Your experiences on Abilify??

[kmm111]

Just curious as to what good or bad experiences you have had. My dr. recommended I start this along with my Zoloft since the Zoloft doesn't seem to be as effective anymore and I've tried pretty much every other medicine out there. Thank you!

[Bigboyuk]

I would personally look at different therapies that are available and combine the 2 it could really help at the end of the day :) Cheers

[panic_down_under]

My dr. recommended I start this along with my Zoloft since the Zoloft doesn't seem to be as effective anymore

As I understand it you're on only 100mg Zoloft so raising that would be a better option than adding an antipsychotic, imho.


and I've tried pretty much every other medicine out there.

What have you tried and what was the maximum dose taken?

[kmm111]

I was on 50mg of Zoloft, then increased to 75, then to 100. The 100mg made my anxiety worse, even after sticking with it for 4 months. That is why the Dr didn't want to ncrease it any further. I've tried Lexapro, Celexa and Cymbalta but they all came with side effects I didn't like.

[panic_down_under]

I've tried Lexapro, Celexa and Cymbalta but they all came with side effects I didn't like.

What were the side-effects?

Lexapro and Celexa are essentially the same med, so you've only really tried 3 antidepressants. There are many more. Generally antidepressants have fewer long-term side-effects than antipsychotics.

[kmm111]

I have also tried Wellbutrin which caused a horrible increase in anxiety. I did mention to my psychiatrist about switching to another SSRI and she suggested staying with Zoloft and adding Abilify. I'm not really sure why (perhaps an incentive from the pharmaceutical company?) but maybe I should have asked.

[panic_down_under]

I have also tried Wellbutrin which caused a horrible increase in anxiety.

Wellbutrin is generally the most stimulating of the antidepressants which can be an advantage for treating depression can have most with anxiety disorders almost literally climbing the walls, but a few do well on it.


I did mention to my psychiatrist about switching to another SSRI and she suggested staying with Zoloft and adding Abilify. I'm not really sure why (perhaps an incentive from the pharmaceutical company?) but maybe I should have asked.

Throwing an antipsychotic into the mix has become increasingly popular in America (and it seems Australia too) in recent years, though the UK has resisted the idea so far. I'm not a fan as antipsychotics can produce serious long-term side-effects, although admittedly this is much less likely at the low doses typically prescribed for supplementing antidepressants. Plus I don't see the point of continuing to take a med which is ineffective at the only doses you can tolerate. It would be better to try something else which works on its own, imho.

As you don't seem to do well with SSRIs and serotonergic SNRIs then maybe a norepinephrine, aka noradrenaline, reuptake inhibitor such as the TCAs nortriptyline (Pamelor) and desipramine (Norpramin), or the SNRIs milnacipran (Savella), or levomilnacipran (Fetzima) would be worth a shot (note: milnacipran and levomilnacipran are essentially the same med, levomilnacipran is a slight tweak of milnacipran developed mostly just to extend the patent, just as Lexapro (escitalopram) was from Celexa (citalopram), so it probably won't matter much which is taken, but because levomilnacipran is still in patent it may be more expensive)..

[kmm111]

Thank you for your reply. It seems as though in the US doctors push the SSRIs and SSNRIs. I've never actually heard of any of the other drugs you mentioned, and even being on meds for over 15 years, no doctor has suggested anything to me other than an SSRI/SSNRI (other than Wellbutrin).

I guess I'll see how the Abilify works, and if it doesn't, I'll ask the doctor for something else. It's disappointing, because I really thought Zoloft was the answer for me, and 50-75mg did help, but I felt I needed something "more". Dr. upped the dose to 100mg and I've been a wreck. I stuck with that dose for 4 months and my anxiety has been out of control, so here I am now.

[panic_down_under]

It seems as though in the US doctors push the SSRIs and SSNRIs.

It isn't just American doctors. Doctors around the world are suspicious of the older meds because they perceive them to be less safe in overdose, which is only partially true, and to be less effective, which is arguably false. For example De Lima MS (https://www.ncbi.nlm.nih.gov/pubmed/12495364), 2003, found the numbers need to treat (https://en.wikipedia.org/wiki/Number_needed_to_treat) (NNT) - the lower the NNT the more effective the med - was MAOIs: 2.9, TCAs: 4.3, SSRIs: 5.1, and the Arroll B (https://www.ncbi.nlm.nih.gov/pubmed/16189062), 2005, meta-analysis reported the NNT to be TCAs: 4, SSRIs: 6.

Over the years I have asked many older psychiatrists who practiced through the MAOI, TCA, SSRI/SNRI eras which antidepressant they would personally take and not one has nominated either a SSRI or SNRI as their first choice.