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When do I Take My Adderall When I'm on Abilify?


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(Mod note: some posts were split off & merged from a different thread due to being more relevant here; however this post was made before this entire thread, and so appears first.)

 

 

 

A very low dose of Abilify works very well for depression. At low doses it is very effective antidepressant, and at higher doses it is an antipsychotic. It is pretty expensive, but if you have insurance it should be no problem.

Actually its an antipsychotic at all doses, Its just not as effective in the lower doses for some people and some people need higher doses to get the desired effect.

A 2mg dose still gets 70% D2 receptor occupancy (Compared with 85% at 10mg, 91% at 30mg, 96.8%+ at 40mg). While these percentage changes might not seem like much, keep in mind an increase from 90% to 91% is actually a 10% decrease of receptors left unoccupied, and may have a larger effect than the numbers suggest.

 

http://www.ncbi.nlm.nih.gov/pubmed/18418366 - 2mg and 40mg dose values.

http://ajp.psychiatryonline.org/article.aspx?articleid=98931 - 10mg and 30mg dose values, also has a pretty picture with other receptor occupancy.

 

All that aside, they listed Abilify as one of the medications that they tried in the past that didn't work. So its a moot point.

 

Not me, you've shown me up there. I have a question for you, how long is Abilify's half-life, how long do the D2 receptors stay blocked? When should I take my stimulant medication, I don't want it competing for D2 especially if they are going to be blocked. I actually did some googling and apparently it has 75 hour half-life and 94 hours for its active metabolite....now what do I do.....  :glare:

 

And I didn't catch that Abilify was one of her discontinued medications, nice catch.

Edited by Mirazh
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A couple concerns of mine, is that Abilify will counteract my Adderall. My reason for taking Abilify is mood stabilization, it really doesn't serve any other purposes for me. However what concerns me is it has a ridiculous half-life (the mean elimination half-lives are about 75 hours and 94 hours for Abilify and its active metabolite holds the half-life of 94 hours) I'm on 10mg and from what a chat moderator pointed out to me

 

 

"A 2mg dose still gets 70% D2 receptor occupancy (Compared with 85% at 10mg, 91% at 30mg, 96.8%+ at 40mg). While these percentage changes might not seem like much, keep in mind an increase from 90% to 91% is actually a 10% decrease of receptors left unoccupied, and may have a larger effect than the numbers suggest.

 

http://www.ncbi.nlm....pubmed/18418366 - 2mg and 40mg dose values.

http://ajp.psychiatr...articleid=98931 - 10mg and 30mg dose values, also has a pretty picture with other receptor occupancy..

 

So I'm aware that D2 is where amphetamines primarily works on....at 85% blockage rate, and such a high half-life it would never really be a good time to take the Adderall without it being negatively affected by the Abilify....so what are your thoughts on this........

 

Take the Adderall in the morning and hope for the best and take the Abilify every evening or even a better idea is every 3 days but of course this wouldn't be the wisest idea.....tell me what you all think!?

Edited by Forbidden91
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It is not a smart idea to adjust your Abilify dosing based on something you read on the internet--ie taking it only every 3 days. I mean that is 100% dumb, and do not do it. Adderall does not solely work on D2, you should still feel most of its effect regardless of when you take Abilify. Take your Abilify as prescribed, and if you really have your panties in a bunch about it, ask for a consult with a psychopharmacologist. 

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You need to take your Adderall and Abilify when your doctor told you to take them. When I was on them, I'd take Abilify at night just because that's when I could remember to take it. I took Adderall in the morning because that's when I needed it--in the morning when at work.

 

Sometimes reading on the Internet isn't a good thing. This may very well be one of those times. Take your meds as directed.

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I think if you have any concerns you should talk to your pharmacist or prescribing doctor but until then you should take your medication as prescribed. As Lark said, it's not smart to change up your doses or take your medication differently based on something you've read online.

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Seriously, the best answer is "Ask your doctor about timing your doses. If you can't ask your doctor soon enough, ask your pharmacist."

 

You are asking for specific medical advice with your question and nobody here is remotely qualified to answer that on a peer-based internet site.

 

There is a big difference between the plasma half life and the bioavailablity half life of a substance. These relationships are complex, especially with more meds in the mix. Trying to predict how often you should take your abilify based on what you see listed in the sidebar of Wikipedia about the drug is a HORRIBLE way to try to figure out a dosing schedule...

 

TALK TO YOUR DOCTOR.

Edited by Wooster
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I realize that I won't get the most informed answers, but I'd also like to get first-hand experiences on people on these two medications or antipsychotics and stimulants in general. Also I didn't personally use Wikipedia. 

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Look, dude... WHATEVER your source...

