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I know many people here have taken Abilify longterm as an adjunct, but I am honestly worried about longterm side effects (weight gain, akasthia). I trialed it twice and it made me constantly hungry, wanting to eat everything (I tried both 2mg, 5mg), made me tap my feet a lot.

I wonder if taking it only on the week that I am very symptomatic (week before menstruation) it would be effective? Is Abilify something that kicks in within a few days of taking it? My other thought was biting the bullet and using Risperdone for this week (which I really hated when I was on it daily, it made me a zombie, and my Prolactin shot through the roof)

The symptoms I want to treat (happen @ 4-7 days per month) are: dysphoria, hypersensitivity, severe depression, anger, uncontrollable crying to exhaustion, suicidal ideations, ruminations, stress and some heart palpitations.

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6 minutes ago, Blahblah said:

 I wonder if taking it only on the week that I am very symptomatic (week before menstruation) it would be effective? Is Abilify something that kicks in within a few days of taking it? My other thought was biting the bullet and using Risperdone for this week (which I really hated when I was on it daily, it made me a zombie, and my Prolactin shot through the roof)

In general, Abilify takes at least a couple of weeks to see improvement, although there are some people that may respond sooner.........Risperdone also takes about 2-3 weeks to see improvement,  sometimes 4-6 weeks.

As for using the risperdone for only a week at a time (when your symptoms are worst), I would suggest asking your pdoc about it.

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1 hour ago, Blahblah said:

I know many people here have taken Abilify longterm as an adjunct, but I am honestly worried about longterm side effects (weight gain, akasthia). I trialed it twice and it made me constantly hungry, wanting to eat everything (I tried both 2mg, 5mg), made me tap my feet a lot.

I wonder if taking it only on the week that I am very symptomatic (week before menstruation) it would be effective? Is Abilify something that kicks in within a few days of taking it? My other thought was biting the bullet and using Risperdone for this week (which I really hated when I was on it daily, it made me a zombie, and my Prolactin shot through the roof)

The symptoms I want to treat (happen @ 4-7 days per month) are: dysphoria, hypersensitivity, severe depression, anger, uncontrollable crying to exhaustion, suicidal ideations, ruminations, stress and some heart palpitations.

I take zyprexa PRN. I don’t know if you’d like that option. But it works well for me. 

They make a med specifically for the week before menstruation. It is called sarafem aka Prozac but you just take it like a bit before you get your period. Just an idea. That way you wouldn’t need to take the Prozac year round. Just on a week or so before your period. 

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2 hours ago, CrazyRedhead said:

In general, Abilify takes at least a couple of weeks to see improvement, although there are some people that may respond sooner.........Risperdone also takes about 2-3 weeks to see improvement,  sometimes 4-6 weeks.

As for using the risperdone for only a week at a time (when your symptoms are worst), I would suggest asking your pdoc about it.

Ah shoot. That is much longer to kick in than I thought. My pdoc from like 15 years ago told me I should have Risperdol on hand for emergency crisis, but I haven't had any recent pdocs recommend that. Do you know if this is the case with Seroquel also (taking weeks to work?)

 

51 minutes ago, Wonderful.Cheese said:

I take zyprexa PRN. I don’t know if you’d like that option. But it works well for me. 

They make a med specifically for the week before menstruation. It is called sarafem aka Prozac but you just take it like a bit before you get your period. Just an idea. That way you wouldn’t need to take the Prozac year round. Just on a week or so before your period. 

Thanks Cheese. I'll keep this in mind. I had my first pdoc from 20 years ago prescribe it daily for psychotic type symptoms, and I could not tolerate it longterm, but would consider taking it if it was only for 5 days or so (although I'd be concerned about a withdrawal effect). It really knocked me out and made me eat all night like a starving person!!! But I cannot remember the dosage I was on.

Sarafam / Prozac I have tried and it didn't work...so seems I may need to go the A/P route or maybe Tegretol or Depakote? I've just been put on Progestrone as a trial and have been given Xanax, but I hate taking benzos as i habituate very quickly to them

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3 hours ago, Blahblah said:

Ah shoot. That is much longer to kick in than I thought. My pdoc from like 15 years ago told me I should have Risperdol on hand for emergency crisis, but I haven't had any recent pdocs recommend that. Do you know if this is the case with Seroquel also (taking weeks to work?) 

I've tried Seroquel as well, so I can tell you what my experience was like.

If you're taking low-dose Seroquel as a sleep aid or as an anxiety PRN, the sedating effects kick in almost immediately (that was my experience when I tried it for sleep).

In general, however, if you're taking Seroquel to stabilize mood, it could take a few weeks to notice improvement....YMMV though.

What does your pdoc say about trying AAPs?

Edited by CrazyRedhead
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Abilify is a very poor med to take as a PRN because, like an antidepressant, it takes a while to kick in. For example, it took 8 weeks to kick in for me and it was only when I hit 10 mg that it began to start working. I think it works faster for psychosis but I could be wrong about that. It certainly does not work as fast as Risperdal.

Risperdal is more likely to work as a PRN, but I have to say that for me the effects were real but subtle. It's not going to make a night and day difference, I don't think. It did give me the ability to make long term plans and to act on them which not even Abilify is doing at the moment.

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15 hours ago, CrazyRedhead said:

I've tried Seroquel as well, so I can tell you what my experience was like.

If you're taking low-dose Seroquel as a sleep aid or as an anxiety PRN, the sedating effects kick in almost immediately (that was my experience when I tried it for sleep).

