By l'appel du vide
Hello everyone, I hope everyone's December has been off to a good start. I am back, on the med merry-go-round and also sober from opiates.... Again (16 days as of now).
So I was taking wellbutrin as an add on to my Prozac, and it really didn't help and might have made me worse, losing dramatic amounts of weight, a lot of intrusive thoughts, very depressed (though that's probably just it not doing much for it. And getting off drugs.) so I'm now on the Rexulti starter pack.
I'm here seeking others experiences with abilify and rexulti, since they are both dopamine partial agonists and 5-ht1a partial agonists, amongst other things. I'm very nervous about taking an antipsychotic for depression, though... And just want to know of other's experiences starting these medications. How were the side effects? If you had any, did they eventually go away? Did you gain weight?
I appreciate anyone who shares their experience. I've asked about these meds before, but I'm so nervous about it I just want reassurance. A lot is changing around me. Thank you all so much, and I hope the holidays have been treating you well.
Hello, it has been awhile!
Well, my old psychiatrist retired and I am now stuck with a new one. A tele-med provider. Without really letting me know if they read my chart (they even made mistakes when asking what meds I was on now) they prescribed me topamax to take alongside my usual anxiety med due to (duh) increase in anxiety. They said the added benefit would be that I would be able to lose weight as well, since my previous meds made me...ahem, chunky. And I told them I have body issues.
Here's the thing. I did a little research about the weight loss and all studies said that it was beneficial to those who were bulimic or over eaters. I have history, and deal with restrictive eating. Making my appetite less would be a very stupid move in my opinion. My other concern is that there is a side effect where your eyes can suffer permanent damage. Not likely of course, but it is noted. I have a degenerative eye problem and I feel that it would be risky to take something that could make my eyesight worse. Of course there is the caveat that if I notice anything like that I can stop the med, but would my eyes regain the vision they "lost"?
I talked to a pharmacist today and they told me it would be very unlikely that I would have any visions problems other than blurriness and that most symptoms are dizziness, hard time focusing, etc the usual. They kind of glossed over the eating part too, saying to just talk to my provider. I have an appointment in a month, and with the Holidays coming up, I decided not to start taking the topamax so as not to ruin any festivities I hope to have with my family.
I guess I just needed to vent a bit because it doesn't seem like my new provider is listening to what I have to tell them...since they keep asking me things that are in my chart already! I miss my old psychiatrist a lot, and don't like this new tele-med set up. In any case, I would love to hear from others who have taken topamax for anxiety and how it worked for them. I know everyone is different, but I'd like to get some feedback nonetheless.
Abilify (Aripriprazole) is a partial agonist on dopamine receptors with 60% the activity of dopamine on receiving neurons and 75% activity of dopamine on firing neurons . Abilify is the only antipsychotic which can increase dopaminergic activity in the mesocortical pathway through dopamine partial agonism. Abilify is a 5HT1A partial agonist (68%), which causes dopamine levels to go up in the prefrontal cortex. Abilify is also a 5HT2A antagonist; which has antipsychotic and antimanic properties .
Here are the Four Dopaminergic Pathways and Abilify's Effect on them
1. Mesolimbic (Abilify decreases activity)
2. Mesocortical (Abilify increases activity)
3. Nigrostriatal (Abilify dampens down)
4. Tuberoinfundibular (Abilify does not cause prolactin release unlike dopamine antagonist antipsychotics. In fact, even low doses of Abilify can reduce prolactin release caused by dopamine blockers).
Abilify reduces neurotransmission in three of the four dopaminergic neuronal pathways.
Aripriprazole: Intrinsic activity = 60% on post-synaptic D2 ; up to 75% on pre- synaptic D2 receptors.
Brexiprazole: Intrinsic activity = Up to 46% 
Cariprazine: Intrinsic activity = Up to 71% 
Aripriprazole is a partial agonist with functionally antagonist activity on receiving neurons and functionally agonist activity on firing neurons; both of which dampen down dopaminergic neurotransmission. Aripriprazole can increase dopaminergic activity in the mesocortical pathway, unlike dopamine blockers, Aripriprazole partially agonizes D2, D3, 5HT1A and to a lesser extent D4 receptors; antagonist at 5HT2A, as other atytpical antipsychotics.
Brexpiprazole has more blocking and less stimulating activity at the dopamine receptors than its predecessor, aripiprazole, which may decrease its risk for agitation and restlessness. Specifically, where Aripiprazole has an intrinsic activity or agonist effect at the D 2 receptor of 60%+, Brexpiprazole has an intrinsic activity at the same receptor of about 45%. 
Cariprazine is a dopamine D2- and D3-receptor partial agonist, with higher affinity for D3 receptors, as opposed to the D2antagonism of most older antipsychotic agents.Cariprazine has lower intrinsic activity at D 2 receptors than aripiprazole. Its intrinsic activity is up to 71% [3 ]
By l'appel du vide
I was curious about Abilify, first off have you personally seen a huge increase in weight after getting on abilify? I hardly have an appetite, even without meds, and it's very hard for me to gain weight. I also exercise pretty modestly, about an hour a day. Would I be safe from weight gain caused by Abilify? The only antipsychotic I've been on long term was Seroquel, helped me a lot and I don't think I gained more than 10 pounds, which could've just been me not being so depressed and having an appetite again. Is the same likely for Abilify? I am just terrified of this because I have gained a large amount of weight, over 20 pounds from one medication which was Remeron. It really messed with my body and I am terrified of that happening again, because honestly, being fat makes me feel ugly and even more depressed.
Second, I wanted to talk about something my psych brought up to me. He said that Abilify and it's relative Rexulti, have "pro-cognitive" effects, meaning they help with brain fog, apathy, concentration, motivation, and even energy. Apparently both are used for ADHD, with even the makers of Rexulti trying to get it approved for ADHD. Have any of your experienced this from either of the two? Because I am in need of something that helps with cognition, mainly apathy and low, low motivation and interest.
Bottom line, I am very interested in Abilify and its sister Rexulti. They are very interesting pharmacologically, with them being sort of unique antipsychotics... I would be taking Abilify for depression and as an add on to an antidepressant, by the way. I've always been scared of the word "antipsychotic" but knowing how Seroquel basically annihilated my depression in the past, I can't deny their benefits. Please share your experience, and as always, thanks for helping me out.