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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by SLS on April 2, 2023, at 23:55:06
Hi.
I haven't heard anyone mention Abilify (aripiprazole) in a long time. Is anyone currently taking it?
If you are, what benefits do you receive from it? How long have you been taking it?
If you started taking Abilify, but subsequently discontinued it, what were your reasons for doing so?
If you have taken Abilify with an inadequate improvement in depression, did you go on to benefit from Rexulti (brexpriprazole) or Vraylar (cariprazine)? All three drugs are antipsychotics with potential antidepressant properties. It is assumed that D2/D3 dopamine receptor partial agonism (DRPA) acts as a dopamine system stabilizer (as per Stephen Stahl).
- Scott
Posted by tensor on April 3, 2023, at 0:01:20
In reply to Does anyone still take aripiprazole (Abilify)?, posted by SLS on April 2, 2023, at 23:55:06
> If you started taking Abilify, but subsequently discontinued it, what were your reasons for doing so?
I took it as an antidepressant adjunct, really wanted this medication to work but gave up on it, some akathisia at higher dose but not a deal braker, simply not effective for me. But I'm guessing you are taking it for BPD?
/tensor
Posted by SLS on April 3, 2023, at 7:42:50
In reply to Re: Does anyone still take aripiprazole (Abilify)? » SLS, posted by tensor on April 3, 2023, at 0:01:20
Hi, Tensor.
> > If you started taking Abilify, but subsequently discontinued it, what were your reasons for doing so?
> I took it as an antidepressant adjunct, really wanted this medication to work but gave up on it, some akathisia at higher dose but not a deal braker, simply not effective for me. But I'm guessing you are taking it for BPD?I took Abilify for a year or more to treat bipolar depression. It was helpful, but not nearly enough. I think the incidence of EPS was underestimated for this drug. Akathisia might be the most significant of its side-effects.
Discontinuing Abilify often causes rebound anxiety. I don't remember having that.
The dosage ranges for Abilify when used for different mood disorders is variable, but usually approximates (guestimates):2.5-5.0 mg/day = Unipolar Depression (Major Depressive Disorder - MDD)
5.0-10.0 mg/day = Bipolar Depression (without mania).
10-20 mg/day = Bipolar Disorder (with hypomania or mania without psychosis);
10-30 mg/day = Bipolar Disorder (with manic psychosis)
20-30 mg/day = Schizoaffective Disorder (bipolar type)
- Scott
Posted by undopaminergic on April 8, 2023, at 10:24:12
In reply to Does anyone still take aripiprazole (Abilify)?, posted by SLS on April 2, 2023, at 23:55:06
> Hi.
Hi.
> I haven't heard anyone mention Abilify (aripiprazole) in a long time. Is anyone currently taking it?
>Not me.
> If you are, what benefits do you receive from it? How long have you been taking it?
>
> If you started taking Abilify, but subsequently discontinued it, what were your reasons for doing so?
>Lack of efficacy and adverse effects.
> If you have taken Abilify with an inadequate improvement in depression, did you go on to benefit from Rexulti (brexpriprazole) or Vraylar (cariprazine)?
>I haven't tried brexpiprazole, but cariprazine was better than aripiprazole. I noticed no side effects from it, and it was slightly energising. I took up to 3 mg, but 3 mg was not better than 1.5 mg. I discontinued it because I wanted to try something else and I wanted to appease the doctor who felt more comfortable with fewer medications.
My adverse effects from Abilify were (eye) accommodation disorder and hypersalivation. I think I was taking 20 mg.
-undopaminergic
Posted by SLS on April 8, 2023, at 11:53:51
In reply to Re: Does anyone still take aripiprazole (Abilify)? » SLS, posted by undopaminergic on April 8, 2023, at 10:24:12
Thanks for the thorough description.
I said something to my doctor yesterday that I don't think is part of a psychopharmacologist's calculus in trying to evaluate their patient's response pattern. It's a very simple, but inescapable concept.
An individual can have opposite reactions to the same drug depending on the drug that preceded it. For me, it was Effexor. Effexor has always been a friend to me. It allows me to read every word in a sentence instead of being forced to quit or skim through paragraphs I experienced a 6-month response to a combination of Parnate + desipramne in 1987. Eventually, a nasty mania emerged. My doctor at the time had me discontinue the two medications. I relapsed into depression two months later. Parnate + desipramine never worked again, despite trying it multiple times at higher dosages. This doesn't appear to be a rare occurrence.
- Scott
> > Hi.
>
> Hi.
>
> > I haven't heard anyone mention Abilify (aripiprazole) in a long time. Is anyone currently taking it?
> >
>
> Not me.
>
> > If you are, what benefits do you receive from it? How long have you been taking it?
> >
> > If you started taking Abilify, but subsequently discontinued it, what were your reasons for doing so?
> >
>
> Lack of efficacy and adverse effects.
>
> > If you have taken Abilify with an inadequate improvement in depression, did you go on to benefit from Rexulti (brexpriprazole) or Vraylar (cariprazine)?
