adding Abilify or Lactimal to antidepressant

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

hawwa
New Member


Date Joined Sep 2013
Total Posts : 8
   Posted 10/2/2017 11:50 AM (GMT -6)   
I have short frequent episodes of depression (once to twice a month) and have been taking clomipramine (tricyclic antidepressant) which works only partially. I still get the episodes. I am thinking I should add a med to my antidepressant.

I have read that this could be called rapid cycling. I do not get hypomania very often, but I do get irritable and anxious. It is mostly depression that affects me.

Has anyone tried to do this with either Abilify or Lamictal?
What was your experience, and between the 2 meds which one would be best?

Tim Tam
Veteran Member


Date Joined May 2016
Total Posts : 1021
   Posted 10/2/2017 3:35 PM (GMT -6)   
hawwa:

In this same forum, Bipolar, "kellyincali" has two posts under her name about the subject title of Bipolar II.

This would be the same group you indicated you were in, Bipolar II, which, as with yourself, has only hypomania, but no full blown mania I have had without medication as a Bipolar I person.

She has really gone into depth on Bipolar II, which she thinks she has, so I think you could learn something from that.

You might also check the "depression" forum on this website since you said you get frequent episodes of depression. They may can address questions you have about antidepressants.

Also, drugs .com said,

"Abilify is an antipsychotic medicine used to treat the symptoms of schizophrenia and bipolar disorder"

and

"Lamictal is used either alone or in combination with other medications to treat epileptic seizures in adults and children. Lamotrigine is also used to delay mood episodes in adults with bipolar disorder (manic depression)."

That drugs.com website also for Lamictal had a section called "User Reviews" which in addition had a section about "compare": or something like that which may have compared that medicine with others.

Also on the same drugs.com website, for Abilify, to get to "user reviews," it listed at or near the top of the first page, some six topics such as "side effects," and then noted "More" as in more topics.

I clicked on that, and "user reviews" was one of the other topics.

I would look at that. It looked like it had a great deal of information.

I haven't used the medicines you mentioned. As a bipolar I person, I take Lithium for the mania and Mirtazapine for the depression.

You said, your current antidepressant "works only partially" noting,
"I have short frequent episodes of depression" and "It is mostly depression that affects me."

You stated, "I am thinking I should add a med to my antidepressant."

I wonder, should you add a med or take a new antidepressant instead of the one you are now taking?

How long have you been on the one you think is not working?

Are you seeing a psychiatrist?

theHTreturns...
Elite Member


Date Joined Mar 2009
Total Posts : 19780
   Posted 10/2/2017 6:02 PM (GMT -6)   
not the right meds for you i'd say. am on lamictal. been on abilify-it is an anti-psychotic. lexapro better fit, works on depression and anxiety.

kellyinCali
Regular Member


Date Joined Apr 2009
Total Posts : 284
   Posted 10/2/2017 9:03 PM (GMT -6)   
I think Lamictal (anti-seizure/mood stabilizer) is favored over 2nd generation anti-psychotics like Abilify as a first line of defense. I was one of the unfortunate few to get the "Lamictal rash." I hear many good things about Lamictal for Bipolar. I am now taking a med similar to Abilify named Latuda. For me, it reduces my need for benzos (diazepam) but also makes me extraordinarily tired and fatigued. Keep in mind that everybody's chemistry is different. Some people find AP's activating. Does you P-doc think you could have Bipolar?

theHTreturns...
Elite Member


Date Joined Mar 2009
Total Posts : 19780
   Posted 10/2/2017 11:31 PM (GMT -6)   
abilify is less of a stand alone medication. bar johnsons, rare, lamictal is good, but as a foundation, and works best with other meds in support of the main. usually an anti-dep. pristiq ect. yes we all wired differently, seek input from a psychiatrist, esp for dx and getting the best meds for you.

Anxious Scientist
Regular Member


Date Joined Mar 2017
Total Posts : 160
   Posted 10/3/2017 8:52 AM (GMT -6)   
I have had both lamictal and abilify.

Abilify was a nightmare. I experienced akathisia to the point where I couldn't even drive my car as I had zero control over the involuntary "kicks" I was having.

Lamictal I was on for awhile just to find out it was doing absolutely nothing for me.

The only thing that has seemed to control my bipolar really good is 1 tablet of the Lithium Carbonate ER.
Diagnosed With: Bipolar Disorder, Generalized Anxiety Disorder, Panic Disorder
Treatment: Lithium Carbonate ER (450 mg), Sertraline (100 mg)

hawwa
New Member


Date Joined Sep 2013
Total Posts : 8
   Posted 10/3/2017 9:34 AM (GMT -6)   
Thanks all, very much.
I have taken the antidepressant clomipramine for 25 years. Replacing this with another antidepressant is out of the question. My psychiatrist is suggesting that I add either abilify or lamictal.
Lithium would aggravate my psoriasis.

