Jump to content
CrazyBoards.org

Is akasthesia? From abilify dose dependent


Recommended Posts

I used to take 30 mg abilify in evening and slept.  Now, pdoc changed it ton15 mg in morning.  I also take lexapro and Wellbutrin in morning. I get this tingly sensation in my legs.  It may be there all of the time. But I notice when I try to sleep.  I am taking magnesium which might help a little.  I am hardly sleeping, I wake up and can’t sleep. I don’t know if this is related.  I see pdoc Th, not sure what to ask.

Link to comment
Share on other sites

I'm basing this off a pharmacist/Naturopath doing a 1am talk radio show. But RLS can be either muscular as you take magnesium for, or nerve related. So a supplement for nerve pain sometimes apparently works better

  • Like 1
Link to comment
Share on other sites

3 hours ago, confused said:

I used to take 30 mg abilify in evening and slept.  Now, pdoc changed it ton15 mg in morning.  I also take lexapro and Wellbutrin in morning. I get this tingly sensation in my legs.  It may be there all of the time. But I notice when I try to sleep.  I am taking magnesium which might help a little.  I am hardly sleeping, I wake up and can’t sleep. I don’t know if this is related.  I see pdoc Th, not sure what to ask.

For me akathisia got worse as the dose went up. After a week on thirty I literally wanted to die, I’m not exaggerating. If I wanted to sit down and be slightly comfortable I had to. Use a rocking chair. Unfortunately I was so fucked up mental health wise at that point my pdoc thought it would be unsafe to take me off (I ended up having to get ECT anyway) so instead I had to take benzo and beta blocker to manage it 

  • Like 1
Link to comment
Share on other sites

10 hours ago, confused said:

I used to take 30 mg abilify in evening and slept.  Now, pdoc changed it ton15 mg in morning.  I also take lexapro and Wellbutrin in morning. I get this tingly sensation in my legs.  It may be there all of the time. But I notice when I try to sleep.  I am taking magnesium which might help a little.  I am hardly sleeping, I wake up and can’t sleep. I don’t know if this is related.  I see pdoc Th, not sure what to ask.

I used to take Abilify, and my pdoc at the time, said that Abilify can be taken any time of the day......He told me that I could see what time of day worked the best for me, and when I chose a time of day, stick to around the same time each day.

When you see your pdoc Thursday, I would suggest asking doc if you could try taking it in the evening, like you did before.

  • Like 1
Link to comment
Share on other sites

9 hours ago, CrazyRedhead said:

When you see your pdoc Thursday, I would suggest asking doc if you could try taking it in the evening, like you did before.

i always question any doctor who is intent on having me take a medication at any given time. like, why? what is the purpose? it's understood that if it's causing problems with sleep or drowsiness at a certain time, then switching times may be beneficial, but i generally ask for reasoning and then decide on my own how to take the medications i'm prescribed each day regardless of what the physician thinks is best because i'm the one taking these drugs and i have a rather clear amount of insight on how they affect me.

not to say that OP shouldn't ask, but it should be framed around rationale rather than permission, at least from my vantage point.

  • Like 2
Link to comment
Share on other sites

I saw a different pdoc in the same office. The other one seemed distracted.  I told him I don't want to add medication.  I thought it might be awkward if I saw the other one but it was fine

 

He moved abilify up to 20 mg.  I had stopped Wellbutrin and he is taking me off it.  He said to stand and walk more during the day. I can try melatonin.  We talked a little about keto and intermittent fasting. 

I asked if IFS therapy is okay to do since I have had psychotic symptoms and you try to communicate with parts of yourself. He did not think that would be an issue.

He asked how much sleep I get. My Fitbit registers about 2 hours. And then I am exhausted during the day.

Link to comment
Share on other sites

1 hour ago, confused said:

He asked how much sleep I get. My Fitbit registers about 2 hours. And then I am exhausted during the day.

If you feel comfortable sharing, what was the doc's response when you told him you're only getting 2 hours sleep per night?

I'm sorry you're having sleep problems, and feeling so tired during the day.

  • Like 1
Link to comment
Share on other sites

Thank you. 

Well, I had already said I don't want to add medication. He did not say much just looked like he understood.  I like him. 

If things don't improve I will reconsider medication. I used to take a small dose of Seroquel and slept better

He thinks I may have some anxiety so that is why he increased abilify.  He told me to walk and stand more if I can.