 

You are ASKING FOR PERSONALIZED MEDICAL ADVICE the way you have phrased your question.

 

If you are truly seeking personal experiences of people who have taken BOTH these meds at the same time, you should say that...

 not "Hey I think I should only take my abilify every third day... what do you think?"

 

Do you see the difference?

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A couple concerns of mine, is that Abilify will counteract my Adderall. My reason for taking Abilify is mood stabilization, it really doesn't serve any other purposes for me. However what concerns me is it has a ridiculous half-life (the mean elimination half-lives are about 75 hours and 94 hours for Abilify and its active metabolite holds the half-life of 94 hours) I'm on 10mg and from what a chat moderator pointed out to me

 

I feel like I have to say this, since you bought it up... The post you mention regarding the receptor occupancy was directed at you saying abilify wasn't an antipsychotic at low doses. It had absolutely nothing to do with it blocking stimulants.

 

A very low dose of Abilify works very well for depression. At low doses it is very effective antidepressant, and at higher doses it is an antipsychotic. It is pretty expensive, but if you have insurance it should be no problem.

^ This was the post in question.

If you are so worried about stimulants not working, Ask your doctor for strattera - it doesn't even work on dopamine, its purely an NRI and works really well for most people. The effect most people desire when people use stimulants seems to be from NA not dopamine, furthermore you should always take medications as directed so this is just outright stupid. The half life being long allows the medication to build up to a level which wouldn't be seen otherwise, an effective level. Thus a single low dose might do nothing, but repeated dosing will. For another example of this have a look at Prozac, Its a fantastic example of what a long half life and repeat dosing can do as it inhibits its own metabolism in time and actually allows enough to build up in the blood to be effective - a single dose does little to nothing.

 

 

I realize that I won't get the most informed answers, but I'd also like to get first-hand experiences on people on these two medications or antipsychotics and stimulants in general. Also I didn't personally use Wikipedia. 

I personally take a low dose of dexamphetamine and it works just fine, despite being on a high dose of saphris.

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Thank you Wooster, I do see the difference and I agree. 

 

Not me thank you for clearing that up, I just used the information you provided previously to an irrelevant post, as a basis for my "argument". Thank you for the thorough response, Prozac seems to be a great example.

Edited by Forbidden91
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Not gonna lie, I didn't read everything; however, I take abilify and adderall. I take my abilify at night before bed, and my adderall in the morning, mid afternoon, and evening.

 

It seems to work fine for me.

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I don't think it will matter what time of day you take them. That Abilify will always be in your system. I would just stick with what the bottle says. See how it goes. If you find Adderall isn't as effective as it was, you can raise that with your pdoc. Personally I haven't noticed a difference from when I was on Concerta with Seroquel and now Concerta without an AAP. Theory often doesn't translate to real life and neuroscience is probably infinitely more complex than we currently understand.

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Not me, you've shown me up there. I have a question for you, how long is Abilify's half-life, how long do the D2 receptors stay blocked? When should I take my stimulant medication, I don't want it competing for D2 especially if they are going to be blocked. I actually did some googling and apparently it has 75 hour half-life and 94 hours for its active metabolite....now what do I do.....  :glare:

 

And I didn't catch that Abilify was one of her discontinued medications, nice catch.

Its not really the topic, but I'll bite. The half life depends on your race to some degree, some backgrounds are more prone to what is termed extensive or ultrarapid metabolism and some are poor. In an intermediate its around 75 hours and in an extensive its around 45, but there is a huge amount of individual variation in this - its almost entirely up to your genes. Depending which ones are expressed it might be shorter or much longer. As for the metabolite, the half life is somewhat unknown, but its level in your blood doesn't seem to change based on CYP2D6 metabolism, it is perhaps a different metabolism path.

 

How long the receptors stay blocked is a tricky question as abilify doesn't actually work via antagonism, its a partial agonist for D2, so they never get blocked to begin with. What it essentially does is occupies the receptors and fires off signals at a reduced rate compared to normal. So instead of firing off signals at a one to one ratio, the receptors fire one in three (No idea on the actual number, I don't think anyone actually knows). As for how long it stays bound to the receptors, I don't know.

 

http://www.ncbi.nlm.nih.gov/pubmed/17965519 - Half life study relating to CYP2D6

http://www.ncbi.nlm.nih.gov/pubmed/17828532 - PM vs EM showing different dosages needed to get a response.

http://www.ncbi.nlm.nih.gov/pubmed/22377745 - Plasma concentrations of dehydroaripiprazole were unchanged throughout the study period.

http://www.ncbi.nlm.nih.gov/pubmed/19032724 - the plasma concentration : dose ratios of dehydroaripiprazole were not different across the CYP2D6 genotype.

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