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Am I still depressed on Abilify?


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I have Bipolar II, and I have been navigating this condition ever since my teens, with it only getting worse as I aged.

I didn't start taking medications until about three years ago and even then I wasn't on bipolar medications until about two years ago (when we finally realized that I had Bipolar disorder). Once we discovered that I had bipolar disorder, my psychiatrist and I decided to try putting me on Antipsychotics. The first one I got put on made me unreasonably angry at everything and the next few were not covered by insurance. Eventually I got put on Abilify and for a long time I thought it was working out great for me! Now I'm not so sure.

I noticed that, whenever I have no obligations such as school or work, I usually just stay in bed and don't come out from under the covers unless I need to eat or use the bathroom. I'd assume this might be a seasonal thing, but this even happened during the summer school break as well! It's miserable when I have nothing to do, and I can't help but feel as though maybe it's not the medication's fault. Maybe it's my fault. I have the energy to get up, as can be proven by my ability to get up early for school. So, if that's the case, why can't I motivate myself to get out of bed?

I don't think my medication is making me tired, don't get me wrong. In fact, this medication gives me energy that I didn't previously have. But with that being said, I can't help but wonder if the Abilify just isn't working as completely as a mood-stabilizer is supposed to act? By the way, I am taking it alone and without an Antidepressant, so maybe that might be part of the problem. Hmm...

I'm seeing my psychiatrist on Thursday morning to talk more about this and (fingers crossed) I might get switched onto a different medication.

But I wanted to know, is it a sign of depression if, even after taking this medication, I still can't motivate myself to get out of bed in the mornings? Or even motivate myself to do anything else like pick up extra shifts at work or go out to see friends?

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For me personally, Abilify became sedating when I hit 7.5 mg. However, my motivation is still better on it than when depressed, but probably lower than many people's. I don't know if it's the medication or underlying depression affecting you this way, but there are lots of options for things you could add on.

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4 hours ago, dancesintherain said:

Lack of motivation/lack of interest in things can be a sign of depression. It doesn’t necessarily mean you would have to ditch the abilify.  If it’s working, save this one problem, i would probably look at adding something on.

I'll be discussing this with my doctor, but those aren't the only problems I've been experiencing with my Abilify. The amount of problems I've been experiencing with it have been minimal but troublesome all the same. I want to try something else and possibly go back to Abilify in the future, if need be. But you're right, perhaps I need something added onto a mood-stabilizer instead of just taking a mood-stabilizing drug alone. But gosh I am so afraid of what any change to my medication regimen is going to do. Thank God I'm making this adjustment at the end of the semester where I don't need to worry about it affecting my grades.

3 hours ago, Juniper29 said:

For me personally, Abilify became sedating when I hit 7.5 mg. However, my motivation is still better on it than when depressed, but probably lower than many people's. I don't know if it's the medication or underlying depression affecting you this way, but there are lots of options for things you could add on.

You're right, there probably are a lot of things I could add onto it. I'll see with my psychiatrist if I need to change my Abilify (because this isn't all the troubles I've been experiencing with Abilify) and if we change it or even just keep me on it, I think I'll see about adding something on, just because I think it may help.

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I will second @mikl_pls suggestion for lamictal. I was on lamictal and abilify for quite a while before I went completely over the edge. I think they (at least IME) complimented each other well. Lamictal is known for helping BP depression. I'd inquire about lamictal if you want to at your pdoc appointment. Lamictal is a mood stabilizer.

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10 hours ago, mikl_pls said:

Have you ever taken Lamictal?

 

1 hour ago, Wonderful.Cheese said:

I will second @mikl_pls suggestion for lamictal. I was on lamictal and abilify for quite a while before I went completely over the edge. I think they (at least IME) complimented each other well. Lamictal is known for helping BP depression. I'd inquire about lamictal if you want to at your pdoc appointment. Lamictal is a mood stabilizer.