Link to comment
Share on other sites

@confused

I think the original pdoc may have halved the dose and told you to take it in the morning because you weren't sleeping. Aripiprazole (Abilify) does seem to be stimulating for most but it is sometimes calming at the high end of the dose range for some, and pdocs sometimes forget that. A low dose of quetiapine (Seroquel) could help with sleep or hydroxyzine (Atarax/Vistaril) depending on whether you respond to it. However, if you already discontinued the bupropion (Wellbutrin), it may be good to see if that resolves some of the sleep issues. Bupropion tends to not cause sleep problems, but it's not totally clear with aripiprazole on-board.

In reality, the escitalopram (Lexapro) and aripiprazole are way more likely to cause insomnia than the bupropion though. It's just a matter of how you manage it. A low dose of trazodone (50-100mg) or mirtazapine (7.5-15mg) could help tremendously with sleep. You should talk to your pdoc about some of those options.

  • Like 1
Link to comment
Share on other sites

20 hours ago, confused said:

Which is the least likely to leave you groggy in the morning.?  Thank you @browri 

Well.....that's a different story. Between trazodone and mirtazapine, the trazodone is MARGINALLY less likely to cause next-day sedation. However, they're both probably not great in that department. I suppose the real question is whether you have issues with sleep initiation (falling asleep) or sleep maintenance (staying asleep). More on that below.

20 hours ago, confused said:

slept 6 hours last night :)

That's awesome! Suffice to say the aripiprazole probably was disturbing your sleep. It has a fairly high incidence of insomnia.

19 hours ago, Iceberg said:

Have you ever tried a z-drug for sleep? Personally both of those caused morning sedation. The sleep med sonata (zaleplon) is short acting and may cause less morning issues. 

This is definitely an option if your pdoc is open to it. If the quetiapine caused next-day sedation, trazodone and mirtazapine may have similar effects, but z-drugs like zolpidem and zaleplon are immediate release and have short half-lives. So they help you fall asleep, but they wear off in the middle of the night. This is fine if you don't have issues staying asleep. And it also means that they are far less likely to cause next-day sedation.

Eszopiclone is another option in this class, but it does have a longer half-life. This means it will help you stay asleep if you are having issues with sleep maintenance, but it also means that if you don't plan to get 8-9 hours of sleep, then you might feel a bit groggy the next day. The other thing about eszopiclone is that it's actually approved for maintenance use. So you can take it every night for an indefinite period of time without developing a tolerance. And because of the long half-life, rebound insomnia from eszopiclone when you stop taking it is far less than for zolpidem or zaleplon.

19 hours ago, confused said:

I took seroquel but did not like the morning grogginess.  Thank you

Just to confirm, you were taking the quetiapine (Seroquel) in addition to the aripiprazole, right? The quetiapine was just for sleep? If so, were you taking like 50mg of the immediate release at bedtime? Much like eszopiclone, it may be about taking it early enough and planning to have enough sleep, but I've certainly heard of the next-day sedation from quetiapine being quite profound. That was generally my experience with mirtazapine in lower doses as well.

18 hours ago, psychwardjesus said:

Obviously YMMV, but I know from what I've observed working with patients, what various psychiatrists have told me and a very small dosage trial for me, it tends to be more activating on the lower end, i.e. ≤ 15mg.

This is very true. Aripiprazole tends to be activating at the bottom end of the dose range and gets more sedating as you increase. This is why for schizophrenia the starting and target doses are 10-15mg and for acute bipolar mania they want to start you on 15mg. Doses like 2mg and 5mg would be agitating in those cases. That being said, I personally know of two cases in my immediate family where 5mg of aripiprazole is effective in outpatient bipolar maintenance.

Link to comment
Share on other sites

Wow, thank you

I took 25 mg Seroquel along with 30 mg abilify at the time. It was years ago.  I did sleep but was groggy the next day.

I went from 30 to 15 mg abilify back up to 20 mg.  I take it mainly for psychosis but also agitation.  My symptoms have been pretty well controlled except anxiety. To be Lexapro helps.

I have trouble both falling and staying asleep.  I have never heard of eszopiclone.  Does insurance usually cover?  I can ask pdoc about it next time.

 

Link to comment
Share on other sites

45 minutes ago, confused said:

  I have never heard of eszopiclone.  Does insurance usually cover?  I can ask pdoc about it next time.

@confused, Eszopiclone is otherwise known as "Lunesta".....

Lunesta's been around for awhile, and a generic version is available.....As far as I know, insurance usually covers it...(Mine did when I tried it).

Edited by CrazyRedhead
  • Like 1
Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

 Share

×
×
  • Create New...