In general, however, if you're taking Seroquel to stabilize mood, it could take a few weeks to notice improvement....YMMV though.

What does your pdoc say about trying AAPs?

My pdoc is thinking of Abilify (Daily, not as PRN) but I've already tried Abilify.. twice. I'm just feeling quite resistant, hopeless, like nothing is working for my pattern and symptoms. I must have a major personality defect, because my brain isn't responding ideally to anything I throw at it. I end up trialing the same med like 2-3 times hoping for different results. Second-guessing.

She says that Abilify has been most helpful for people with my symptoms. So I guess I'm just stuck with eating everything in the house and jiggling my legs restlessly. ? Rexulti is too expensive.

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14 hours ago, jt07 said:

Abilify is a very poor med to take as a PRN because, like an antidepressant, it takes a while to kick in. For example, it took 8 weeks to kick in for me and it was only when I hit 10 mg that it began to start working. I think it works faster for psychosis but I could be wrong about that. It certainly does not work as fast as Risperdal.

Risperdal is more likely to work as a PRN, but I have to say that for me the effects were real but subtle. It's not going to make a night and day difference, I don't think. It did give me the ability to make long term plans and to act on them which not even Abilify is doing at the moment.

@jt07 You've been on your regimen a long time. What are your thoughts about just Lamotrigine + Abilify + Ritalin? I've heard Abilify really only works best with an antidepressant (for someone treating depression symptoms, NOT psychosis/mania).

A/Ds don't really do much for my daily lows and constant ruminations -  they only helped me in longer term Major episodes. My pattern is very atypical - like I've mentioned, with ultra-rapid intense dysphoric / mixed cycles. The worst of it lasts a couple hours to a few days, but my day-to-day baseline is just moderate depression and anhedonia which no meds seem to touch. In fact, taking meds daily, often make my moderate depression & anhedonia much worse.

Maybe if the Abilify does not work I guess I would try Effexor again which I tolerated, but that helped more with anxiety, not so much depression. A/Ds make me feel numb, but I guess I must choose ?

 

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3 hours ago, Blahblah said:

 She says that Abilify has been most helpful for people with my symptoms. So I guess I'm just stuck with eating everything in the house and jiggling my legs restlessly. ? Rexulti is too expensive.

Have you told pdoc that Abilify causes these unwanted symptoms for you?.....

You should tell her you're not comfortable with it and why.....You do have a say in your treatment.

Edited by CrazyRedhead
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4 hours ago, Blahblah said:

@jt07 You've been on your regimen a long time. What are your thoughts about just Lamotrigine + Abilify + Ritalin? I've heard Abilify really only works best with an antidepressant (for someone treating depression symptoms, NOT psychosis/mania).

A/Ds don't really do much for my daily lows and constant ruminations -  they only helped me in longer term Major episodes. My pattern is very atypical - like I've mentioned, with ultra-rapid intense dysphoric / mixed cycles. The worst of it lasts a couple hours to a few days, but my day-to-day baseline is just moderate depression and anhedonia which no meds seem to touch. In fact, taking meds daily, often make my moderate depression & anhedonia much worse.

Maybe if the Abilify does not work I guess I would try Effexor again which I tolerated, but that helped more with anxiety, not so much depression. A/Ds make me feel numb, but I guess I must choose ?

 

Yes, my cocktail has been good to me. As for Abilify + Lamotrigine + Ritalin, I think you really should take the Abilify with an antidepressant as recommended. You might get some antidepressant effect from Abilify alone, but it's going to be much better with an AD on board even if that AD doesn't do much on its own.

About the side effects of Abilify ... the overeating/appetite increase side effect went away for me and akathesia (legs moving) is treatable so that you can still remain on the med. But CRH is right, you should discuss this all with your doctor.

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3 hours ago, CrazyRedhead said:

Have you told pdoc that Abilify causes these unwanted symptoms for you?.....

You should tell her you're not comfortable with it and why.....You do have a say in your treatment.

Yep....but I guess I'm willing to endure them I guess, because I don't have any new viable options at this point that won't cause bad side effects. Other A/Ps had waaaaay worse side effects and sedation and i cannot afford Rexulti...I've tried every A/D, my doc doesn't recommend Tricyclics (she says side effects are much worse with sedation, weight gain) or MAOI's (maybe because of risks/monitoring and diet reasons)

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2 hours ago, Blahblah said:

Yep....but I guess I'm willing to endure them I guess, because I don't have any new viable options at this point that won't cause bad side effects. Other A/Ps had waaaaay worse side effects and sedation and i cannot afford Rexulti...I've tried every A/D, my doc doesn't recommend Tricyclics (she says side effects are much worse with sedation, weight gain) or MAOI's (maybe because of risks/monitoring and diet reasons)

Just to be clear: your looking for a med to take round the clock for one week or to take PRN when things start going south? If it’s the second one I agree low dose seroquel can be calming quickly. Sedation can suck though. For what it’s worth I do know of people who take risperdal PRN for dysphoria type stuff 

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On 4/10/2019 at 7:35 PM, Iceberg said:

Just to be clear: your looking for a med to take round the clock for one week or to take PRN when things start going south? If it’s the second one I agree low dose seroquel can be calming quickly. Sedation can suck though. For what it’s worth I do know of people who take risperdal PRN for dysphoria type stuff 

I really prefer not to add on more meds to take around the clock.

My preference was a PRN for 1 week per month, but sounds like my pdocs suggestion of Abilify does not work really as a PRN. So Iceberg, yeah I guess Seroquel or Risperdal would be the other 2 viable options.

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