In answer to your questions, no I have never been on Lamictal. And quite frankly, I'm afraid to be on it at all. I hear you can get a deadly rash from it and I'm just scared, haha...

No but if my psychiatrist can assure me that it will be safe, then maybe I will go on it. We'll have to see.

Edited by Bimbo Bear
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45 minutes ago, Bimbo Bear said:

 

In answer to your questions, no I have never been on Lamictal. And quite frankly, I'm afraid to be on it at all. I hear you can get a deadly rash from it and I'm just scared, haha...

No but if my psychiatrist can assure me that it will be safe, then maybe I will go on it. We'll have to see.

Your chances of getting the rash are pretty minimal, and it is minimized by following the slow titration schedule. But should you get the rash, you would certainly know, and you would need to call your pdoc immediately, and you would need to stop the Lamictal immediately. But do know that Lamictal and other anticonvulsants are known for causing rashes in general, not necessary the SJS rash.

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2 hours ago, mikl_pls said:

Your chances of getting the rash are pretty minimal, and it is minimized by following the slow titration schedule. But should you get the rash, you would certainly know, and you would need to call your pdoc immediately, and you would need to stop the Lamictal immediately. But do know that Lamictal and other anticonvulsants are known for causing rashes in general, not necessary the SJS rash.

Still pretty scary in my opinion, especially since my psychiatrist will be gone from the 19th until January 1st. But even still, if she says it would be okay then I could certainly try it. I just hope that, whatever she ends up putting me on, that it doesn't end up making me fatigued again.

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18 minutes ago, Bimbo Bear said:

Still pretty scary in my opinion, especially since my psychiatrist will be gone from the 19th until January 1st. But even still, if she says it would be okay then I could certainly try it. I just hope that, whatever she ends up putting me on, that it doesn't end up making me fatigued again.

Lamictal is usually pretty stimulating at first, sometimes a bit too stimulating. But it usually levels out when you get to the target dose.

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Well, I went to see my psychiatrist today and we went over my concerns with my medications. I informed her about the lack of motivation and other side effects that I was experiencing and she decided to just up my dosage of Abilify to see if that would help. She also prescribed me the generic version of Vistaril to help me sleep at night since insomnia was one of my problems as well.

Guess I'll just have to see if maybe I was overreacting or not. I see her again in January the day before school starts. Hope that everything evens out or something because I'm tired of seeing her multiple times for the same issues. This was my second time seeing her within the span of less than a month.

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Abilify tends to work within a narrow dose range. The way to find that range is start slow and go up slowly, giving the med time to become stable before raising it. For Abilify this is about 2 weeks. A month is a reasonable amount of time to expect changes, when I am trying out meds it is always "come back in a month". We wish psycomeds worked faster but for a large number of them they take time.

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5 hours ago, Bimbo Bear said:

Well, I went to see my psychiatrist today and we went over my concerns with my medications. I informed her about the lack of motivation and other side effects that I was experiencing and she decided to just up my dosage of Abilify to see if that would help. She also prescribed me the generic version of Vistaril to help me sleep at night since insomnia was one of my problems as well.

Guess I'll just have to see if maybe I was overreacting or not. I see her again in January the day before school starts. Hope that everything evens out or something because I'm tired of seeing her multiple times for the same issues. This was my second time seeing her within the span of less than a month.

Agree with above. Abilify is slow among aaps so the best way to avoid side effects really is wait several weeks to a month. I learned this the hard way as a pdoc was jacking up the Dose fast to keep me out of hospital....ended up maxed out with no improvement but lots of horrible side effects. It really does suck to spend multiple visits on one issue but i feel like unfortunately that as the nature of the beast. There were times when things were so complicated I had to go to the pdoc every week just to nail things down (that's extreme but just making a point). All I'm saying is don't base progress just on whether an issue is gone, because the spectrum of symptoms is way more complicated than that 

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On 12/13/2018 at 4:35 PM, notloki said:

Abilify tends to work within a narrow dose range. The way to find that range is start slow and go up slowly, giving the med time to become stable before raising it. For Abilify this is about 2 weeks. A month is a reasonable amount of time to expect changes, when I am trying out meds it is always "come back in a month". We wish psycomeds worked faster but for a large number of them they take time.