I am thinking now not to add anything, as all these meds sound unpleasant to take, with a lot of additional side effects (clomipramine already causes dry mouth, constipation, sedation, weight gain etc.).

I am afraid also they would cause me to be in a no man's land where I am neither depressed, nor not depressed, just blah.

Tim Tam
Veteran Member


Date Joined May 2016
Total Posts : 1021
   Posted 10/3/2017 6:45 PM (GMT -6)   
Your saying that you have been taking a tricyclic for 25 years, adds another dimension to your situation, for that's where I was until a few years ago.

For about 25 years, I too was taking a tricyclic (Sinequan), with your such med being “clomipramine” tricyclic antidepressant.

A few years ago, my psychiatrist said, "I want to change you to another anti-depressant." Well, I didn't really know if I wanted to change because I had been on Sinequan for a long time.

She said, "Tricyclics can cause or aggravate heart problems" giving me some reason to change, for I have high blood pressure and cholesterol, and had chest pain during a stressful time of my life.

(everydayhealth.com mentions heart problems in its review of tricyclic antidepressants when it says:

“Don't take a tricyclic antidepressant if you: •Recently had a heart attack” and cautions against if you are: “under age 25 or over age 65” or •”Have diabetes, heart problems, or a thyroid disorder”)

You may be reaching an age when this could affect you, whereas 25 years ago it did not. You’re probably going to have to switch off sooner or later.

Another reason for switching away from clomipramine is that you’re still depressed even while taking that med, for you say, “I have taken the antidepressant clomipramine for 25 years. Replacing this with another antidepressant is out of the question.”

And yet you say:

“I have short frequent episodes of depression” and “It is mostly depression that affects me.” And you say you take “clomipramine" which works only partially. I still get the episodes (of depression).”

So, it looks like your antidepressant is not working, but you vow to stick with it. It’s the same type med (tricyclic) I stuck with for about 25 years, sinequan. I didn’t want to give it up, either, but I did for I believed my psy. knew what she was doing. I’m now on Mirtazapine anti-dep.

(You don’t mention being on a mood stabilizer like lithium. But if you’re bipolar II, taking only an anti-dep. could throw you into hypo mania, so you need something treating the mania also.

(These are all my opinions as a bipolar. You need to consult with your doctor.)

So if you switched antidepressants, where would you go? Of course your psy. would be your “go to” person, but above one contributor above said, “Lexapro (used for major depression) better fit, works on depression and anxiety”

So what is another stabilizer, like Lithium? You, yourself, mentioned Abilify, which drugs.com said “ is an antipsychotic medicine used to treat the symptoms of schizophrenia and bipolar disorder"

Another contributor above said a possible stabilizer like Lithium is, “Lamictal”, saying "lamictal is good, but as a foundation, and works best with other meds in support of the main. usually an anti-dep. Pristiq. etc.”

(“Pristiq is used to treat major depressive disorder in adults being an anti-depressant, while Lamictal is used either alone or in combination with other medications to treat epileptic seizures in adults and children. Lamotrigine (Lamictal) is also used to delay mood episodes in adults with bipolar disorder (manic depression)."
drugs.com]

A third contributor above says, “I think Lamictal (anti-seizure/mood stabilizer) is favored over 2nd generation anti-psychotics like Abilify as a first line of defense. I was one of the unfortunate few to get the "Lamictal rash." I hear many good things about Lamictal for Bipolar. I am now taking a med similar to Abilify named Latuda. For me, it reduces my need for benzos (diazepam) (short term tranquilizers like Librium) but also makes me extraordinarily tired and fatigued. Keep in mind that everybody's chemistry is different. Some people find AP's (anti-psychotics) activating. Does you P-doc think you could have Bipolar?”

As for myself (Tim Tam), I take Mirtazapine anti-depressant, and Lithium for the stabilizer to control the mania, but you said you couldn’t take Lithium. I’ve taken an anti-psychotic, with no other meds, and it did not agree with me.

You noted, “I am afraid also they would cause me to be in a no man's land where I am neither depressed, nor not depressed, just blah.”

That what the anti-psychotic that I took by itself (stelazine) did for me, left me with no emotions. When I was switched away from the anti-psychotics for my stabilizer (Litihium) and Mirtazapine for my anti-depressant, I did very well.

