the EPS stuff, twitching and all, sometimes subsides as the brain and body adjust a bit. the anhedonia...-eek- . antipsychotic induced misery (the underused clinical term is 'neuroleptic induced dysphoria,' apparently)...that's rough stuff. im prone to it, myself. i do OK with abilify, unless the dose gets too high (or an add on med bumps blood levels...same difference, really), and then its..odd. no eps, usually...no akathisia...but veggie time, all the time. its worth noting...

when Thorazine first hit psych wards, they combined relatively low doses of it with other drugs (not sure which ones...I'm guessing that barbiturates were involved?) to put the patients into 'artificial hibernation.' old psych text books are ridiculously blunt about what these drugs do...apathy, indifference, loss of interest in surroundings and any hallucinations, etc....

but, hey; some people do better on a reasonably dosed tranquilizer than on anything else, or nothing at all. blah. im one of them, so I "feel your pain," but...not really, because I'm not smarmy enough to say that and actually mean it.

relatively recent research, according to my current psych, shows that about 60% of the D2 receptors need to be blocked for anti-manic and anti-psychotic effects. I think she said...80% or so...twitches, cognitive problems, depression. some drugs are better than others. Haldol is ridiculously neuro-toxic and can reliably cause TD, even at low doses. it has a toxic metabolite that does some of the dirty work, apparently. Seroquel is kind of interesting...its low potency (like Thorazine...100s/mgs for required effects, usually), and low potency drugs generally cause more sedation, less EPS, TD -does- occur, but its less frequent than with the high potency drugs (Risperidone comes to mind...Haldol, Prolixin).

ok. rambling...one reason I politely decline 2+ antipsychotic drug-drug combinations is because...all antipsychotics work on the D2 receptors. im not a doctor or any kind of expert, but...that's their core target. don't hit D2, its not an antipsychotic. the other thing is...after a certain point, adding more antipsychotic a) probably makes EPS and maybe TD more likely and b) the doctor is probably going more for sedation and just calming someone down, not an actual 'antipsychotic' and/or 'anti-manic' effect. example: I now take 15mgs/Abilify. I was on 20. 15 is just as effective in terms of -core- problems (schizophrenia, some forms of Bipolar I), but it isn't as tranquilizing/mildly sedating as the 20 or 30 Abilify, both of which are FDA-approved, available dosages. inpatient/hospital treatment often involves higher antipsychotic doses than needed...

for behavioral control (a docile patient is, apparently, a 'good patient...').

sorry to ramble. i just think the safest, easiest thing would be to talk to shrinky shrink about what his/her goals are in your treatment and if its possible to get the cocktail down to 1 antipsychotic, at least long term. it also dawned on me...my shrink is forever pushing Vraylar on me, but im kinda stuck with Abilify...but, Vraylar is supposed to be kind of like Abilify (read: fewer noxious adverse effects, for a lot of people) with a more pronounced anti-manic, anti-agitation effect.

just random thoughts, etc. i do hope things get better for you. :-)