> >
>
> I haven't tried brexpiprazole, but cariprazine was better than aripiprazole. I noticed no side effects from it, and it was slightly energising. I took up to 3 mg, but 3 mg was not better than 1.5 mg. I discontinued it because I wanted to try something else and I wanted to appease the doctor who felt more comfortable with fewer medications.
>
> My adverse effects from Abilify were (eye) accommodation disorder and hypersalivation. I think I was taking 20 mg.
>
> -undopaminergic
>
Posted by SLS on April 9, 2023, at 21:32:27
In reply to Re: Does anyone still take aripiprazole (Abilify)? » undopaminergic, posted by SLS on April 8, 2023, at 11:53:51
Sorry. I lost my train of thought.
Like I said, someone can have opposite reactions to the same drug depending on the one that preceded it.
Effexor always produced a mild improvement for me, but nothing close to satisfactory. Still, I felt better on it than off of it.
Three years ago, I tried vortioxetine for at least four weeks. It produced intolerable brain-fog and a sense of detachment from my surroundings. I stopped taking it. Having no better ideas at the time, I asked to go back on Effexor until something new came along.
When I reintroduced Effexor, I experienced a torturous and painful brain-fog. Not only did my depression not improve, it became significantly worse. This was not the Effexor that I knew.
Wash-out periods are not just to allow a drug to clear the bloodstream. It also allows the brain time to reregulate itself back to a baseline similar to what had existed before drug exposure.
Think about how neuroscientists gather information by exposing a rat to one compound to see how it affects its reaction to a second compound. This is called "pre-treatment". One experiment might be to see how pre-treating a rat with a 5-HT7 antagonist (vortioxetine) changes the way the rat reacts to Effexor. If vortioxetine upregulates 5-HT7 receptors after prolonged exposure, will introducing Effexor afterwards produce more anxiety or less anxiety compared to Effexor alone?
Perhaps we should pay more attention to this when evaluating the therapeutic worth of a drug.
- Scott
Posted by undopaminergic on April 10, 2023, at 11:01:35
In reply to Re: Does anyone still take aripiprazole (Abilify)?, posted by SLS on April 9, 2023, at 21:32:27
> Sorry. I lost my train of thought.
>
> Like I said, someone can have opposite reactions to the same drug depending on the one that preceded it.
>
> Effexor always produced a mild improvement for me, but nothing close to satisfactory. Still, I felt better on it than off of it.
>
> Three years ago, I tried vortioxetine for at least four weeks. It produced intolerable brain-fog and a sense of detachment from my surroundings. I stopped taking it. Having no better ideas at the time, I asked to go back on Effexor until something new came along.
>
> When I reintroduced Effexor, I experienced a torturous and painful brain-fog. Not only did my depression not improve, it became significantly worse. This was not the Effexor that I knew.
>
> Wash-out periods are not just to allow a drug to clear the bloodstream. It also allows the brain time to reregulate itself back to a baseline similar to what had existed before drug exposure.
>
> Think about how neuroscientists gather information by exposing a rat to one compound to see how it affects its reaction to a second compound. This is called "pre-treatment". One experiment might be to see how pre-treating a rat with a 5-HT7 antagonist (vortioxetine) changes the way the rat reacts to Effexor. If vortioxetine upregulates 5-HT7 receptors after prolonged exposure, will introducing Effexor afterwards produce more anxiety or less anxiety compared to Effexor alone?
>
> Perhaps we should pay more attention to this when evaluating the therapeutic worth of a drug.
>
>
> - ScottYes.
Pramipexole was the only drug I tried that was anti-anhedonic -- I got my sense of reward back. However, it apparently desensitised my dopamine D3/D2 receptors, so that the same drug would no longer work, despite a period of wash-out.
Sulpiride yielded a powerful (more so than methylphenidate) "motivational" stimulant effect at first, but apparently desensitised my dopamine autoreceptors, so that the same drug would no longer make a difference. Then I used selegiline for a while and some of the initial effects of sulpiride came back -- maybe selegiline re-sensitised the autoreceptors.
Reboxetine changed my brain permanently, so that I became more depersonalised-derealised -- my emotions were numbed, so that experiences that used to bring me to tears would no longer touch me. It was a welcome effect at the time, but now I wonder what my life would have been without it.
-undopaminergic
Posted by SLS on April 10, 2023, at 20:46:02
In reply to Re: Does anyone still take aripiprazole (Abilify)? » SLS, posted by undopaminergic on April 10, 2023, at 11:01:35
Hi.
I'm truly sorry about your experience with reboxetine. I tried reboxetine, too. It produced a hideous suicidal depression. I even called my parents to let them know that I would be getting my affairs in order. I was riddled with anxiety and feelings of doom. I guess I was lucky that the drug left me with no persistent damage.
I did not try pramipexole. After trying bromocriptine and watching the transience of the improvement from taking it, I was not surprised that so many people on Psycho-Babble reported similar experiences produced by pramipexole. I couldn't justify trying it at any point along the way. However, I very rarely exclude any untried drug from consideration.