Have you been diagnosed as bipolar II? Do you see a psychiatrist?

hawwa
New Member


Date Joined Sep 2013
Total Posts : 8
   Posted 10/4/2017 6:35 AM (GMT -6)   
Thanks TimTam, how did you discontinue sinequan? Did you decrease the dosage very slowly, waited for the drug to be flushed of your system, then started mirtazapine? It is a slow drawn out process, and I am terrified that if I do this I will relapse into severe depression. Which is what happened every time I tried to come off anafranil.

Anxious Scientist
Regular Member


Date Joined Mar 2017
Total Posts : 160
   Posted 10/4/2017 8:23 AM (GMT -6)   
hawwa said...
Thanks all, very much.
I have taken the antidepressant clomipramine for 25 years. Replacing this with another antidepressant is out of the question. My psychiatrist is suggesting that I add either abilify or lamictal.
Lithium would aggravate my psoriasis.

I am thinking now not to add anything, as all these meds sound unpleasant to take, with a lot of additional side effects (clomipramine already causes dry mouth, constipation, sedation, weight gain etc.).

I am afraid also they would cause me to be in a no man's land where I am neither depressed, nor not depressed, just blah.


Hawwa,

I'm very sorry! This makes the "medication game" a whole lot more complex when you have other indications confounding the issue (i.e. No lithium due to the psoriasis). I had a very good discussion with my doctor this past year. There is controversy about prescribing SSRIs to bipolars as it could produce more mania. After my own medication reshuffle, we found that even with my diagnosis of bipolar, I needed the SSRI. My doctor was fine with putting me on the SSRI since my bipolar was already controlled with the lithium.

Unfortunately, we bipolars need to make a choice. We have an array of medications available to us, but unfortunately most of those medications can cause very unwanted side-effects. I've found, you really have to pick and choose your side-effect battle. What can you handle? What can you absolutely not handle? For me, I told my doc that I absolutely wanted to stay away from medications that caused weight gain. My doc was able to sit down with me, go through her medication book and compare medications to find the correct one for me. It ended up being Zoloft for me, which has not given me the weight issues.

SSRIs aside, the actual medications for bipolar, wow. The side effects are pretty crazy for most of them. Lithium has not caused me any side effects, but I quickly found out that 2 tablets is absolutely toxic for me.

Talk to your doctor. Tell them what you absolutely do not want to deal with. Tell them what you're afraid of. Communicate your uneasiness.

I will swear up and down against Abilify. I can't say how your body chemistry will be. You may react completely different to it than I did. As far as Lamictal goes, I did not experience any side effects with that either. The side effect you want to be cautious for is the rash. If you get the Lamictal rash, that's an immediate cause to communicate with your doctor right away.

All you can do is try one or the other and see how it works. If it bothers you too much, tell the doc, and continue on with trying out different medications.

I have learned to accept with having bipolar, that I'm probably going to have to play the medication game for the rest of my life at different points. It seems every 5 years that a medication fails and warrants a new one. Try not to be so afraid, but be hopeful. Be hopeful that adding something new could potentially be the answer to making you feel better. Many blessings!

hawwa
New Member


Date Joined Sep 2013
Total Posts : 8
   Posted 10/4/2017 12:31 PM (GMT -6)   
Thanks anxious scientist for your encouragement!

Tim Tam
Veteran Member


Date Joined May 2016
Total Posts : 1021
   Posted 10/4/2017 2:53 PM (GMT -6)   
You said: “how did you discontinue sinequan? Did you decrease the dosage very slowly, waited for the drug to be flushed of your system, then started mirtazapine? It is a slow drawn out process, and I am terrified that if I do this I will relapse into severe depression. Which is what happened every time I tried to come off anafranil (clomipramine).”

My psychiatrist said to stop taking the sinequan antidepressant that night, and to start taking the new or Mirtazapine antidepressant.

There was no gap in-between.

You said, “My psychiatrist is suggesting that I add either abilify or lamictal." (as a stabilizer, like Lithium)

"Lithium would aggravate my psoriasis.”

1. To your question if anyone had tried either of those two, one respondent above said,

“Ambilify (an anti-psychotic) Abilify was a nightmare. I experienced akathisia to the point where I couldn't even drive my car as I had zero control over the involuntary "kicks" I was having.”

(As for the definition of a “akathisia” above, net says, “is a movement disorder characterized by a feeling of inner restlessness and a compelling need to be in constant motion, as well as by actions such as rocking while standing or sitting, lifting the feet as if marching on the spot, and crossing and uncrossing the legs while sitting. People with akathisia are unable to sit or keep still, are prone to feelings of restlessness, and they may also fidget, rock from foot to foot, and pace.”

(I, Tim Tam, had this when I took an anti-psychotic, stelizene, many years ago. I guess it was called a “lst generation antipsychotic,” and they’ve supposedly improved since then. Ask your doctor.)

