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Abilify Stopped Now Nuvigil


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#1 laura73

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Posted 05 June 2011 - 11:10 AM

Had to stop Abilify bc EPS. Started Nuvigil as add-on to Lexapro yesterday. Last dose of Abilify was Thursday morning. Took Nuvigil 250mg yesterday and had major panic attack at work and was awake 22 hours. Can't talk to pdoc on weekend so asked pharmacist if I could cut in half and he said yes. So today took Nuvigil 125mg. I'm getting sad/crying again. I know Nuvigil is mostly for energy. There was something really good with the Abilify that helped thoughts and energy. Does anyone know if there's a withdrawal from Abilify? Does Nuvigil get better with time?

Edited by laura73, 05 June 2011 - 11:37 AM.

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#2 Blue Heron

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Posted 05 June 2011 - 11:24 AM

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"Note also how we don’t worry about taking medicine for pain the way we often do about taking 'happiness' pills like antidepressants. We worry that by artificially changing our mood we risk not being 'us.' But no one feels inauthentic because he took ibuprofen to relieve his back pain."

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#3 horselover

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Posted 05 June 2011 - 02:14 PM

Had to stop Abilify bc EPS. Started Nuvigil as add-on to Lexapro yesterday. Last dose of Abilify was Thursday morning. Took Nuvigil 250mg yesterday and had major panic attack at work and was awake 22 hours. Can't talk to pdoc on weekend so asked pharmacist if I could cut in half and he said yes. So today took Nuvigil 125mg. I'm getting sad/crying again. I know Nuvigil is mostly for energy. There was something really good with the Abilify that helped thoughts and energy. Does anyone know if there's a withdrawal from Abilify? Does Nuvigil get better with time?

Well, Nuvigil is for sleep disorders. Like to keep you awake. And that is what it did. That might have been too big a first dose. 150mg is also a recommended dose. (Stahl) Insomnia and anxiety are common side effects. Have you had any sedation from your other meds? What was Nuvigil prescribed for?

Abilify is a totally different med type, not a stimulant, and the energy you felt was something I felt in the beginning with it also. In the beginning, but not later. :mad:
Nuvigil is a stimulant. Abilify is an antipsychotic, but approved as add-on for depression. Is that why you were taking Abilify?

And yes, you might experience some effects of stopping the Abilify cold, even after only just a month. Did Abilify help with your panic attacks? Because if it did you might expect them to return as a rebound, but not necessarily this fast, since it takes two weeks for it to wash out. Whatever Abilify helped you with, you could expect that you might get rebound on those symptoms, and it might be worse than before. It is recommended that you taper it to discontinue, for 6-8 weeks (Stahl).

Edited by horselover, 05 June 2011 - 03:38 PM.

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HL

Current meds:
Viibryd 30mg
Abilify 10mg
Lamotrigine 100mg
levothyroxine 0.05mg
Protonix 40mg qam for GERD


Previous meds.:
Lexapro
Pristiq
Ativan

#4 laura73

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Posted 05 June 2011 - 05:16 PM


Had to stop Abilify bc EPS. Started Nuvigil as add-on to Lexapro yesterday. Last dose of Abilify was Thursday morning. Took Nuvigil 250mg yesterday and had major panic attack at work and was awake 22 hours. Can't talk to pdoc on weekend so asked pharmacist if I could cut in half and he said yes. So today took Nuvigil 125mg. I'm getting sad/crying again. I know Nuvigil is mostly for energy. There was something really good with the Abilify that helped thoughts and energy. Does anyone know if there's a withdrawal from Abilify? Does Nuvigil get better with time?

Well, Nuvigil is for sleep disorders. Like to keep you awake. And that is what it did. That might have been too big a first dose. 150mg is also a recommended dose. (Stahl) Insomnia and anxiety are common side effects. Have you had any sedation from your other meds? What was Nuvigil prescribed for?

Abilify is a totally different med type, not a stimulant, and the energy you felt was something I felt in the beginning with it also. In the beginning, but not later. :mad:
Nuvigil is a stimulant. Abilify is an antipsychotic, but approved as add-on for depression. Is that why you were taking Abilify?