The drugs that gave me a big improvement during the first week that disappeared by the second week include bromocriptine, moclobemide, sulpiride, and amphetamine. Do you think there is any advantage to taking amisulpride over sulpiride?
> > Sorry. I lost my train of thought.
> >
> > Like I said, someone can have opposite reactions to the same drug depending on the one that preceded it.
> >
> > Effexor always produced a mild improvement for me, but nothing close to satisfactory. Still, I felt better on it than off of it.
> >
> > Three years ago, I tried vortioxetine for at least four weeks. It produced intolerable brain-fog and a sense of detachment from my surroundings. I stopped taking it. Having no better ideas at the time, I asked to go back on Effexor until something new came along.
> >
> > When I reintroduced Effexor, I experienced a torturous and painful brain-fog. Not only did my depression not improve, it became significantly worse. This was not the Effexor that I knew.
> >
> > Wash-out periods are not just to allow a drug to clear the bloodstream. It also allows the brain time to reregulate itself back to a baseline similar to what had existed before drug exposure.
> >
> > Think about how neuroscientists gather information by exposing a rat to one compound to see how it affects its reaction to a second compound. This is called "pre-treatment". One experiment might be to see how pre-treating a rat with a 5-HT7 antagonist (vortioxetine) changes the way the rat reacts to Effexor. If vortioxetine upregulates 5-HT7 receptors after prolonged exposure, will introducing Effexor afterwards produce more anxiety or less anxiety compared to Effexor alone?
> >
> > Perhaps we should pay more attention to this when evaluating the therapeutic worth of a drug.
> >
> >
> > - Scott
> Yes.
>
> Pramipexole was the only drug I tried that was anti-anhedonic -- I got my sense of reward back. However, it apparently desensitised my dopamine D3/D2 receptors, so that the same drug would no longer work, despite a period of wash-out.
>
> Sulpiride yielded a powerful (more so than methylphenidate) "motivational" stimulant effect at first, but apparently desensitised my dopamine autoreceptors, so that the same drug would no longer make a difference. Then I used selegiline for a while and some of the initial effects of sulpiride came back -- maybe selegiline re-sensitised the autoreceptors.
>
> Reboxetine changed my brain permanently, so that I became more depersonalised-derealised -- my emotions were numbed, so that experiences that used to bring me to tears would no longer touch me. It was a welcome effect at the time, but now I wonder what my life would have been without it.
>
> -undopaminergic
- Scott
Posted by undopaminergic on April 11, 2023, at 8:21:05
In reply to Re: Does anyone still take aripiprazole (Abilify)?, posted by SLS on April 10, 2023, at 20:46:02
> Hi.
Hi.
> I did not try pramipexole. After trying bromocriptine and watching the transience of the improvement from taking it, I was not surprised that so many people on Psycho-Babble reported similar experiences produced by pramipexole. I couldn't justify trying it at any point along the way. However, I very rarely exclude any untried drug from consideration.
>It's possible that higher doses (several milligrams) might yield more lasting results. I've read about people developing addictions on it, which suggests their reward systems are hyperactive.
> Do you think there is any advantage to taking amisulpride over sulpiride?
>Not in my experience, but there is a lot more research to back up amisulpride. At least that is true of clinical research. Sulpiride seems to be more often used in animal experiments.
-undopaminergic
Posted by SLS on July 6, 2023, at 12:09:47
In reply to Re: Does anyone still take aripiprazole (Abilify)? » SLS, posted by undopaminergic on April 11, 2023, at 8:21:05
> > Hi.
>
> Hi.
>
> > I did not try pramipexole. After trying bromocriptine and watching the transience of the improvement from taking it, I was not surprised that so many people on Psycho-Babble reported similar experiences produced by pramipexole. I couldn't justify trying it at any point along the way. However, I very rarely exclude any untried drug from consideration.
> >
>
> It's possible that higher doses (several milligrams) might yield more lasting results. I've read about people developing addictions on it, which suggests their reward systems are hyperactive.
>
> > Do you think there is any advantage to taking amisulpride over sulpiride?
> >
>
> Not in my experience, but there is a lot more research to back up amisulpride. At least that is true of clinical research. Sulpiride seems to be more often used in animal experiments.
>
> -undopaminergic
>
I am under the impression that amisulpride was used to treat depression and dysthymia at low dosages only. 25-50 mg/day, if I remember correctly.
- Scott
Posted by undopaminergic on July 7, 2023, at 10:41:17
In reply to Re: Does anyone still take aripiprazole (Abilify)?, posted by SLS on July 6, 2023, at 12:09:47
>
> I am under the impression that amisulpride was used to treat depression and dysthymia at low dosages only. 25-50 mg/day, if I remember correctly.
>
>
> - ScottYes, there is a concern that at higher doses, it might block too many post-synaptic dopamine D2-receptors, which could counteract the desired effect of blocking pre-synaptic receptors (autoreceptors) which enhances dopamine release.
-undopaminergic
This is the end of the thread.
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