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Dr. Bob is Robert Hsiung, MD,
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Posted by Alexei on April 25, 2012, at 7:07:50
In reply to Re: Abilify vs Seroquel » Christ_empowered, posted by tensor on April 24, 2012, at 23:43:40
> I'm taking Seroquel 200-300mg now with 50mg of Lamictal (going up to 100mg tomorrow) and 45mg of Remeron. The last week with Seroquel onboard I have problems with early awakenings and almost impossible to fall asleep again. I blame the NET effect from Seroquel for this.
> I'm taking these meds for TRD MDD and I'm starting to feel something, not sure yet, but it feels positive. Anyway, I do not need the antimanic effect from the AAPs, so if I were to choose Abilify again I would probably take max 7.5mg/day.
> The idea from the beginning was the Abilify-Lamictal combo, but I had to titrate up Lamictal before adding Abilify. I was also taking nortrip back then, but I got problems with anxiety so I replaced nortrip with Seroquel. And now I'm not sure if I should keep Seroquel while reaching target dose of Lamictal (100mg or 200mg?) or switch to Abilify now.
> Primarily it's the efficacy of the med that counts. However, chances are that I will take either of these meds indefinitely so the long-term effects are also important. Perhaps in the lower dosing range it doesn't matter which one you choose.
>
> /tI'm in literally the same situation as you. Why do you want to switch over to abilify? Do you have daytime sedation from seroquel? Abilify is giving me insomnia, whereas seroquel fixed it. Seroquel is much better for anxiety for me.
I wake up early, too. Maybe it's the seroquel? I was toying with the idea of taking both.... But I doubt it. Can you get to sleep without seroquel? or does the remeron help?
May I ask what happened with nortriptyline?
Posted by tensor on April 25, 2012, at 7:31:56
In reply to Re: Abilify vs Seroquel, posted by Alexei on April 25, 2012, at 7:07:50
> I'm in literally the same situation as you. Why do you want to switch over to abilify? Do you have daytime sedation from seroquel? Abilify is giving me insomnia, whereas seroquel fixed it. Seroquel is much better for anxiety for me.
>
> I wake up early, too. Maybe it's the seroquel? I was toying with the idea of taking both.... But I doubt it. Can you get to sleep without seroquel? or does the remeron help?
>
> May I ask what happened with nortriptyline?
>
>No I don't have any daytime sedation with Seroquel, it's the metabolic side effects along with anticholinergic properties and alpha 1 adrenergic antagonism that I don't like. These and Abilify being possibly more effective are the main reasons for a switch. I agree that Seroquel is better for anxiety, that is important. I've been thinking about my insomnia and I now believe that Lamictal is the reason, not Seroquel.
I can't recall that I had any problems with insomnia when I took Seroquel in doses up to 600 or 800mg several months ago. Nothing really happened with nortrip, it simply didn't work, was at 150mg for several weeks./t
Posted by Alexei on April 25, 2012, at 7:42:37
In reply to Re: Abilify vs Seroquel » Alexei, posted by tensor on April 25, 2012, at 7:31:56
> No I don't have any daytime sedation with Seroquel, it's the metabolic side effects along with anticholinergic properties and alpha 1 adrenergic antagonism that I don't like. These and Abilify being possibly more effective are the main reasons for a switch. I agree that Seroquel is better for anxiety, that is important. I've been thinking about my insomnia and I now believe that Lamictal is the reason, not Seroquel.
> I can't recall that I had any problems with insomnia when I took Seroquel in doses up to 600 or 800mg several months ago. Nothing really happened with nortrip, it simply didn't work, was at 150mg for several weeks.
>
> /tThanks for your reply. I'm at 100mg lamictal, also, but I've acclimated to it well. I just began abilify 2.5mg, but am leery that my anxiety will worsen w/o seroquel.
Abilify can cause metabolic and blood sugar issues as well.
Does Remeron help you? Any trouble with weight gain, increased hunger?
