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Having to choose which med to rechallenge


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So, I tried to go antipsychotic free (still on 150 Lamictal and 1200 Lithium) and promptly started to go into a mixed state full of agitation and anxiety.  To put it shortly, after a week, I resumed my 10mg Zyprexa last night and am feeling a little better (still agitated but not as much).  The reason I tried to go AAP free is that I tend to not do well on the more stimulating AAP's and I gain a lot of weight on Zyprexa. I also suspect that it pushes me too far down and I feel dysphoric after being on it for a couple of weeks.  Seroquel has decided it wants nothing to do with me either as I've had several retrials of it over the past year and a half and get the same agitated response.

So I thought, why not rechallenge another AAP?  Abilify comes to mind.  I've tried it at 5mg and 10mg and was met with anxiety and insomnia.  My thought is that if I go even higher (15 maybe?), I'll have less of the agitation as it seems to be the case around here.  I've heard the same with Latuda.  I've only been up to 40mg of that and again, anxiety, but are higher doses more sedating?  Maybe lumateperone? Maybe go another route with Amoxapine?  Any feedback is appreciated.  TIA.

Edited to add: My mood is fine.  Maybe a little down as I feel jumpy and agitated (hopefully that dies down soon), but no depression.

Edited by Arj72
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4 hours ago, Arj72 said:

So, I tried to go antipsychotic free (still on 150 Lamictal and 1200 Lithium) and promptly started to go into a mixed state full of agitation and anxiety.  To put it shortly, after a week, I resumed my 10mg Zyprexa last night and am feeling a little better (still agitated but not as much).  The reason I tried to go AAP free is that I tend to not do well on the more stimulating AAP's and I gain a lot of weight on Zyprexa. I also suspect that it pushes me too far down and I feel dysphoric after being on it for a couple of weeks.  Seroquel has decided it wants nothing to do with me either as I've had several retrials of it over the past year and a half and get the same agitated response.

So I thought, why not rechallenge another AAP?  Abilify comes to mind.  I've tried it at 5mg and 10mg and was met with anxiety and insomnia.  My thought is that if I go even higher (15 maybe?), I'll have less of the agitation as it seems to be the case around here.  I've heard the same with Latuda.  I've only been up to 40mg of that and again, anxiety, but are higher doses more sedating?  Maybe lumateperone? Maybe go another route with Amoxapine?  Any feedback is appreciated.  TIA.

Edited to add: My mood is fine.  Maybe a little down as I feel jumpy and agitated (hopefully that dies down soon), but no depression.

I had mixed feelings about Latuda, but I definitely felt that the higher doses tended to be a bit more sedating. The issue is I once tried it for acute mixed mania it it was kind of unhelpful, although I took it at 120 mg for a mixed depression and it worked better. Ever tried risperdal or Vraylar? 

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1 minute ago, Iceberg said:

Ever tried risperdal or Vraylar? 

Unfortunately both did not work out.  Risperdal caused me to have feelings of impending doom and was overall just very uncomfortable.  Vraylar gave me intractable insomnia at all doses up to 4.5mg.

 

2 minutes ago, Iceberg said:

I had mixed feelings about Latuda, but I definitely felt that the higher doses tended to be a bit more sedating.

Did you have any issues with anxiety at the lower or higher doses?

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16 minutes ago, Arj72 said:

Unfortunately both did not work out.  Risperdal caused me to have feelings of impending doom and was overall just very uncomfortable.  Vraylar gave me intractable insomnia at all doses up to 4.5mg.

 

Did you have any issues with anxiety at the lower or higher doses?

Hard to tell just because my preexisting  level of anxiety symptoms was way different when I started it the first time vs the second time 

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Just an update.  Doc rx'ed 15mg Abilify and started it 3 nights ago.  Not sure if it's placebo but I definitely feel more tired and less squirrely than when I tried 5 and 10mg.

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On 5/5/2020 at 11:42 AM, Iceberg said:

Good luck!

Thank you!  6 pills in and just experiencing insomnia in the form of light sleep and wake ups, but otherwise doing okay.

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On 5/6/2020 at 5:37 PM, Arj72 said:

Thank you!  6 pills in and just experiencing insomnia in the form of light sleep and wake ups, but otherwise doing okay.

That is really common. I had to add Ativan to my usual PM meds for a while but I ended up getting off Ativan and back to usual (6 mg Lunesta + 1 mg Klonopin).

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