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On 2 antipsychotics...for depression??


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Pretty much what the title says. My main diagnosis is MDD. Been on all sorts of meds and combos, etc. I have this problem with always being exhausted and one day I decided to stop taking my antidepressant (Pristiq) (with my dr's ok also). Ever since then, I've actually felt better (although still exhausted) depression wise. Not sure if it was from getting off of the Pristiq or starting EMDR therapy. But I'm still stuck with the Abilify 5mgs. Since I'm still having trouble sleeping, my doctor prescribed 100mgs of Seroquel for sleep. So now I'm on 2 antipsychotics, but have never had any psychotic symptoms. I just think that's really....off. For some reason, I think I'm extra sensitive to the Abilify, because every time I try to get off of it, I seem to get really bad mood swings and really bad irritability. 

Since I've been doing extra well lately I decided to try taking 4mgs of Abilify (2 2mgs) (also because I seem to be a glutton for punishment..errr). I'm already getting irritable and it's only been 3 days. :(  Anybody know what's up with that? There's no antidepressant for it to be added to, can it be used as an antidepressant alone? I'm just confused. 

I'm just tired of being on meds. They never seem to work and just come with tons of side effects. Getting off the Pristiq (and/or starting EMDR) has made me feel the best I've ever felt in all of the 19 years I've been on meds. 

So I was just wondering if there's any rational reason why I'm stuck on 2 antipsychotics. Heh. 

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Well, most if not all of the atypical antipsychotics have antidepressant properties and this is especially true of Abilify and Seroquel. The doses that you are taking of Abilify and Seroquel aren't really antipsychotic doses. In fact, Seroquel acts as an antipsychotic only at a much higher dose. It doesn't even act as a mood stabilizer at 100 mg. Mostly, 100 mg is a sleeping dose with maybe a little mood component. But it is largely for sleeping. Abilify at 5 mg is a good adjunct to antidepressants, but it is possible to act as an antidepressant on its own. That is why your mood changes when you decrease your dose.

There is not much to worry about in taking 2 antipsychotics at the doses you are taking. If you were taking, say, 30 mg of Abilify and 800 mg of Seroquel for depression then you might be able to say that you are overmedicated, but not at the doses you are taking.

Personally, antidepressants never did work much for me. I get a lot more from atypical antipsychotics and mood stabilizers than I do from antidepressants. The antidepressants that I'm taking now mainly help with anxiety and for that they do work fairly well. But they don't affect my depression very much at all.

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I concur with jt07, that low of a dose of seroquel is barely useful for helping with any kind of mood issues, it's pretty much for sleep. As far as Abilify goes, I will say I am one of the few who are extremely sensitive to it, and I get a lot of benefit out of 2mg. It kills almost all of my depression, but also causes insomnia and increases my anxiety. A low dose might help you.

Have you tried Cymbalta? My SO has MDD and has found it to be extremely effective over several other meds.

Antipsychotic meds are a broad umbrella of drugs that carry a negative connotation. Many of them are actually great for treating depression that SSRIs/SNRIs don't work for, not just psychosis. Don't let the classification scare you, it mostly has to do with the mechanism of action of the drug.

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Thanks you two! I wish my doctor would have told me that. Grr. 

I have been on Cymbalta in the past. Up to 120mgs. Like most meds, it worked for awhile, then just pooped out. 

It's been a little over a week with the decreased Abilify dose and it pretty much sucks. Totally irritable & cranky. I really hope that's just a withdrawal symptom and not just me. Heh. Because holy shit...it's like constant pms. :o 

I have no idea why I'm fighting this and I don't just go back on the full 5mgs. Sheesh. 

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You are reducing the med that has done you the most good. If I were you and my doctor prescribed 5 mg of Abilify and I were doing well on it, I'd take the full 5 mg. It is not a high dose at all. (I take 30 mg.) 

Try to remember that you are/were doing well because of meds. There is no cure for MI and you are likely to feel very bad again by getting off meds.

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  • 5 weeks later...

