease. Call it Lyme, call it whatever.
I did not arrive at this revelation on my own. It was shown to me by two different doctors who both played a role in bringing me back from treatment resistant suicidal depression that had failed all drugs and ECT. Those doctors are LLMD's (Lyme Literate M.D.s). Specially trained experts. Every state has a few of them. You would do well to hunt for one in your area. They can take you way further in your journey than psychiatrists can, that is for sure.
So both of them told me something that was so profound that it freaks everybody here out. Freaks them out. But it's true. I've seen it with my own eyes. So here goes. They said that 9 out 10 new patients they get come poorly managed from other doctors - often psychiatrists - and nearly all of them are already on psychiatric medications. But by the time they are done with LLMD treatment, they are either doing well off of meds or doing well at much lower doses. 9 out 10 turn out that way. I was one of them.
yep. I was one of them.
It is my opinion that between 6 and 9 of every 10 people right here at babble would actually do very well with an LLMD relative to their current psychiatrist. That's because whether a patient actually has Lyme or not doesn't matter - the methods these doctors employ work. They just work. Period. Patients with mood issues who see an LLMD are going to have greatly improved mood issues - and remission - compared to treatment from any other class of doctors or specialists.
That is my experience, my opinion. And I hope it sheds new light on your own journey.
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