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What are my medication options? (I currently only take 5MG Abilify)


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I don't have problems with my sleep so not sure its mania. But obviously I know you don't always need to have sleep problems to have it. if it turns out I am having an episode because I don't understand it myself as I am either really down or feeling normal and doing stupid things like getting a tattoo. I have this inability to make decisions and stick with them. I'm so frustrated because I don't know how I am going to be in the morning.

 

Anyway I only take 5mg Abilify. I don't need more meds to make me blow up because I am already overweight as it is.

 

What are my options?

 

I'm seeing someone today but your experience is appreciated.

 

I have had 4 opinions and half of them told me I had paranoid schizophrenia and the other said it was schizoaffective (but only had that one psychotic episode 5 years ago). I strongly believe it is bipolar as its been so long since I had the psychotic epside I guess time will only tell.

Edited by Pearly
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There are way to many options to just list. I'm not trying to be difficult, it is just impossible. You aren't even on very much Abilify. It could be that is the main med you need, but who knows? Who put you on the Abilify, and for what?

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Originally I was put on it by a pdoc for paranoid schizophrenia on the NHS. She discharrged me from Early Intervention. Now a pdoc (because I never see the same one) has left me on it for schizoaffective. My dose was upped about 5 months ago for depression but recently decreased to 5mg again and it was a terrible mistake.

Edited by Pearly
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My pdoc started me on 10mg of Abilify because of my history w/ paranoid delusions. But because it has been so long since I've been psychotic we're lowering it to 5mg (eventually we'll get there) which, I guess, is a decent mood stabilizing dose, at least for me, I hope (? I dunno, I'm not a doc). I am currently diagnosed Bipolar (NOS I guess) despite having had at least 4 delusional episodes lasting a while each time, and only one of my (major) delusional episodes stemming from my mood swings, as well as a history of general paranoia (though I admit the non-specific paranoia is mostly caused by mixed episodes). Maybe the DSM is like a choose your own adventure book for pdocs :). One doc says this, another says that and yet another says something completely different. I hope you get everything figured out soon.

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  • 2 weeks later...

Maintainance dose of Abilify for bipolar is somewhere around 15-25mg. Acute episodes 30mg. I have bipolar I am just staying afloat sometimes on 15mg a day. If you have bipolar and suffer psychotic symptoms then 5mg a day is negligable. Talk to your doctor about your options. One of them might be increasing the dose of Abilify. Or he/she might suggest another medication.

Try not to focus on labels too much... The important thing is treating your symptoms and allowing yourself to be able to function better.

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If you do have bipolar, then what you probably need first and foremost is a mood stabilizer. Lithium, Depakote, and Lamictal are all mood stabilizers, each with different pharmacokinetics. There are quite a few anti-psychotics approved to treat bipolar, such as Abilify, Geodon, Risperdal, Saphris, Seroquel, Thorazine, Zyprexa...Sometimes Topamax and Tegretol are also tried, if more conventional mood stabilizers don't work. Sometimes SSRI's or SNRI's are give, or benzos, and there are just too many of those to try to name.

 

If you look at the signatures of the bipolar crowd here on CB, you'll notice that most of them contain medication cocktails rather than single medications. Polypharmacy is very, very common in treating bipolar.

 

So you have loads of options. But if I were you, I would try to start with a mood stabilizer. You need a fighting chance at knowing how you're going to be in the morning.

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I am bipolar and Latuda (aap) is what brought me back to normal out of mixed episode. I was on it for several years alone and it worked well for me. Then I started having breakthrough depression and antidepressants did nothing for me so we added Lamictal. I have been on that combination for about a year now and doing well.

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There are a million combo's to try. It took years to find a good one for me, and it gets changed once in a while. It's not hopeless.

 

Generally, like Gearhead said, the main med is a mood stabilizer. Lithium is the only "true" mood stabilizer, the others are anti-convlsants (for seizures) but many of them work well, and several are weight neutral. Topamax isn't the best mood stabilizer (and has shitty side effects for a while) but it has a side effect of weight loss. 

 

Sometimes they'll prescribe an antipsychotic. Seroquel, Zyprexa, Latuda and many more are approved for bipolar disorder and they can be taken as a primary mood stabilizer. I'm on Seroquel as a mood stabilizer. Often benzo's are prescribed (for anxiety, to help with mania, sometimes for sleep), and many are take as needed (PRN) Some antipsychotics are PRN as well. 

 

Sometimes they'll prescribe an anti-depressant, but some people get manic from them. I take Wellbutrin, which is one of the few that don't make me manic. It's a lot of trial and error.

 

Abilify sucked for me. I'd never go on it again. I got akathasia (extreme inner and outer restlessness) and couldn't lose weight on it. Some people have a lot of luck with it, but that's just my experience. 

 

Lots to try. It's not all bad. Meds have side effects, though, but they often go away with time. My worst side effect is dry mouth.

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