That's good to know. But the reason I had to go to her was because when I asked for a medication change, she decided to decrease my dosage for some dumb reason and it just made some of my adverse side effects come back. So she had me come back in just to tell me that we were going to put me back on my original dose of 10 mg. I'm just really frustrated at the moment, that's all.

20 hours ago, Iceberg said:

Agree with above. Abilify is slow among aaps so the best way to avoid side effects really is wait several weeks to a month. I learned this the hard way as a pdoc was jacking up the Dose fast to keep me out of hospital....ended up maxed out with no improvement but lots of horrible side effects. It really does suck to spend multiple visits on one issue but i feel like unfortunately that as the nature of the beast. There were times when things were so complicated I had to go to the pdoc every week just to nail things down (that's extreme but just making a point). All I'm saying is don't base progress just on whether an issue is gone, because the spectrum of symptoms is way more complicated than that 

I guess you might be right about that. I just hope that this particular symptom goes away at some point with the help of medication or some kind of intervention because I feel miserable having no motivation to do anything and just staying in bed all of the time. It makes me wonder what I'm even alive for since I'm not doing anything with my life, aside from going to school and working.

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  • 2 weeks later...
On 12/14/2018 at 8:02 PM, Bimbo Bear said:

That's good to know. But the reason I had to go to her was because when I asked for a medication change, she decided to decrease my dosage for some dumb reason and it just made some of my adverse side effects come back. So she had me come back in just to tell me that we were going to put me back on my original dose of 10 mg. I'm just really frustrated at the moment, that's all.

I guess you might be right about that. I just hope that this particular symptom goes away at some point with the help of medication or some kind of intervention because I feel miserable having no motivation to do anything and just staying in bed all of the time. It makes me wonder what I'm even alive for since I'm not doing anything with my life, aside from going to school and working.

How has the increase in Abilify been working for you?

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2 hours ago, browri said:

How has the increase in Abilify been working for you?

It's been working alright I guess, except that I still don't feel any drive to do any hobbies. At first I felt like it was my fault, but no matter how much I try to engage in activities that once made me feel joy, it doesn't do much of anything. So I think maybe it's still the depression.

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Well two things that I will note. Firstly, hydroxyzine (generic name for Vistaril and Atarax) can be depressing for people. What a lot of people don't realize is that the body metabolizes hydroxyzine into cetirizine (Zyrtec). Both hydroxyzine and cetirizine have been shown to have depressant effects in some people.

Secondly, you might need an antidepressant and that could make all the world of difference. Because you're already taking Abilify, low dose antidepressants could go a long way. If you're having issues with anhedonia (inability to feel pleasure or show interest in activities that were once enjoyable), bupropion (Wellbutrin) probably makes the most sense. It will give a boost of energy that may help you get out of bed, and it has been shown to improve anhedonic symptoms where serotonergic antidepressants like paroxetine, sertraline, citalopram/escitalopram are less effective.

Another thing worth trying is augmenting the aripiprazole with lamotrigine (Lamictal). Your pdoc may be more receptive to this suggestion because lamotrigine is a mood stabilizer but it's stronger against the depressive side of things. It's usually stimulating in the beginning and calms down in the higher doses but may give you some oomph as well.

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if the issues are from apathy I'd consider Wellbutrin as said above but if you think they're from. Anxiety than that's a risky call....and from what u said it sounds like ur doc is somewhat conservative. The lamictal rash seems to get exaggerated as far as it prevalence and while it is a big deal every med has some super scary effects so idk that you should rule it out..... However o would wait on the effect of the abilify at the new dose first cuz why add it if you end up not needing it 

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