Posted by tensor on April 25, 2012, at 8:52:15
In reply to Re: Abilify vs Seroquel » tensor, posted by Alexei on April 25, 2012, at 7:42:37
> Thanks for your reply. I'm at 100mg lamictal, also, but I've acclimated to it well. I just began abilify 2.5mg, but am leery that my anxiety will worsen w/o seroquel.
>
> Abilify can cause metabolic and blood sugar issues as well.
>
> Does Remeron help you? Any trouble with weight gain, increased hunger?
>Are you gonna stay at 100mg of Lamictal? I think Abilify is more anxiolytic at higher doses, say from 15mg and up. Regarding Abilify's and Seroquel's side effects, have a look here:
http://www.psychresidentonline.com/atypical%20antipsychotics.htmI have essentially been on Remeron since -98 so it doesn't really sedate me much anymore. No increase in hunger except when it kicks in at bedtime, as long as I don't satisfy my hunger at that point there's no problem.
Btw, why did you switch to Abilify?
/t
Posted by Alexei on April 25, 2012, at 11:10:42
In reply to Re: Abilify vs Seroquel » Alexei, posted by tensor on April 25, 2012, at 8:52:15
> Are you gonna stay at 100mg of Lamictal? I think Abilify is more anxiolytic at higher doses, say from 15mg and up. Regarding Abilify's and Seroquel's side effects, have a look here:
> http://www.psychresidentonline.com/atypical%20antipsychotics.htm
>
> I have essentially been on Remeron since -98 so it doesn't really sedate me much anymore. No increase in hunger except when it kicks in at bedtime, as long as I don't satisfy my hunger at that point there's no problem.
>
> Btw, why did you switch to Abilify?
>
> /tWow, that is a great link. Some good info. I will give 100mg lamictal one month and then re-evaluate how I feel. It is a very subtle drug, but I think it is helping.
I switched to abilify because I was too sedated on seroquel. But I now realize that I did not go high enough with the seroquel dose, or do it quickly enough... so the sedation never had a chance to go away.
I have read the ideal augmenting dose for quel is 200-300. Very little dopamine antagonism at those doses. But abilify can antagonize DA much sooner. Like around 10mg.
Have you decided what you will do?
Btw ... Has remeron been a good antidepressant?
Posted by tensor on April 25, 2012, at 12:27:46
In reply to Re: Abilify vs Seroquel » tensor, posted by Alexei on April 25, 2012, at 11:10:42
> Wow, that is a great link. Some good info. I will give 100mg lamictal one month and then re-evaluate how I feel. It is a very subtle drug, but I think it is helping.
>
> I switched to abilify because I was too sedated on seroquel. But I now realize that I did not go high enough with the seroquel dose, or do it quickly enough... so the sedation never had a chance to go away.
>
> I have read the ideal augmenting dose for quel is 200-300. Very little dopamine antagonism at those doses. But abilify can antagonize DA much sooner. Like around 10mg.
>
> Have you decided what you will do?
>
> Btw ... Has remeron been a good antidepressant?
>Okay, how high did you go on Seroquel? I think my long exposure to Remeron has desensitized me to H1-antagonism, at least to some extent, I mean I do get very tired of Seroquel, enough to let me fall asleep. But it wears of quickly, within a few hours, even with the XR version.
I agree, high doses with Abilify can hardly be justified for MDD, however, I had no luck at any dose up to 15mg. I didn't do well on Seroquel, Abilify or Lamictal on their own (+ some ADs), but now with two weeks on Lamictal and Seroquel I have had the best day today probably for over a year, I've got a lot done, and I wanted to, wasn't forced. There seems to be something about the AAP + Lamictal combo, I think it was Scott (SLS) who suggested it to me.
I have decided to stay on Seroquel for now, since I will step up to 100mg Lamictal tomorrow, I won't touch the dosage either. Since I'm doing okay it's wisest to do only one change at a time.
