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Adding Latuda or Abilify for BP depression


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I'm thinking of asking my gdoc to rx an AAP to help my BP depression. I won't get to see a psychiatrist for a few months. My last pdoc wanted me to reduce or eliminate the ADs I take. I've reduced my Cymbalta from 120 to 60mg and Remeron from 15 to 7.5mg without any problems. I'm trying to move out of my parents place right now and really need some improvement. I keep reading positive stories about Latuda and Abilify in particular.

Does abilify only work if you take an AD? Does it work for BP dep or just unipolar? Is there a chance I could talk my GP into adding one of them, considering I can't see a psychiatrist for months? There are no legal issues preventing him from writing a script. Which would be preferable, theoretically? I know you can't recommend meds, so which did you prefer?

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Many people love Abilify & I've heard it works especially well when an A/D poops out. I don't really know anyone that takes it as monotherapy, but is used for both BP and Unipolar depression. Usually as an adjunct to boost an A/D. That being said, I don't know if it's doing much for me, may be helping a little bit. I tried to go up in dose, but it really increases my appetite too much (gives me the whole wake up in the middle of night to snack thing). It can also give some people akathisia (restless movement) so watch out for that.  I've never tried Latuda & there is also Rexulti (similar/newer than Abilify). I'd say it's definitely worth a try! it kicks in faster than A/Ds also, you should notice a difference pretty quickly, by 5mg.

Edited by Blahblah
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  • 2 weeks later...

@mcjimjam adding to what @Blahblah said, adding an antipsychotic can take effect pretty quickly, and if you need something to "pick you up" or rather be a bit more on the stimulating end, Abilify would be where it's at. However, start low and go slow. Many people say they have to get to 5mg or 10mg before they really notice a difference, but also keep in mind that Abilify has a long half-life so you may have to give a dose a good 2-3 weeks before you'll know for sure if it's for you. Another thing to consider is that because Abilify has such a long half-life, it can actually take a while for some of the side effects to show up. Especially the akathisia/restlessness. I've heard that for Abilify that one can build up slowly over time like it creeps up on you. Just keep an eye out for the restlessness because that can be permanent and generally doesn't go away over time.

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6 hours ago, browri said:

@mcjimjam adding to what @Blahblah said, adding an antipsychotic can take effect pretty quickly, and if you need something to "pick you up" or rather be a bit more on the stimulating end, Abilify would be where it's at. However, start low and go slow. Many people say they have to get to 5mg or 10mg before they really notice a difference, but also keep in mind that Abilify has a long half-life so you may have to give a dose a good 2-3 weeks before you'll know for sure if it's for you. Another thing to consider is that because Abilify has such a long half-life, it can actually take a while for some of the side effects to show up. Especially the akathisia/restlessness. I've heard that for Abilify that one can build up slowly over time like it creeps up on you. Just keep an eye out for the restlessness because that can be permanent and generally doesn't go away over time.

Is the akathisia dose-dependent or is it equally likely to occur at any dose? By permanent do you mean it may persist until Abilify is discontinued or even after that?

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From experience I can say that for me the akathisia was dose-dependent with Latuda. It got progressively worse as we increased and didn't completely go away when we decreased, which is why I stopped taking it ultimately. When I took Abilify I was already experiencing akathisia from Latuda and I wasn't on Abilify long enough to really tell. It is true that YMMV with these medications as some people can't tolerate 2mg of Abilify and some don't feel akathisia until they get to 10-15mg or more.

EDIT: If you want to try an antipsychotic that's light on side effects, you can try loxapine which is what I'm taking now. I arrived at it after Latuda, Saphris, Abilify, Zyprexa, and Fanapt. It's very tolerable and works as a great add-on to my Prozac for bipolar depression much the way Zyprexa does.

Edited by browri
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