[mossanimal]

As mentioned in other posts.. I've been fighting a nasty depression for the last several weeks. I haven't been to the pdocs because of a strange snafu with insurance and all of a sudden I was being charged per visit (My wife is an employee of the hospital and the BH doctors were not in that network for whatever reason. It will very soon be fixed) but I've been communicating via their email service. I'm asking them for other solutions for depression since the Zoloft was a disaster. I tried Abilify and I hated it. But now they are trying to push me into that again. I'm going to clarify this when I can finally get into see them again.. but why push the Abilify? It made me feel awful and I refuse to accept the weight gain. I want to try Wellbutrin. I never felt like the mania was the bigger issue (other than the mixed stuff)... but it seems like they are more concerned about that.

edit: I'm currently on Lamictal 200 mg

[CobolCapsule]

Try a low dose abilify combined with wellbutrin. I use a low dose neuroleptic with wellbutrin.

[Coconutzo]

I was on lamictal 200. They added abilify and I couldn't tolerate it. Instead we went to lamictal 400 and it helped immensely. Maybe see if you can just adjust the one?

[mossanimal]

Originally Posted by Coconutzo

I was on lamictal 200. They added abilify and I couldn't tolerate it. Instead we went to lamictal 400 and it helped immensely. Maybe see if you can just adjust the one?

I asked that a while ago because the lamictal was doing a great job moderating my response to stress, etc. .. but the depression was still recurring. But my pdoc said that over 200 not much happens? I don't know... I have a feeling that may have been the same deal.. trying to keep me from being manic or having the mixed state. I would love it if ONE medication took care of me. And I love lamictal so far...

[Coconutzo]

That's a funny thing for them to say! I've noticed a HUGE difference! I'm not one to suggest fiddling with your meds on your own, but...

[crunchyt]

Currently titrating down from abilify. I feel really depressed too. I asked to decrease my dose and we're splitting the 15 mg.

[mossanimal]

Originally Posted by Coconutzo

That's a funny thing for them to say! I've noticed a HUGE difference! I'm not one to suggest fiddling with your meds on your own, but...

Well they also told me that Abilify doesn't cause weight gain. :-) I'm telling you.. they are determined. I will try to get more out of them next visit.. but I'm really thinking that their opinion is that the mania/mixed is my real issue... and are steering me away from anything that might make me go up. But they haven't sat in my shoes during a depression.

[Coconutzo]

I get that. It's not super effective for mania but it definitely helps with depression and mixed states for me. I hope they find some way to meet you in the middle on this.

[wildflowerchild25]

I would stand your ground. You know how abilify made you feel. They don't. I hate when pdocs try to bully patients, especially if they've already tried something and it didn't work/had too many side effects. I always get uncommon side effects and I've had pdocs tell me what I was experiencing was "impossible". Well you're not in my body or head so stfu.

[fishin fool]

Originally Posted by mossanimal

Well they also told me that Abilify doesn't cause weight gain. :-) I'm telling you.. they are determined. I will try to get more out of them next visit.. but I'm really thinking that their opinion is that the mania/mixed is my real issue... and are steering me away from anything that might make me go up. But they haven't sat in my shoes during a depression.

Abilify sure caused weight gain when I was on it.
Just like you I can not understand a med that makes you gain weight
when you are already depressed. It makes no sense.

I think you should hold your ground too. (At least until they give logic a chance(!)) I've been on Lamictal for years and adjusting dosages (various levels between 200 and 400) has been a key strategy. Wouldn't have been if it hadn't have worked. So <raises hand> it's worked for me too.

Not saying it's been the only strategy, but it is the first one. Always. If/when that doesn't work, then another med will be added or adjusted. And, you know, we went with something that had already proven helpful in the past(!)

I know 200 mg is called "therapeutic dose", but it seems rather dogmatic to see that so literally and rigidly. I wonder if that is reflected in solid (and current) research or if it's simply the thing that got stuck in people's heads at one point then not really thought about subsequently. TOTALLY a pondering, but it might be worth looking into.

I'd push on the low risk angle for sure. What HARM is there in TRYING a dosage increase? As a starting point. That is all you are asking. It is perfectly reasonable. It's not like you're ruling out looking at other options if that doesn't work. You are NOWHERE NEAR a ceiling effective dosage. (Generally considered to be 400mg) It's a med you have not had trouble with. That's important. It's a very logical place to start (as you already know of course).

Maybe you can throw in, "humor me". (Who knows, they might even learn something to do so(!) )