Remeron, well I'm not so sure why I'm taking it anymore, but I always seem to do worse without it, so I'm keeping it just to be 'safe'. It was the first antidepressant I responded to and it completely wiped out my depression./t
Posted by Alexei on April 25, 2012, at 15:31:30
In reply to Re: Abilify vs Seroquel » Alexei, posted by tensor on April 25, 2012, at 12:27:46
> Okay, how high did you go on Seroquel? I think my long exposure to Remeron has desensitized me to H1-antagonism, at least to some extent, I mean I do get very tired of Seroquel, enough to let me fall asleep. But it wears of quickly, within a few hours, even with the XR version.
> I agree, high doses with Abilify can hardly be justified for MDD, however, I had no luck at any dose up to 15mg. I didn't do well on Seroquel, Abilify or Lamictal on their own (+ some ADs), but now with two weeks on Lamictal and Seroquel I have had the best day today probably for over a year, I've got a lot done, and I wanted to, wasn't forced. There seems to be something about the AAP + Lamictal combo, I think it was Scott (SLS) who suggested it to me.
> I have decided to stay on Seroquel for now, since I will step up to 100mg Lamictal tomorrow, I won't touch the dosage either. Since I'm doing okay it's wisest to do only one change at a time.
> Remeron, well I'm not so sure why I'm taking it anymore, but I always seem to do worse without it, so I'm keeping it just to be 'safe'. It was the first antidepressant I responded to and it completely wiped out my depression.
>
> /t
Hey, that's fantastic that you're feeling good! Hope it continues. I believe your theory about being desensitized at the H1 receptor cuz of remeron. Makes perfect sense.I got up to 50mg seroquel xr. That dose is way too low, I now realize. That is zombie zone... Not even a therapeutic dose. I intend to get to 200-300mg. May I ask what your dose is?
I'm on effexor 225mg, but I'm not impressed. My doc wants to "create" an snri by mixing zoloft & nortriptyline.... have not ruled out Parnate.
Did it take a while for the quel to start working? So you're at 45mg Remeron with no weight gain or hunger? Astounding.
I'll be eager to hear your progress ...
Posted by tensor on April 26, 2012, at 3:06:17
In reply to Re: Abilify vs Seroquel » tensor, posted by Alexei on April 25, 2012, at 15:31:30
> Hey, that's fantastic that you're feeling good! Hope it continues. I believe your theory about being desensitized at the H1 receptor cuz of remeron. Makes perfect sense.
>
> I got up to 50mg seroquel xr. That dose is way too low, I now realize. That is zombie zone... Not even a therapeutic dose. I intend to get to 200-300mg. May I ask what your dose is?
>
> I'm on effexor 225mg, but I'm not impressed. My doc wants to "create" an snri by mixing zoloft & nortriptyline.... have not ruled out Parnate.
>
> Did it take a while for the quel to start working? So you're at 45mg Remeron with no weight gain or hunger? Astounding.
>
> I'll be eager to hear your progress ...
>I take 300mg of Seroquel, 100mg of IR and 200mg of XR, that way I fall asleep faster and the XR should keep me asleep through the night, that's the idea anyway. I think the insomnia from Lamictal will wear off with time. It took about a week at 200-300mg of Seroquel to get some improvement.
After yesterdays success I was a little undecisive about upping the Lamictal dosage, was thinking of staying at 50mg. But I decided to wait to the morning and see how I feel and decide then. Well, I wasn't that eager to get out of bed so I decided to raise the dosage to 100mg.2.5mg of Abilify is a tiny dose, what is the plan regarding the dosing, do you have a target dose? Interesting to see how it works out for you. Do you think Effexor is doing you any good? I tend to avoid meds that interfere with my sexual function, I hate anorgasmia and other related dysfuntions, but maybe Effexor isn't giving you that sort of problems.
