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Augmenting antidepressants with antipsychotics.


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I am currently on Anafranil for a wide range of things. I think it helps to a degree but not much.

I'm a little wary about the whole Abilify thing. Is this a med that has had consistent results for treating depression? It seems like a med like this could make my anxiety worse (Or maybe not?). Then, there's the Seroquel thing. I personally do not understand how this med could actually help depression at all. I took a dose one time and basically took a 30 hour nap. I think the dose might have been to high or something. I see it advertised for bipolar depression. I don't have bipolar. It it that Seroquel only helps bipolar and not unipolar depression?

I know there are plenty of antipsychotics that are used off label of depression augmentation. I have heard of risperidone being helpful.

Is it worth trying an antipsychotic for my depression or am I just better off switching antidepressants?

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Honestly, this is something best discussed with your doctor. It's really hard to give medication advice without knowing much about your history.

One thing it depends on is how much you like what the Anafranil is doing for you. If you don't feel like you're getting enough out of it to justify continuing to take it, switch. If it works for you, but not quite well enough, consider augmentation. If you have failed a lot of ADs before, and Anafranil is the best of a bad bunch, you might lean more towards augmentation.

With antipsychotics, they can certainly help with unipolar depression, but what they're going to do for you is almost impossible to predict. People have very variable reactions to them. With the more sedating ones, like Seroquel, you risk oversedation, but with the more activating ones like Abilify, you risk anxiety or agitation. But it's only a risk. You really won't know until you try whether it will help you and what the side effects will be.

Like I said, it all depends on your own personal preferences, and on what medications you've tried in the past and what they did for you.

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Zyprexa is also known to help depression. Antipsychotics have a lot of uses besides psychosis. I've tried a few of them, and I've never experienced psychosis. They're helpful drugs.

How is your OCD? If it's flaring up, Risperdal would be a good option - plus it does help with depression.

Abilify has a very good antidepressant effect in a lot of people. It has a long half-life, so withdrawal issues between doses isn't a problem. I didn't find it particularly activating or sedating, honestly. It toned down some of the noise in my head. Didn't seem to slow down the mood cycling, so I stopped taking it and switched to Geodon. Geodon has really helped with irritability and depression with me. Unfortunately, OCD is flaring up again. Which eh. That's what therapy is for.

I've taken Seroquel, and I found it helpful for OCD but not so much depression. I have issues with sedation hitting me hard, so I think it was too much for me. I made it up to 400 mg, and I was still depressed and tired. So pdoc and I nixed that. For most people, higher doses aren't particularly sedating and are all around helpful for mood. I'm just an oddball. Which goes to show you how response can vary so much.

Really, you have a ton of options. If you think you need to augment your antidepressant, there is lots to choose from.

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I agree with tryp with regards to the switching; she said it best.

I'm a little wary about the whole Abilify thing. Is this a med that has had consistent results for treating depression? It seems like a med like this could make my anxiety worse (Or maybe not?).

I don't know what abilify did for treating my depression (slight effort or none) but god it has done WONDERS for my anxiety. Without Abilify I am approximately 1000x times more anxious. Seriously, when I accidentally forgot to refill my script (and Abilify has such a long halflife that there's no withdrawal symptoms [for me], so that's nice) I was too anxious to call for a refill. When I'm on Abilify, no such problems.

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Is you psychiatrist recommending that you start an antipsychotic?

How many antidepressants have you tried?

Are you seeing a psychiatrist or some other type of doc?

1.Yes the pdoc has recommended anti-psychotics before as an adjunct and/or by itself if I end up needing it.

2. I have tried a lot of them (too many worth mentioning) however it might be as well I never had taken them. My old was not very good at prescribing meds. He didn't really pay much attention to me and got into the treating the side effects trap... adding this...then this...then that,

Now that I have a competent pdoc I would be willing to try almost any med again.

3. I am seeing a psychiatrist.On top of prescribing meds he will do some light therapy too if you need it. He is much easier to communicate to than the last pdoc. He spends a full hour with me. The last guy would only see me for like 15-20 minutes if that.

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