[Hopeful Camel]

My doc just put me on Abilify. I'm also on Saphris and Zyprexa, albeit at a low dose. A previous psychiatric nurse practitioner once told me that you should never be on more than one anti-psychotic at a time.

Now I'm worrying about this recent addition of another AAP. I feel like I am already on a lot of heavy duty meds. Sometimes I wonder if the meds aren't what is making me feel bad.

The only thing that my current doc is working on taking me off of is the Tegretol. I am being weaned off of it.

Do folks have any thoughts on the 3 anti-psychotics at once thing?

[splitimage]

I'd ask your pdoc about what he hopes to accomplish with each of the 3 different AP's. Even among the Atypicals, they all work slightly differently on the brain, and are used to treat different symptoms. For example I'm on Risperidone, as a booster to my Anti-D and to help minimize dissociation, and on Seroquel for Anxiety. my pharmacy intially freaked out about me being on both, but they calmed down.

[BipolaRNurse]

It's unusual, but not unheard-of for a person to be on multiple anti-psychotics. Like the above poster said, they each have different effects on the brain and do different things. I'm on Geodon mainly for sleep and mania, and Zyprexa for anxiety and mixed episodes.

I was hoping to come off of APs at some point because nobody really wants to be on them forever, but it's not looking very good because they WORK. Zyprexa especially is the drug that pulls everything else together. I still have mild breakthrough mood episodes, but they are nothing compared with what I used to experience. Guess I'll have to worry about the long-term effects if/when I get there.

Hopefully you won't need to be on 3 APs for long. Wishing you well.

Dang that is alot of pills and how dose the doctor know if one pill is not working if your on so many ?
I wonder if doctors get bonus if they have people on as many drugs then they need to be .
I would go get a second opinion and see what the doctor says .

[Lexi232]

i agree, i would go for a 2nd opinion too.
and also abilify is often prescribed along side of other meds..
and the fact the pdoc is weening you off, and only adding on me med at a time, is a good thinf, as it shows that the pdoc has experience-and that alone can be pretty hard to find.
however, a second opinion could help ease things a bit.
ive had a pnurse tell me that she wasnt going to follow the doctors orders because it was "pointless" and "dangerous" for her to give me an "upper and a downer" at the same time.. and yet, here i am 3 years later and taking them just as the pdoc ordered.. they dont always know as much as they believe that they do.
i was on mine because of a different reason than the commonly known reasons for the meds. seperately they lacked things, but taken together that lacking became nonexistant,

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[Swabbingred]

I was simultaneously on two medications, both newer generation antipsychotics. One being Abilify (10mg) and the other being Amisulpiride (100mg). I eventually weaned off of Abilify as the side-effects were crippling and made me feel like a sleepless depravity but my psychiatrist mentioned that having two medications operating at once is not an issue unless they intertwine with an unstable interaction or cross-link between a specific neurotransmitter and somehow causes a fluctuation in its regularity.

Taking two or more antipsychotics concurrently is known as antipsychotic combination therapy as opposed to monotherapy which is not uncommon but not a practitioners first line of administrating medication. As long as your sense of wellbeing has not diminished, you don't experience too many adverse effects and the severity of symptoms don't exacerbate or persist then there should not be an issue.

[CamW]

Hopeful camel - Aside from the atypical antipsychotics having slightly different mechanisms of action, the reason to use multiple medications can be to reduce the secondary effects of the medication. All medications have a slightly different side effect profile, so by using more than one can reduce the the side effects.

I would ask your psychiatrist if this is why he/she is using multiple medications. Prescribing is an art in that physicians rely on past experience to find the medication(s) that are most effective for your specific needs.

As for feeling bad, could you expand on that? Things like tiredness or lack of energy are common start up side effects and usually go away over time. This could be one of the reasons that he/she is using the three atypicals. You would have to ask him/her, though.

I hope that this is of some help. - Cam