/t
Posted by Alexei on April 26, 2012, at 7:49:50
In reply to Re: Abilify vs Seroquel » Alexei, posted by tensor on April 26, 2012, at 3:06:17
> I take 300mg of Seroquel, 100mg of IR and 200mg of XR, that way I fall asleep faster and the XR should keep me asleep through the night, that's the idea anyway. I think the insomnia from Lamictal will wear off with time. It took about a week at 200-300mg of Seroquel to get some improvement.
> After yesterdays success I was a little undecisive about upping the Lamictal dosage, was thinking of staying at 50mg. But I decided to wait to the morning and see how I feel and decide then. Well, I wasn't that eager to get out of bed so I decided to raise the dosage to 100mg.
>
> 2.5mg of Abilify is a tiny dose, what is the plan regarding the dosing, do you have a target dose? Interesting to see how it works out for you. Do you think Effexor is doing you any good? I tend to avoid meds that interfere with my sexual function, I hate anorgasmia and other related dysfuntions, but maybe Effexor isn't giving you that sort of problems.
>
> /tHi tensor... No, I'm not impressed with effexor. Ive run the gamut of ssri and snri... and only zoloft packs any punch for me. Yep, definitely sexual problems.
You said that remeron killed your depression. Have you had any weight gain?... I took it for one week and the sedation and insatiable hunger were intolerable. Yet you seem not to have this issue.
Abilify vs seroquel... I'm still on the fence. 2.5 abilify might be low, but my doc would not want me past 10mg... if that. The dopamine antagonism starts to hit hard at 10-15mg. I have insomnia and GAD, so that points to seroquel. But abilify has a nice kick to it for depression.
If, in the end, they are both equal for depression, it probably makes more sense for me to work with quel.
So you can truly feel seroquel is helping you? Do you have daytime sedation or apathy/mental dulling, etc?
Posted by tensor on April 26, 2012, at 9:54:35
In reply to Re: Abilify vs Seroquel » tensor, posted by Alexei on April 26, 2012, at 7:49:50
> Hi tensor... No, I'm not impressed with effexor. Ive run the gamut of ssri and snri... and only zoloft packs any punch for me. Yep, definitely sexual problems.
>
> You said that remeron killed your depression. Have you had any weight gain?... I took it for one week and the sedation and insatiable hunger were intolerable. Yet you seem not to have this issue.
>
> Abilify vs seroquel... I'm still on the fence. 2.5 abilify might be low, but my doc would not want me past 10mg... if that. The dopamine antagonism starts to hit hard at 10-15mg. I have insomnia and GAD, so that points to seroquel. But abilify has a nice kick to it for depression.
>
> If, in the end, they are both equal for depression, it probably makes more sense for me to work with quel.
>
> So you can truly feel seroquel is helping you? Do you have daytime sedation or apathy/mental dulling, etc?
>
>
>I had some weight gain the earlier years, and sure, I have had some extra kilos during the years thanks to it. I know because one summer I stopped Remeron for awhile and only took Wellbutrin and Zoloft and I rapidly lost about ten kilos without changing any habits. That combo didn't work and Remeron was resumed. Now I am on a strict low calorie diet and have lost over 25 kgs over a four months period. Well, it's not really a diet, more of a healthier lifestyle, eating lean proteins and cutting out carbohydrates.
Remember that Abilify is a partial agonist at D2, so give 15mg a chance if you're not responding on lower doses. With Abilify's long halflife it takes over two weeks to reach steady-state and once there, you should give it a few weeks and assess its efficacy. With Seroquel it's much faster which is an advantage when finding the right dosage.
Seroquel is helping and is great for anxiety. Today with the increase of Lamictal to 100mg I felt some sedation that was quite pleasant, like anxiolytic. No mental dulling but rather some cognitive improvement actually./t
Posted by Alexei on April 27, 2012, at 11:02:28
In reply to Re: Abilify vs Seroquel » Alexei, posted by tensor on April 26, 2012, at 9:54:35
> I had some weight gain the earlier years, and sure, I have had some extra kilos during the years thanks to it. I know because one summer I stopped Remeron for awhile and only took Wellbutrin and Zoloft and I rapidly lost about ten kilos without changing any habits. That combo didn't work and Remeron was resumed. Now I am on a strict low calorie diet and have lost over 25 kgs over a four months period. Well, it's not really a diet, more of a healthier lifestyle, eating lean proteins and cutting out carbohydrates.
