Thinking of change to Cocktail

[LostSoul]

Hey there. See sig below for current meds.

I'd been stable for about 6 months until about a month and a half ago when I started feeling depressed. Nothing major, basically dysthymic. Not my usual dysphoric hypomania/atypical depression/mixed states/whatever the hell it is. Just depressed. Sad. Loss of interest in pleasurable activities. Starting to hate going to work. Not having energy to exercise. Problem is, I start craving a 'pick me up' in this state - not good given my vast history of substance abuse and the holidays coming up.

Topamax had been working wonders for my OCD, irritability/rage, and intrusive thoughts with minimal side effects, but was still having some thoughts of drinking, so we increased from 150 to 200 about 2 weeks before the depression set in. No depression whatsoever on previous dosage increases. In fact, topamax seemed to energize me a little bit. Could this increase have caused the depression? I don't want to go down because I have ZERO desire to drink now that I'm on 200.

We increased the Zoloft from 100 to 150 - it's been 6 weeks now. Increased the Zyprexa from 2.5 to 5 about 2 weeks after the Zoloft increase (doc said it would help until the Zoloft increase kicked in). Felt great for about 2 weeks, but now I'm feeling depressed again. The Zoloft should have kicked in by now. It works wonders for my OCD, but maybe it's causing apathy?

Question: should I ask to switch the Zyprexa for Abilify? I'm also concerned about significantly elevated cholesterol and triglyceride levels on my most recent lab work, even though I've started exercising and eating better since the previous labs. Have been on the Z for 4 years, from 2.5 - 5. I've heard horror stories about Akathesia and problems sleeping on Abilify, but I feel like I need something activating. I have no motivation to do anything and just want to lay in bed all day on weekends. Does increasing Lamictal beyond 200 have any therapeutic effects?

Sorry for the long post. Your replies are greatly appreciated.

[LunaRufina]

I don't have any personal experience with Zyprexa, but I know it can be sedating.

I'm on 20mg of Abilify right now, was up to 30mg at one point, both with no problems of akathesia. Everyone is different though. I find it is a really good medication for me. I felt at 30mgs, after a while, it might be making me feel a bit "duh" and that's why I lowered it. I don't remember if I had any sleeping problems to start or not.

[usernametaken]

i couldn't distinguish the abilify under the Z. make sure everything is open and flowing with your pdoc. also with the winter, might not hurt to throw in a sunlamp. certainly hella healthier and more legal than those other pickmeups. Z is certainly more sedating than Abilify so a switch might do the trick. again, not a medical professional here

i didn't get akathesia

[LostSoul]

Thanks for the replies, Luna and UNT, I really appreciate it. Saw Doc yesterday morning and he gave me samples of Abilify 5 mg. Told me to take 2.5 in am for a few days to see if I get any sides, then increase to 5. If it goes well, we'll keep Zyprexa at 5 for a week, then 2.5 for 2 weeks, then 1.25 for 2 weeks, then stop.

Took one yesterday morning - no akathisia but not activating at all. Was pretty sedated about 3 hours after taking it. Ingested large amounts of coffee to make it through work. But I felt very calm, no anxiety, and no depression! Problem was, I had a really hard time falling asleep last night. I also kept waking up every hour or so and had a hard time falling back alseep. Today I feel ok - no depression, somewhat sedated, tired from poor quality of sleep.

If I had problems sleeping with AM dosing, I can't imagine what bedtime dosing would be like. In anyone's experience does the sedation and difficulty sleeping pass after a while? I've got some extra Klonopin and will take a .5 tonight to see if that helps. I know I'll have some difficulty sleeping for a while when I stop the Zyprexa, and I hope the Abilify sleeping issues will have resolved by then. Thanks for any input.

[wbl526]

Just wanted to share my experience with Abilify. I started at 5mg, the first week seemed great and I was able to get a lot done, increased to 10mg and I was a zombie, I mean it knocked me on my ass! I felt dizzy when driving, blurred vision and just out of it. Decreased the dose to 5mg and now I'm better BUT Abilify has not been activating for me since I first started taking it. If anything it's sedating for me. I'm now on Provigil to try and get my energy back.