Being Realistic

[blakismom]

My psych says that she wants me to be on one med alone for my bipolar, the med of choice is Abilify.
Is it realistic to think that one mood stabilizer will do the trick? I am having a real problem with the depressed side, and Abilify just doesn't seem to be helping.

Perhaps I need an increase in my dose which is now a 15mg once daily. What do you think?

[ILADVOCATE]

  Not all medications have the same concern as regards weight gain and full mood stabilizers (anti depressents have that potential) generally will not cause mania although each person responds to differently to each medication. Lamictal is one realistic option within a psychiatrist's discretion that you could ask about and if things have gotten to this point it would be worthwhile to go back to a psychiatrist again. All medications have different side effects and there should be one that would be of help to you. There still are many options left.

[torrancegal]

i went off epival in 2009. i've been trying so hard to manage my anxiety and my depression and i did get private counselling this past spring/summer until the money ran out. i hate to go on meds because they seem to always make me manic and gain weight. but i'm at end of rope. I believe JimGreg here suggested lamictal to me. i'll raise it with my doctor. i won't say suicidal thoughts to my doc because i have a disabled daughter and if something was to happen to me i'm so afraid my insurance might be denied. so that's what i live for - to stay alive to pay bills so my daughter won't be out on the street. good a reason as any i guess but i'm just so down and it's so hard to keep my clients happy (I'm self employed) when it's SO hard to even approach my work. I've even been faking out my docs so I look cheery when I come in to the office for allergy shots, etc. damn, i'm even paranoid to say what i really feel here in case some insurance claims person sees this. i am simply terrified that i die accidentally and someone tries to say i was depressed and my only possible money to leave my daughter is from life insurance. without that, she'd lose everything. even with it, i'm up to my eyeballs in debt. that's why i avoid talk of being depressed, etc, with my doctors. but its so bad. wake up crying, go to sleep crying (down to just one lorazepam a night which i'm addicted to even tho it's low dose) and i seriously don't care if i live any longer. thank goodness for debt or i would step in front of a bus.

[adel_ezz]

Hi

This piece of information that abilify can turn people manic is new to me. Agitation and irritability possible but not mania It's an antipsychotic so it just can't by definition. Besides it's a second generation atypical so instead of suppressing dopamine it regulates it. For some this drug turned their life rose and for some it brought insomnia and a bit of agitation, but mania this is totally new. I heard that lamictal can bring mania but very rarely when over 600mg say but therapeutically it works from 150, but abilify never heard about that.

Incidentally both abilify and lamictal as you noted are good for depression, like seroquel except that this one is weaker in this sense because it's a strong antimanic but has more stabilizing properties. Sio for depression abilify works better for sure. However it's worth asking the pdoc about that it might bring mania. There are sites which rank abilify as the best stabilizer then comes seroquel then lamictal then risperidone then lithium, etc...zyprexa... So whether an antipsychotic can work as a mood stabilizer depends on whether it lifts depression and al;l the past AP's do it with varying capacity.

However you can be correct if an abuse of abilify is the case. Perhaps... who knows  I also know well that abilify can stop mania like i know that some pdocs lifted mania with lamictal which is strange to me either

Here is a paragraph from a medical article in which they reported a case of possible induction of mania with the use of aripiprazole (abilify)

http://ajp.psychiatryonline.org/cgi/content/full/164/1/172-a

however they iterated to conclude the following

"""Although this case report adds to the literature on atypical results of atypical antipsychotics, caution needs to be used while interpreting the results, since aripiprazole is approved for the treatment of acute mania. Possible differences in response to aripiprazole in patients with bipolar affective disorder versus those with schizoaffective disorder need to be investigated. Furthermore, a drug screen was not performed to assure the patient’s denial of substance abuse""".  

[paranoid_cataclysm]

I hear you on no energy, I wake up feeling tired after eight hours but I have trouble falling asleep at the same time.  Geodon sorta fixed that because it knocks me out but it leaves me feeling tired a lot of the time.

[blakismom]

Thanks so  much for that information. I like a drug to be activating because of the fact that I am always soooo tired, so I like the energy and will take it wherever I can get it from.

My psych appt is in the morning so I will ask her about upping my dose.

[jimgreg]

if you bp then your more than ,.Ikey high and low is what bp is..the ablifi can make you mania even when its working..but you also need to be on something for deppreshion  such as lamictail.....talk this over with ur pdoc..but yes most bi polars are on ore than 1 med...some takes yrs to get there =combo..i took ablifi it threw me into mania in 4 days...

[adel_ezz]

I bet your pdoc is one of the few who reason well. abilify is a new atypical antipsychotic manufactured by a japanese company and some doctors rank it as the 1st among mood stabilizers. It's very good for depression very activating, the only drawback a bit of anxiety and insomnia, this is why they give it in the mornings. If you don't get them i would advise you to proceed. if i remember the therapeutic dose is 15-30, i.e. she is giving you the min, so you can ask her to up your dose.

The less the no of drugs the better the outcome and any complications you will know from which drug

the other alternative is lamictal it's an anti-epileptic drug used off-label to stabilize bipolars, usually pdocs prefer to start with antipsychotics, and abilify is the latest

good luck