At one point I was on Fetzima (SNRI), Remeron ("Tetracyclic antidepressant" taken for insomnia caused by the Fetzima), and Latuda (at first as adjunct therapy with the Fetzima). I was doing pretty good, so I began to think 3 powerful drugs for depression was overkill, so I began (with my doctor's blessing) to wean off Latuda. However after 3 days at 20 mg I was feeling pretty bad, so I went back up to 40 mg and felt better. Then I began (again with my doctor's approval) to wean off of Fetzima. After I was off Fetzima I felt fine. Once I was off Fetzima I didn't need the Remeron so I stopped that too. Still felt fine. So it's the Latuda, an atypical anti-psychotic, alone that is treating my depression better than anything I had ever tried.

My current doctor and I had decided to try moving to Emsam (an MAOI), to try to treat my anxiety, but I've decided I don't ever want to risk going off Latuda (or dropping the dose below 30 mg which was the plan). Plus I just learned about Intuniv and I was reminded that anti-histamines can have an anxiolytic effect and I haven't tried either.

Life for my wife and I has been better in the last 3 months (I've been taking it about a year, but until 3 months ago my life was in constant turmoil and I'm just now settling down) than in the last 3 years. I'm not going to risk losing that.

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That's pretty interesting perfectfire. I've been on the full dose of Abilify for me (the 5mgs), but things still weren't really getting better. My dr decided to raise the Seroquel to 200mgs, but that caused some major insomnia for me. (Damn it body, what's wrong with you??) I tried going back down to 100mgs, but found that too sedating during the day. I'm not able to function at all during the days. He added Dexedrine (which I've been on before and has worked), but only once a day and that's not touching the sedation and dopiness. So I'm pretty much stuck again. :( 

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6 minutes ago, ImperfectJenny said:

That's pretty interesting perfectfire. I've been on the full dose of Abilify for me (the 5mgs), but things still weren't really getting better. My dr decided to raise the Seroquel to 200mgs, but that caused some major insomnia for me. (Damn it body, what's wrong with you??) I tried going back down to 100mgs, but found that too sedating during the day. I'm not able to function at all during the days. He added Dexedrine (which I've been on before and has worked), but only once a day and that's not touching the sedation and dopiness. So I'm pretty much stuck again. :( 

Hey I'm also on Dexedrine (15 mg twice a day). This is the third time I've been on it. I'm going to start weaning off of it when I get my next refill.

I actually tried Abilify before I tried Latuda. I can't for the life of me remember why I decided to stop taking it. There must have been a bad side effect. Anyway, there were Latuda ads all over the doctor's waiting room and I looked it up and it seemed better than all the other  atypical antipsychotics out there, so I said how about Latuda and the doctor said ok sure. And it turns out it works great and I can manage the side effects for the most part (I'll probably gain 40 pounds once I'm off the dextroamphetamine though).

I see you're on trazadone. Is it for the insomnia? I had been on trazadone a long time ago and felt it helped me sleep (once they increased the dose to 250 mg), but I think it also kept me very sleepy during the day. My mother and sister's experiences with Ambien scared me away from hypnotics, so to counteract the Fetzima I suggested Remeron from my research and it worked great. Solid sleep, no side effects. The only catch is I will feel sleepy for about 9 hours and start to feel sleepy at around 30 minutes. I have to take it right before I go to bed and I have to make sure that I get at least about 8 and a half hours of sleep. Any less and I'll was literally nodding off while driving to work (at the time a 45 minute drive at 75 - 80 mph most of the way).

If things aren't getting better with Abilify, have you tried other antipsychotics (other than Seroquel obviously)? My mother was on Risperdal during a really bad time for her. That's what inspired me to try an adjunct antipsychotic and I ended up with Latuda as monotherapy for MDD (doesn't help with anxiety though).

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I've made some fairly large jumps downward with my Abilify dose- like from 10 to 7.  I remember irritability being something I encountered but kept in check mentally so I would not act inappropriately.  It probably wasn't too intense though.   I found that the benefits of decreasing my dose outweighed the negative and the irritability went away on its own.  I do believe that the issue was med withdrawal rather than a mood disorder that I have inherintly.  YMMV

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I think that for some people Abilify makes you feel worse before you feel better. I didn't end up staying on it for very long (my insurance declined to cover it), but when I first started taking it made me feel much more insane that I'd felt without it. Very activated. Antsy.

And I don't get psychosis either, but I've been on 50-100 mgs of Seroquel for sleep for years...over a decade, come to think of it. 

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