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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by 4wd on October 6, 2005, at 22:20:59
Okay. So I saw my pdoc today. I told him I thought the Celexa didn't help anxiety, might be increasing it. I wanted to lower it to 5mg, also because of the neck pain and spasms which it causes. But he's afraid such a low dose will be ineffective for depression
So he suggested adding Abilify. Starting low at 2.5mg. I've read all the archives here re: abilify and don't know what to think.
At 10mg of Celexa I don't have much depression, mostly just a lot of anxiety especially in the mornings and until early evening. I sleep great. Will Abilify calm me? I understand it's a DA partial agonist but I don't understand what that means in practical terms.
Should I take it in the morning or at night?
Marsha
Posted by Phillipa on October 7, 2005, at 18:08:28
In reply to Scared to start Abilify, posted by 4wd on October 6, 2005, at 22:20:59
Isn't an antipsychotic? And from what I've read hear it can make you anxious. Did he give you any reason for prescribing this med? Fondly, Phillipa
Posted by 4wd on October 7, 2005, at 20:41:19
In reply to Re: Scared to start Abilify » 4wd, posted by Phillipa on October 7, 2005, at 18:08:28
> Isn't an antipsychotic? And from what I've read hear it can make you anxious. Did he give you any reason for prescribing this med? Fondly, Phillipa
Just that I've tried all the other APs and they didn't help. Well, Zyprexa did but it woke up my bulimia. He said it balanced dopamine - it could make me more anxious but it could also be calming by reducing dopamine where there was too much.
Marsha
Posted by Jedi on October 8, 2005, at 2:36:20
In reply to Scared to start Abilify, posted by 4wd on October 6, 2005, at 22:20:59
>
> So he suggested adding Abilify. Starting low at 2.5mg. I've read all the archives here re: abilify and don't know what to think.
>
> At 10mg of Celexa I don't have much depression, mostly just a lot of anxiety especially in the mornings and until early evening. I sleep great. Will Abilify calm me? I understand it's a DA partial agonist but I don't understand what that means in practical terms.
>
> Should I take it in the morning or at night?
>
> Marsha
Hi Marsha,
Everyone is different but Abilify gave me terrible akathisia. I could not stand the feeling and only lasted a short time on the medication. I know there are other meds to counteract akathisia so don't let my experience determine your medication choice.
JediTreatment of residual anxiety symptoms with adjunctive aripiprazole in depressed patients taking selective serotonin reuptake inhibitors.
Link:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15820277&query_hl=13[A new atypical antipsychotic with partial dopamine agonist effect (aripiprazole)]
Link:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15825673&query_hl=13Aripiprazole: a partial dopamine D2 receptor agonist antipsychotic.
Link:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12665420&query_hl=15Aripiprazole: a novel atypical antipsychotic drug with a uniquely robust pharmacology.
Link:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15592581&query_hl=15
Posted by blueberry on October 8, 2005, at 8:12:39
In reply to Scared to start Abilify, posted by 4wd on October 6, 2005, at 22:20:59
You could always do some tablet cutting and start with 1.25mg. 2.5mg is pretty low to start with, and some people do just fine with that dose, but if you are really scared of it, cut in half.
Posted by 4wd on October 8, 2005, at 16:13:39
In reply to Re: Scared to start Abilify » 4wd, posted by Jedi on October 8, 2005, at 2:36:20
>
> >
> > So he suggested adding Abilify. Starting low at 2.5mg. I've read all the archives here re: abilify and don't know what to think.
> >
> > At 10mg of Celexa I don't have much depression, mostly just a lot of anxiety especially in the mornings and until early evening. I sleep great. Will Abilify calm me? I understand it's a DA partial agonist but I don't understand what that means in practical terms.
> >
> > Should I take it in the morning or at night?
> >
> > Marsha
>
>
> Hi Marsha,
> Everyone is different but Abilify gave me terrible akathisia. I could not stand the feeling and only lasted a short time on the medication. I know there are other meds to counteract akathisia so don't let my experience determine your medication choice.
> Jedi
>
> Treatment of residual anxiety symptoms with adjunctive aripiprazole in depressed patients taking selective serotonin reuptake inhibitors.
> Link:
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15820277&query_hl=13
>
> [A new atypical antipsychotic with partial dopamine agonist effect (aripiprazole)]
> Link:
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15825673&query_hl=13
>
> Aripiprazole: a partial dopamine D2 receptor agonist antipsychotic.
> Link:
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12665420&query_hl=15
>
> Aripiprazole: a novel atypical antipsychotic drug with a uniquely robust pharmacology.
> Link:
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15592581&query_hl=15
>Thank you so much for the links. I never thought of going to PubMed. I've read them and it sounds like a wonder drug. I do fear the akathisia since I have a tendency to get restless legs but I guess I'll never know if I don't give it a shot. I have some ARtane around I guess I could take to combat the RLS if I had to.