> Remember that Abilify is a partial agonist at D2, so give 15mg a chance if you're not responding on lower doses. With Abilify's long halflife it takes over two weeks to reach steady-state and once there, you should give it a few weeks and assess its efficacy. With Seroquel it's much faster which is an advantage when finding the right dosage.
> Seroquel is helping and is great for anxiety. Today with the increase of Lamictal to 100mg I felt some sedation that was quite pleasant, like anxiolytic. No mental dulling but rather some cognitive improvement actually.
>
> /t
Sounds like you've really got a handle on this. How do you feel today? Is the lamictal 100mg working out?For me, I've pretty much concluded that seroquel is the better option. It targets almost every symptom I have... MDD, insomnia, anxiety, and OCD. Plus, I've already been taking 50mg xr at nite to sleep. And taking both of them is out of the question... (quel & abilify)
You've intrigued me re: remeron. I'm basically worn out from ssri/snri meds... except pristiq. I've always been disciplined about diet, but I've heard so many ppl who gained 25lbs or more.... and the hunger. I haven't ruled out Parnate, either.
What time do you take lamictal?
Posted by Alexei on April 30, 2012, at 8:51:08
In reply to Abilify vs Seroquel, posted by tensor on April 24, 2012, at 6:55:43
> If you responded equally well to Abilify and Seroquel, which would you prefer to take? I'm thinking about tolerability and side effects.
>
> /tHi tensor... How are you doing with the seroquel? Has your depression continued to improve? No trouble with sleep or daytime sedation?
I searched archives, and saw you were once on abilify before... and had insomnia. Is that what had forced you to come off it?
Now that you've been on both, do you find one better than the other?
Take care...
Posted by phidippus on April 30, 2012, at 22:26:32
In reply to Abilify vs Seroquel, posted by tensor on April 24, 2012, at 6:55:43
Seroquel, its much more felxible.
Eric
Posted by tensor on May 1, 2012, at 5:40:57
In reply to Re: Abilify vs Seroquel » tensor, posted by Alexei on April 27, 2012, at 11:02:28
Alexei, can you babble mail me?
/t
Posted by tensor on May 1, 2012, at 11:43:26
In reply to Re: Abilify vs Seroquel » Alexei, posted by tensor on May 1, 2012, at 5:40:57
> Alexei, can you babble mail me?
>
> /tJust checking if you received my mail.
/t
Posted by Alexei on May 1, 2012, at 15:15:16
In reply to Re: Abilify vs Seroquel, posted by tensor on May 1, 2012, at 11:43:26
> > Alexei, can you babble mail me?
> >
> > /t
>
> Just checking if you received my mail.
>
> /tWill do. Yours came through. Did mine?
Posted by Alexei on May 1, 2012, at 16:46:07
In reply to Re: Abilify vs Seroquel » tensor, posted by phidippus on April 30, 2012, at 22:26:32
> Seroquel, its much more felxible.
>
> Eric
In what way? Do you have an opinion as to which is more effective for depression and anxiety?I'm currently taking both, but I'm not sure that is a good idea.
Posted by tensor on May 2, 2012, at 3:58:15
In reply to Re: Abilify vs Seroquel » tensor, posted by Alexei on May 1, 2012, at 15:15:16
> > > Alexei, can you babble mail me?
> > >
> > > /t
> >
> > Just checking if you received my mail.
> >
> > /t
>
> Will do. Yours came through. Did mine?
>
>Yes, it did.