(However, even today net says about possible side effects of abilify:

Get emergency medical help if you have signs of an allergic reaction to Abilify: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• severe agitation, distress, or restless feeling;
• twitching or uncontrollable movements of your eyes, lips, tongue, face, arms, or legs;
• mask-like appearance of the face, trouble swallowing, problems with speech;
• seizure (convulsions);

1st respondent above added: “Lamictal I was on for awhile just to find out it was doing absolutely nothing for me.” (Then he went to Lithium which worked, but you said you couldn’t take.)

2. 2nd above respondent to your question said, “lamictal is good, but as a foundation, and works best with other meds in support of the main. usually an anti-dep. pristiq etc.”

(He also noted: “Lexapro (antidepressant) better fit, works on depression and anxiety”

3. 3rd respondent above said: “I think Lamictal (anti-seizure/mood stabilizer) is favored over 2nd generation anti-psychotics like Abilify as a first line of defense. I was one of the unfortunate few to get the "Lamictal rash." I hear many good things about Lamictal for Bipolar.”

hawwa
New Member


Date Joined Sep 2013
Total Posts : 8
   Posted 10/6/2017 8:18 AM (GMT -6)   
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4919171/

According to this article, Tim tam, switching from clomipramine to mirtazapine requires to taper clomipramine before starting mirtazapine. To properly taper off clomipramine takes a few weeks.
I am afraid of the terrible discontinuation symptoms from clomipramine, which I have experienced in the past.

Tim Tam
Veteran Member


Date Joined May 2016
Total Posts : 1021
   Posted 10/6/2017 1:40 PM (GMT -6)   
I went to that website and it said:

"Withdrawing antidepressants

"If used for longer than six weeks, all antidepressants have the potential to cause withdrawal syndromes if they are stopped or rapidly reduced (with the possible exception of agomelatine). As a result many patients believe that antidepressants are addictive. This is not the case as abusive and compulsive use, tolerance and drug seeking do not occur with antidepressant drugs. Withdrawal syndromes occur with many drugs (such as corticosteroids) when used long term.

"The usual recommended period for antidepressant dose reduction is a minimum of four weeks.2 However, abrupt cessation may at times be unavoidable on clinical grounds. The time frame for dose reduction also depends on individual risk for withdrawal symptoms, patient preference and experience during withdrawal, and drug characteristics such as half-life (Table 1)."

You're right, it did say, "The usual recommended period for antidepressant dose reduction is a minimum of four weeks"

However, what it didn't say was, if you go off of your initial anti-depressant one night, and immediately that same night, you start another anti-depressant, are you going to have withdrawal symptoms from going off the first med?

I didn't. I wouldn't go by my memory, though.

I would ask my doctor about that.

It could also be asked of the net, "withdrawal symptoms when starting a new anti-depressant?"

You might have to reword that 2 or 3 different times to get an answer.

Tim Tam
Veteran Member


Date Joined May 2016
Total Posts : 1021
   Posted 10/6/2017 1:47 PM (GMT -6)   
On search engine, I typed in:

>withdrawal if starting new antidepressant<

several websites came up, one was mayoclinic. org which said:

"Having antidepressant withdrawal symptoms doesn't mean you're addicted to an antidepressant. Addiction represents harmful, long-term chemical changes in the brain. It's characterized by intense cravings, the inability to control your use of a substance and negative consequences from that substance use. Antidepressants don't cause these issues.

"To minimize the risk of antidepressant withdrawal, talk with your doctor before you stop taking an antidepressant. Your doctor may recommend that you gradually reduce the dose of your antidepressant for several weeks or more to allow your body to adapt to the absence of the medication.

"In some cases, your doctor may prescribe another antidepressant or another type of medication on a short-term basis to help ease symptoms as your body adjusts. If you're switching from one type of antidepressant to another, your doctor may have you start taking the new one before you completely stop taking the original medication."
New Topic Post Reply Printable Version
Forum Information
Currently it is Friday, October 20, 2017 8:28 AM (GMT -6)
There are a total of 2,884,680 posts in 316,513 threads.
View Active Threads


Who's Online
This forum has 157631 registered members. Please welcome our newest member, KSara.
379 Guest(s), 8 Registered Member(s) are currently online.  Details
Jayhawk85, Saipan Paradise, lovefishing, DJKWUK, RayB, TC3120, straydog, Lanie G


Follow HealingWell.com on Facebook  Follow HealingWell.com on Twitter  Follow HealingWell.com on Pinterest
Advertisement
Advertisement

©1996-2017 HealingWell.com LLC  All rights reserved.

Advertise | Privacy Policy & Disclaimer