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Have you thought about finding a new pdoc who is open to trying new things?  It doesn't seem like you and current pdoc are working together on this.

I am currently on abilify, causes no side effects except it keeps me from hallucinating (including when I first started it, no side effects).  I am at 30 mg/day (everyone is different though, YMMV).  Anything lower it doesn't help.

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As the shaking is coming back I will stick to the lowest dose he prescribed (7.5mg) to avoid tremors and supplement it with 25mg seroquel (which I still have a supply of from when it used to be a PRN so it is prescribed) hoping my mood will improve.

Seroquel never helped my mood, regardless of the doses I've been on.

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and another doc I want to see for a second opinion is apparently booked up for two months...

Personally I would make this appt with 2nd opinion DR right now.  If this pdoc is already booking 2 months out, then I'd make an appt now.  Better to have one in place than not.  And you wont have to wait as long if you waited to schedule the 2nd opinion after regular pdoc comes back from vacation.  Does that make sense?

 

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I can relate to your post quite a bit med wise and pdoc frustration wise. I don't see mine until mid August as well. If you can afford it, get a pdoc who will listen and treat you better.

I actually take both abilify and seroquel. Seroquel is good for me. So is abilify though. I'm maxed out on doses of each currently (800mg seroquel XR and 30mg abilify). I don't get sky high psychotic mania when I stay on seroquel (I tried to get off it last year and ended up IP). Abilfiy I've been on for a decade with no issue. I'm sorry you have such a bad tremor from it. I am dealing with SZA bipolar type.

To get to your questions - 

Yes abilify and seroquel are in the same class, they are both AAP's (atypical antipsychotics). Although abilify is not usually sedating like seroquel is. 

IME if you can afford it seroquel XR is better for me than the IR (generic). I have taken both now for quite some time. I prefer the XR as I have been able to lose 30+ lbs and I do not get that ravenous hunger like I did all those years with the IR seroquel (and I needed to take the IR 3-4 times a day; the XR is once a day for me). Also I don't get so sedated with the XR. I really think they are similar in results yet very different in side effects IME. I have gained weight from seroquel though over the years, I'm not going to lie to you about that. Also my blood sugar is borderline high, but diabetes runs heavily in my family so who knows the true cause of that issue.

As far as anticonvulsants go, I have tried depakote and lamictal (and lithium although VERY briefly). I can tolerate lamictal and I've been on it forever. Depakote I feared the weight gain so I didn't give it a fair shot. Lyrica was mentioned once for me to try but the psych NP I was seeing didn't want me to be her "test subject" so she prescribed lamictal instead. 

I don't know if your doc (the old one, new one, or GP) would agree, but I wanted to let you know it is possible to take both seroquel and abilfiy (if you do want to continue taking abilify that is). None of my pdocs have had me on only one AAP in a very long time. Hell, I took 3 for a brief while at one point. 

Are there any pdocs covering for your pdoc while he is gone? I hate for you to wait til mid August to get any help. Personally when my pdoc is out of office there is a covering pdoc. Although IME the covering pdocs don't want to live a finger to help in any way and they all say wait until your pdoc gets back. Not helpful in crisis situations. :( 

Hope this helps. 

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Seroquel and Abilify are both AAPs but they are very different drugs. Recently, there are two new drugs which are similar to Abilify but supposedly with fewer side effects. Those are Rexulti and Vraylar. (Yeah, the names are crazier than we are.) You might want to ask your doctor about those.

If you are talking about Seroquel for mood, 25 mg is a sleeping pill and an antihistamine. You need around 200-300 mg for mood.

That's too bad about the Abilify tremor because Abilify is a great med for mood. Every time I had to go off Abilify due to financial reasons, I'd also get a return of depression and my motivation would go out the window. So I understand how that is.

