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Should I switch my AAP from Abilify to Latuda?

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Hello, y'all! 


[296.35] Major Depressive Disorder, Recurrent, In Partial Remission

[300.02] Generalized Anxiety Disorder

[301.13] Cyclothymic Disorder

[314.00] Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type

Thus, I am now taking:

Abilify (aripiprazole) 10mg. for 296.35; 301.13

Adderall (amphetamine salts) 20mg. [10mg. BID] for 314.00

Aplenzin (bupropion hydrobromide) 522mg. for 314.00; 295.35

Lamictal (lamotrigine) 200mg. for 301.13

Nuvigil (armodafinil) 250mg. for 314.00

Neurontin (gabapentin) 1,800mg. [400mg. QID] for 300.02

Pristiq (desvenlafaxine) 50mg. for 296.35

The Abilify (aripiprazole) makes me gain weight. My PDOC suggested Topamax as an adjunct mood stabilizer for its weight-loss properties, but I am not fond of the idea. I love Abilify, it is the most effective medicine I have ever taken, but I can't deal with the weight gain; I've made many lifestyle changes, but they can't seem to conquer the metabolic effects of aripiprazole.

I've read that lurasidone has the lowest weight-gain of the atypical antipsychotics (AAPs). From Wikipedia:

"low propensity for QTc interval changes, weight and lipid-related adverse effects ... was found to produce the second least (after haloperidol) weight gain, the least QT interval prolongation, the fourth most extrapyramidal side effects and the sixth least sedation (after aripiprazole)."
I've never gotten EP or sedation symptoms from Abilify so I'm hoping Latuda is no different.

We chose aripiprazole because it still allows for some endogenous dopamine due to its partial agonism which I also hoped theoretically would mean that it'd allow ADHD stimulants to work better than with other AAPs. How well does Latuda work with stimulants? I've read case reports which suggest they will be attenuated similarly to Abilify but still exert therapeutic value.

Also, according to Wikipedia:

"Lurasidone may be useful for treating the cognitive and memory deficits seen in schizophrenia ... and was found to be superior in doing this to all of the other antipsychotics examined ... Lurasidone has activity at several serotonin receptors that are involved in learning and memory, and unlike most other antipsychotics, lacks any anticholinergic effects (which are known to impair cognitive processes and memory). These properties may underlie its improved effectiveness in treating these symptoms relative to older agents."

I definitely need pro-cognitive effects since I suffer from ADHD. It also has FDA approval for bipolar I depression and I suffer from a form of bipolar depression myself.

Lurasidone even shares aripiprazole's partial agonism at 5-HT1A which is good. It seems similar in every way except that it causes less weight gain. I don't see any reason to not try it instead?



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Hmm, I'm always hesitant to change meds when they are working. But if I am rapidly gaining weight, that's a deal-breaker. If it were me, I think in your situation it would depend on how much weight I had gained, in what sort of timeframe. If it were a significant amount, in a short amount of time, I'd be worried, and want to switch. If I gained a small amount, over say 6 months or a year, I'd just try to manage it. I can't tell you what to do. Sometimes when you go off a med and try it again later, it doesn't work as well. But you don't want to battle with weight gain unnecessarily either. 

Edited by mcjimjam
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I'm just switching from Clozapine to Abilify because of weight gain issues. Reading papers and reports around the internet it seems people really differ in whether they gain or even lose weight on Abilify and my guess would be it really depends on you and your body. If it was me I would definitely give Latuda a try.

All the best!

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