Posted by phidippus on May 3, 2012, at 21:35:53
In reply to Re: Abilify vs Seroquel » phidippus, posted by Alexei on May 1, 2012, at 16:46:07
Seroquel is great for anxiety, while Abilify is not. Both are good for depression.
There's nno harm in taking both. Both have very different and complimentary modes of action.
Eric
Posted by tensor on May 4, 2012, at 2:28:53
In reply to Re: Abilify vs Seroquel » Alexei, posted by phidippus on May 3, 2012, at 21:35:53
> Seroquel is great for anxiety, while Abilify is not. Both are good for depression.
>
> There's nno harm in taking both. Both have very different and complimentary modes of action.
>
> EricI agree.
/t
Posted by Alexei on May 4, 2012, at 11:55:51
In reply to Re: Abilify vs Seroquel » Alexei, posted by phidippus on May 3, 2012, at 21:35:53
> Seroquel is great for anxiety, while Abilify is not. Both are good for depression.
>
> There's nno harm in taking both. Both have very different and complimentary modes of action.
>
> Eric
Thanks Tensor and Phiddipus ...Not sure that I'll be on the abilify much longer anyway ... It's exacerbating my anxiety issues, which were pretty harsh already. Very restless and not relaxed.
Maybe moving Quel up to 200-250mg from 100mg is a better idea.
Posted by tensor on May 4, 2012, at 12:22:17
In reply to Re: Abilify vs Seroquel » phidippus, posted by Alexei on May 4, 2012, at 11:55:51
> > Seroquel is great for anxiety, while Abilify is not. Both are good for depression.
> >
> > There's nno harm in taking both. Both have very different and complimentary modes of action.
> >
> > Eric
>
>
> Thanks Tensor and Phiddipus ...
>
> Not sure that I'll be on the abilify much longer anyway ... It's exacerbating my anxiety issues, which were pretty harsh already. Very restless and not relaxed.
>
> Maybe moving Quel up to 200-250mg from 100mg is a better idea.Ever tried Zyprexa? For anxiety it may be a good idea to dose twice daily, with XR version i.e.
/t
Posted by tensor on May 4, 2012, at 12:25:30
In reply to Re: Abilify vs Seroquel » Alexei, posted by tensor on May 4, 2012, at 12:22:17
> > > Seroquel is great for anxiety, while Abilify is not. Both are good for depression.
> > >
> > > There's nno harm in taking both. Both have very different and complimentary modes of action.
> > >
> > > Eric
> >
> >
> > Thanks Tensor and Phiddipus ...
> >
> > Not sure that I'll be on the abilify much longer anyway ... It's exacerbating my anxiety issues, which were pretty harsh already. Very restless and not relaxed.
> >
> > Maybe moving Quel up to 200-250mg from 100mg is a better idea.
>
> Ever tried Zyprexa? For anxiety it may be a good idea to dose twice daily, with SEROQUEL XR version i.e.
Posted by Alexei on May 4, 2012, at 15:40:46
In reply to Re: Abilify vs Seroquel » tensor, posted by tensor on May 4, 2012, at 12:25:30
> > > Not sure that I'll be on the abilify much longer anyway ... It's exacerbating my anxiety issues, which were pretty harsh already. Very restless and not relaxed.
> > >
> > > Maybe moving Quel up to 200-250mg from 100mg is a better idea.
> >
> > Ever tried Zyprexa? For anxiety it may be a good idea to dose twice daily, with SEROQUEL XR version i.e.
>
>
No, Zyprexa won't happen. Too many metabolic and weight issues with Z. I don't think my pdoc likes it.But taking Quel twice/day is a good thought. I seem to have overcome the sedstion. Maybe 50mg XR morning and evening... and see what happens. Total dose has to be 300mg or less. No dopamine antagonism is needed.
Posted by phidippus on May 5, 2012, at 13:05:44
In reply to Re: Abilify vs Seroquel » phidippus, posted by Alexei on May 4, 2012, at 11:55:51
250 Qule is little ddifferent than 300
Eric
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