Anyway, thanks again.
Marsha
Posted by 4wd on October 8, 2005, at 16:15:07
In reply to Re: Scared to start Abilify, posted by blueberry on October 8, 2005, at 8:12:39
> You could always do some tablet cutting and start with 1.25mg. 2.5mg is pretty low to start with, and some people do just fine with that dose, but if you are really scared of it, cut in half.
That's a great idea. Thanks. I'm going to wait til I get stabilized from the last med change fiasco and probably try the Abilify early next week.
Marsha
Posted by ed_uk on October 8, 2005, at 16:41:18
In reply to Re: Scared to start Abilify, posted by 4wd on October 8, 2005, at 16:15:07
IMO, 1.25mg is a good starting dose.
~Ed
Posted by Sebastian on October 8, 2005, at 16:43:58
In reply to Scared to start Abilify, posted by 4wd on October 6, 2005, at 22:20:59
Only take abilify in the morining, it will wake you up. Abilify will also make your anxiety much worse. I would suggest a different AP, like zyprexa or geodon, which cure anxiety. My personal opinion, not shared by my doctor either is that celexa makes anxiety worse.
Posted by Emme on October 8, 2005, at 17:32:48
In reply to Re: Scared to start Abilify » Jedi, posted by 4wd on October 8, 2005, at 16:13:39
> I do fear the akathisia since I have a tendency to get restless legs but I guess I'll never know if I don't give it a shot. I have some ARtane around I guess I could take to combat the RLS if I had to.Abilify has been used as a treatment for RLS. (I do not remember exactly where I saw this - sorry.) Two doses of Abilify completely stopped some mild restless legs symptoms I was having (I also mentioned this somewhere in the other thread). Otoh, restless legs are listed as a possible side effect of Abilify. But you might get lucky in the RLS department.
emme
Posted by 4wd on October 8, 2005, at 21:59:38
In reply to Re: Scared to start Abilify, posted by Sebastian on October 8, 2005, at 16:43:58
> Only take abilify in the morining, it will wake you up. Abilify will also make your anxiety much worse. I would suggest a different AP, like zyprexa or geodon, which cure anxiety. My personal opinion, not shared by my doctor either is that celexa makes anxiety worse.
I've suspected that Celexa increases anxiety in me. I know I'm more anxious at 20mg than at 10mg. However, it's not as bad as Prozac, Paxil, Zoloft, Lexapro or Wellbutrin. Effexor used to help with anxiety but quit working for depression and when I went back on it, it didn't help with the anxiety anymore either.
Geodon was only very minimally helpful with the anxiety. Seroquel not at all. Risperdal didn't help much either. Zyprexa is great but I can't take it - recovering bulimic and Zyprexa brings me right back into fullblown bingeing and purging. So Abilify is kind of a last resort. Tried Remeron and got the same kind of hunger thing (and gained 3 pounds overnight from something, water retention?) Also had bad RLS.
At least Celexa keeps me out of deep depression and has very minimal side effects. And I took it without increased anxiety a couple of years ago. The anxiety just started up a year ago after a couple of bad traumas and after stopping Effexor. It could be from being on Effexor for years and not having anxiety and then stoppi g the Effexor. @Who knows?
Anyway, thanks. I am going to start low with the Abilify and if it makes me super anxious, I have my Klonopin to come down with.
Is anxiety your primary diagnosis? Or do you have depression mixed with anxiety? Do you take a benzo?
Marsha
Posted by 4wd on October 8, 2005, at 22:03:55
In reply to Re: restless legs » 4wd, posted by Emme on October 8, 2005, at 17:32:48
>
> > I do fear the akathisia since I have a tendency to get restless legs but I guess I'll never know if I don't give it a shot. I have some ARtane around I guess I could take to combat the RLS if I had to.
>
> Abilify has been used as a treatment for RLS. (I do not remember exactly where I saw this - sorry.) Two doses of Abilify completely stopped some mild restless legs symptoms I was having (I also mentioned this somewhere in the other thread). Otoh, restless legs are listed as a possible side effect of Abilify. But you might get lucky in the RLS department.
>
> emme
>Emme,
That's great to know. When I read about people experiencing akathisia, I just kind of figured restless legs was what they were talking about. Some people mentioned akathisia and I figured that's kind of a total body restless legs feeling. And agitation, I'm not sure if that means anxiety or not. When I'm anxious I feel agitated but I can imagine being agitated with feeling scared.
Anyway, thanks. And thanks for all the information in your other posts.
Marsha
Posted by 4wd on October 8, 2005, at 22:04:38
In reply to Re: Scared to start Abilify » 4wd, posted by ed_uk on October 8, 2005, at 16:41:18
> IMO, 1.25mg is a good starting dose.
