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Old Jul 31, 2022 at 04:07 AM
  #1
 
Have you ever been prescribed a bipolar disorder (or schizoaffective) medication a 2nd or 3rd time, years after first trying and subsequently going off it? If so, did the medication give you fewer or different side effects than the first or other trial(s)? Examples?

Why I'm curious is because my current psychiatrist has twice said he would rather I take Abilify than Seroquel. However, I did once take Abilify for almost a year, about 12 or 13 years ago, and was taken off during a psychiatric hospitalization. I recall having mild akathisia on it and presumed that Abilify simply couldn't tame my mania sufficiently. At that exact time, I was also on about 300 mg Lamictal. My Abilify dose, I can't remember. I do think Lamictal was overly stimulating at that dose. I'm just unsure what Abilify could/couldn't do if with other medications? Also, would it again give me akathisia?

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Old Jul 31, 2022 at 08:26 AM
  #2
 
In my experience, it's pretty random. The first time I tried Haldol I didn't have any side effects, the second time I had severe akathisia, muscle spasms, and an increased appetite. The first time I tried Depakote, my hair started falling out, I felt depressed, gained a significant amount of weight, and was tired all the time. Second time around, I just felt a little flat without any of the former. The only way to be certain of what Abilify will do for you now is to try it again.

Why does your pdoc want to replace the Seroquel with Abilify? Is the Seroquel not working or giving you bad side effects?

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Old Jul 31, 2022 at 08:51 AM
  #3
 
I tried Geodon twice. First time was weird I was hypomanic from it in every way but for hours after each dose I couldn’t stay awake. I was in a pretty bad depression before I started it.

2nd time it didn’t make me sleepy at all - I actually had insomnia. No other signs of hypomania.

And not a bipolar / schizoaffective med really but avanza / mirtazapine I tried twice. First time it knocked me out every time I took it and gave me a massive appetite and huge weight gain. 2nd time about 10yrs later no sleepiness and no change in appetite.
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Old Jul 31, 2022 at 09:03 AM
  #4
 
Thanks so much for sharing, unlived and MuddyBoots! It's certainly interesting (kinda odd, I guess) how there are such differences. I wonder if one's mood state when taking it again plays a part. I've also had cases of different reactions with other meds a second or third time. Also, some meds were great for months or even years, then suddenly turned south. Geodon was an example. Seemed no-side effect, then four years later I developed the worst akathisia in my life. Geodon was the culprit.

@MuddyBoots, my guess is that my new psychiatrist sees Abilify as a "friendlier" antipsychotic than Seroquel. I suppose it can be, but I think like most of them it varies by person how well it works and the side effects. I am concerned about Seroquel eventually causing diabetes 2. I am pre-diabetic now, and though I know my diet should be improved, it certainly isn't any worse than many people who aren't diabetic or pre-diabetic. I am overweight and getting more so. I'm sure Seroquel plays a part, though many in my family have/had more weight gain than me without any weight unfriendly medications. My cholesterol and triglycerides are only in normal range because I take medications for them. Without, I'd worry they'd skyrocket again. Anyway, I think some docs just have favorite meds to prescribe.

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Psych Medications:
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* Quetiapine ER 400 mg
* Quetiapine IR 200 mg
* Pregabalin 100 mg
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Old Jul 31, 2022 at 10:27 AM
  #5
 
I agree I think it varies from pdoc to pdoc, and they each have their favorite drugs that seem to cause the least side effects.. I’ve often wondered if this is a geographical tendency? If there isn’t some genetic and local things to take into consideration? Of course it could all be hocas pocus too.

The only drugs I’ve been on multiple times is lamictal and that has always had the same results, works marvelously to contain my mania but renders me flat.

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Old Jul 31, 2022 at 06:02 PM
  #6
 
Oh, yes, I've been on psych meds since I was 23, I'm 59 now. So lots of repeat medications. Each time I take one I've already been on I have different reactions.

The pdocs/med providers I've seen usually want to replace Seroquel with Abilify for the reason you've stated - they consider Abilify a "friendlier" drug. And it is. Far less dangerous to one's health.


Lamictal...I'm certainly not saying it's impossible, but at 300mg most people (myself included) find Lamictal flattening, not overstimulating.

Would Abilify give you akethisia again? It's anybody's guess. Your own body is in a different place than it was years ago. You're on a different med cocktail. I really believe that the only way to know is to try it.

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Old Aug 26, 2022 at 11:35 PM
  #7
 
@Soupe du jour Abilify is notorious for akatisia–I think 25% of patients experience it, but I personally did not have akatisia on it. I had akathisia on other APs (relieved with Gabapentin). the reason I could not tolerate Abilify: severe nausea to which I could not accommodate. I plan to try again, this time with Zofran in hand.

I very much recommend Gabapentin as an antidote to akathisia. It has a very mild side effects profile and does not interact with other drugs. to me personally, it also acts as an AD. Finally, it improves deep sleep.
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Old Aug 26, 2022 at 11:56 PM
  #8
 
I've been on abilify several times and Zyprexa several times.

Did you take abilify in the morning? my son has to take it at night to combat akathisia. My symptoms are too strong abilify but with the help of toriizine it made it a lot better (until recently). I was on a high dose before the injection (30 mg). Thorizen was added later when I was going manic but it helps with my SH thoughts.

There are certain medications I will not try (or try again) Seroquel being on my list but that's because I started to develop tics on it. Have you done genetic testing yet? Is that an option?

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Old Aug 27, 2022 at 12:36 AM
  #9
 
Quote:
Originally Posted by Miguel'smom View Post
Have you done genetic testing yet? Is that an option?
MM can you tell us more about genetic testing and what it helps with? Is it true that insurance does not pay for it?
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Old Aug 27, 2022 at 01:05 AM
  #10
 
I haven't had it. I will ask for it when I move if they want to switch my medications. Because despite current Bs it works for me. It gives a list of meds that work best for you. I'd check your insurance.

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