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I have taken seroquel and Latuda which are both in the antipsychotic class with Abilify.  Seroquel caused almost immediate and severe involuntary arm and leg movement. I then switched to Latuda.  I was able to tolerate it for about a year before hand tremors and mild difficulty swallowing caused me to stop.  I still have a very mild tendency to choke on thin liquids such as water.  I'm obviously not someone who can tolerate long term antipsychotic meds.  Fortunately, my mood stabilizer/antidepressant cocktail is ok for now.  I agree with the other people that commented here about getting in to a doctor soon. Involuntary movements can become permanent and your doc needs to know about it.  

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I've honestly never heard of permanent tremors from Abilify. If that were the case, I'd think it would be all over sites like this (anti-psych sites excluded). Tremors are not T.D. so you don't have that to worry you. To be clear, I do know that tremors are a side effect of Abilify, but just not permanent tremors. I think you should talk to your pdoc about this and get his/her advice as to the permanence of the tremors. Also, lithium can cause tremors and it really caused me to have them.

Again, I will mention Rexulti and Vraylar as the best alternatives to Abilify because they have similar mechanisms of action (dopamine partial agonists).

Also, I'm moving this to the antipsychotics forum because it's about ... antipsychotics.

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4 hours ago, notloki said:

No one has mentioned Inderal (propranolol) which is the go to med for hand tremors. One dose in the morning and I m tremor free all day.

Propranolol does help the hand tremors (also the helping the headaches and anxiety), IME.

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  • 2 weeks later...

I suggest asking about Rexulti, if you can afford it. Abilify was the best AAP for mood stabilization I had tried, but it caused intolerable insomnia beyond 2mg for me, along with GI upset and akathesia. I switched to Rexulti, and the only SE is very slight akathesia (doesn't need medicating.) From what I've read, people who do well on Abilify tend to do as well on Rexulti, if not better.

But I am highly biased, Rexulti is the only AAP that works for me without major side effects, and it's absolutely wonderful. It's not FDA approved for bipolar, so no official dosing guidelines, but my pdoc was willing to work with me and we found the right dose.

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Hope you find a better doctor and/or a good solution soon.

I take Seroquel at night, and Abilify in the morning, so they're not mutually exclusive. Abilify is new to me (as of last week) and I'm not noticing any difference, good or bad. Will see what the doc says next week. 

Edited by pocketpanda
Added "not" to "not mutually exclusive."
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15 hours ago, pocketpanda said:

Hope you find a better doctor and/or a good solution soon.

I take Seroquel at night, and Abilify in the morning, so they're mutually exclusive. Abilify is new to me (as of last week) and I'm not noticing any difference, good or bad. Will see what the doc says next week. 

Abilify didn't work right away for me either.  Took me 7 weeks to finally feel the full effect of the med.

How long have you been on the Abilify?

I would give the abilify at least 4 weeks to see if you feel any different (unless there are life-threatening or severe side effects where you need to stop taking it).

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On 7/22/2016 at 5:52 AM, melissaw72 said:

Abilify didn't work right away for me either.  Took me 7 weeks to finally feel the full effect of the med.

How long have you been on the Abilify?

I would give the abilify at least 4 weeks to see if you feel any different (unless there are life-threatening or severe side effects where you need to stop taking it).

4 weeks? 7 weeks?! I don't have that much time left on my leave. :(  3 weeks of my leave were wasted fighting with insurance co on Rexulti earlier. Sigh.

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31 minutes ago, pocketpanda said:

4 weeks? 7 weeks?! I don't have that much time left on my leave. :(  3 weeks of my leave were wasted fighting with insurance co on Rexulti earlier. Sigh.

Yes, it can take up to that amount of time to feel the full effects of the med.  It did for me ... almost 7 weeks exactly.  The reason I could tell it was finally working was that I was experiencing less hallucinations and was less delusional.  I mean it didn't all go away, but got better than I had been.

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I get a temor hands) from abilify and I simply treat it with Inderal and it totally goes away Abilify is too effective to not use it if it only gives me one minor side effect. The tremors are not permanent. 

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