>
> ~EdThat's exactly what I'm going to do!
Thanks, Ed.
Marsha
Posted by Sebastian on October 9, 2005, at 15:28:15
In reply to Re: Scared to start Abilify » Sebastian, posted by 4wd on October 8, 2005, at 21:59:38
My diagnosis????
PTSD, psychosis, schizoaffective, anxiety. Mainly.
Posted by Sebastian on October 12, 2005, at 11:58:19
In reply to Re: Scared to start Abilify » Sebastian, posted by 4wd on October 8, 2005, at 21:59:38
Depression and anxiety. No benzo. Schizoaffective.
Posted by 4wd on October 12, 2005, at 15:27:43
In reply to Scared to start Abilify, posted by 4wd on October 6, 2005, at 22:20:59
Well I took my first Abilify yesterday morning. I took 1.25 mg. And I've had a headache ever since, started about three hours after I took it. It was bad yesterday, a little better today but aspirin, ibuprofen, etc. don't touch it.
On the plus side, no other side effects. No increased anxiety, no restlessness. Actually I did feel rather drugged, and sluggish and tired. And for a couple of hours last night, I felt kind of a sense of derealization - I was in a group of people I knew but I seemed not to really be there. They were farther away then they really were. It was weird. I don't know what to thin of that.
Marsha
Posted by fauna on October 13, 2005, at 10:28:27
In reply to Re: Scared to start Abilify followup, posted by 4wd on October 12, 2005, at 15:27:43
Hi Marsha!
I too began Abilify 2.5mg just last night in addition to the 30mg of Cymbalta that I began a couple weeks ago. Supposed to take the 2.5mg for 3 days then go to a whole tab daily if no significant S/E occur. Have had depression since I was about 14 (43 now). Been on everything under the sun in the past (TC's and SRRI's). But my new pdoc feels pretty certain that I've actually been(or have progressed to) Bipolar II. So that's why the Abilify has been initiated. It bothers me to start it as well. But because I know I can't really process info well enough right now to make effective decisions for myself, I really need to place my trust in my pdoc to do what's right for me at this point.As far as the initial Abilify dose, I didn't sleep worth a darn last night and was extremely nauseated for a bit this morning. May switch to morning dosing. Still very anxious-- but I was that way before the med changes. Also taking .25 to .50mg of Xanax as needed to help control the anxiety.
Would really like to compare our reactions to the Abilify as we go along! I hope it works well for you! Take care!
Posted by 4wd on October 13, 2005, at 21:48:14
In reply to Re: Scared to start Abilify followup » 4wd, posted by fauna on October 13, 2005, at 10:28:27
> Hi Marsha!
> I too began Abilify 2.5mg just last night in addition to the 30mg of Cymbalta that I began a couple weeks ago. Supposed to take the 2.5mg for 3 days then go to a whole tab daily if no significant S/E occur. Have had depression since I was about 14 (43 now). Been on everything under the sun in the past (TC's and SRRI's). But my new pdoc feels pretty certain that I've actually been(or have progressed to) Bipolar II. So that's why the Abilify has been initiated. It bothers me to start it as well. But because I know I can't really process info well enough right now to make effective decisions for myself, I really need to place my trust in my pdoc to do what's right for me at this point.
>
> As far as the initial Abilify dose, I didn't sleep worth a darn last night and was extremely nauseated for a bit this morning. May switch to morning dosing. Still very anxious-- but I was that way before the med changes. Also taking .25 to .50mg of Xanax as needed to help control the anxiety.
>
> Would really like to compare our reactions to the Abilify as we go along! I hope it works well for you! Take care!
I stopped my Abilify. The headache was just too bad. In fact, I haven't taken any since Tuesday and the headache is just now beginning to lessen. (It's weird, I don't get headaches, never have more than a brief two or three per year and this has been a three day headache.) I didn't have any other side effects, though. No nausea or insomnia. I'm thinking I may wait until the headache is completely gone and try again. If it comes right back I'll know for sure if it's the Abilify.I think I may have also been misdiagnosed or have progressed to some form of bipolar. The anxiety is so bad in the mornings and I read a description that sounded just like me. I had though that mania or hypomania had to feel good - some euphoria or elation. Mine is so not like like. Here's the description: "Patients experience 'too much energy inside my skin' like they're going to 'explode'" That's how I wake up every morning. And it's a negative energy. Like too much adrenaline coursing around in me, causing obsessive thinking and fear.
I think a mood stabilizer is definitely in my future. OTOH, maybe it's just agitated depression. I don't know how they decide. I guess partly from the poor response to SSRIs.
Anyway, best of luck with the Abilify. I found that Zyprexa worked like a dream for me, with no short term side effects except that I went back to binging and purging because of the unbearable hunger. But it was great for anxiety. Apparently htat's not an issue with Abilify.
Marsha
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