And yes, you might experience some effects of stopping the Abilify cold, even after only just a month. Did Abilify help with your panic attacks? Because if it did you might expect them to return as a rebound, but not necessarily this fast, since it takes two weeks for it to wash out. Whatever Abilify helped you with, you could expect that you might get rebound on those symptoms, and it might be worse than before. It is recommended that you taper it to discontinue, for 6-8 weeks (Stahl).


I was taking Abilify as an add-on for depression. Because of EPS (lip tremor and jaw movements) pdoc DCd it. I've been through all SSRIs and SNRIs. She ordered Nuvigil in hopes that it would provide some energy boost since the Abilify did that so well. I remember now the long half-life of Abilify so I guess it makes sense it would take a while for rebound of symptoms. I felt edgy on the Nuvigil 250mg and I think it precipitated panic attack- along with a cup of coffee. My next step if I don't benefit from Nuvigil is MAOI. My pdoc is trying to avoid the washout because of recent hospitalization and severity of depressed mood so recently. I actually took an unintentional nap about 12 hours after today's Nuvigil dose. Maybe in a day or two I'll have sleep regulated at the lowered dose and can tell if there's a benefit. Will call pdoc tomorrow too. Thanks for your reply/info.
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#5 Kay8

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Posted 05 June 2011 - 07:50 PM

She ordered Nuvigil in hopes that it would provide some energy boost since the Abilify did that so well.


I didn't experience any energy boost from Nuvigil/Provigil. It's unusual among stimulants that its main effect is to help people stay awake, not give them more energy/concentration when they already are awake. I could also sleep after taking Provigil if I laid down -- the difference that it made for me was that when I was hit with excessive daytime sleepiness, I could usually push through it when on Provigil without falling asleep sitting up at my desk, whereas I couldn't without it.

Had you already tried other stimulants more commonly used as add-ons for depression (i.e., Ritalin)?
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#6 laura73

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Posted 05 June 2011 - 08:04 PM

She ordered Nuvigil in hopes that it would provide some energy boost since the Abilify did that so well.


I didn't experience any energy boost from Nuvigil/Provigil. It's unusual among stimulants that its main effect is to help people stay awake, not give them more energy/concentration when they already are awake. I could also sleep after taking Provigil if I laid down -- the difference that it made for me was that when I was hit with excessive daytime sleepiness, I could usually push through it when on Provigil without falling asleep sitting up at my desk, whereas I couldn't without it.

Had you already tried other stimulants more commonly used as add-ons for depression (i.e., Ritalin)?


Ritalan was the only one she tried with me. I tolerated 10mg twice a day but minimal boost and no energy at end of work day. I had anxiety and panic when I tried higher dose. Maybe if the Nuvigil doesn't help she will consider a low dose of a longer acting traditional stimulant.
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#7 Deep Sea Philosopher

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Posted 06 June 2011 - 09:04 AM

I would hesitate to call Provigil/Nuvigil a Stimulant. It technically is, but it is very atypical. It is promoted as a "Wakefulness Promoting Agent", and that label suits the drug a lot better than the traditional Methylphenidate/Amphetamine-type Stimulant.

Ritalin is Methylphenidate, and all of its derivatives fall under that class. The Amphetamine class includes Adderall, Dexedrine, and Vyvanse. Methylphenidate does more Dopamine Reuptake Inhibition, while Amphetamines fall more under the "increasing/enhancing" of Dopamine. A lot of people have entirely different responses to both classes, and even sometimes between medications in the same class. For example, Ritalin clashed with my Schiz side, so we immediately ruled out the Methylphenidate class. Both formulations of Addys increased my Anxiety, while Dexedrine IR and Vyvanse, respectively, peaked extremely fast or lasted 16-20 hours. Dexedrine Spansule (Extended Release) is the smoothest Stimulant that I have been on, but I have to take it twice a day for maximum efficacy, smoothness, and the minimalization of side effects that I experience with other Stimulants. I do not have ADHD, but Stimulants somewhat help with the cognitive issues that I experience.

For the record, Provigil/Nuvigil have been used off-label for both ADHD and to help people cope with sedating cocktails, but all I experienced on Provigil were side effects. Just a tip, do not take Provigil/Nuvigil on an empty stomach or combine with coffee. Your toilet will thank you.


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