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Adding Abilify To Lamictal & Stimulant? Atypical Depression? Anyone?

atypical depression bipolar ii abilify

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#1 allknots

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Posted 09 October 2012 - 10:41 AM

Hi, I'm new and pretty badly in need of insight. This place seems amazing. Hopefully one of you will have had some sort of similar experience (not that I would ever wish my state of mind on anybody). I edited this down to 10% of what it was so I'm sorry if it's still too long. key bits are bolded if you're nice enough to read this but dont want to wade through the murky crap.

MAIN QUESTION: Has ANYONE here had an experience with Abilify being added to a mood stabilizer and stimulant? I'm scared to take anything that will make me eat more, sleep more, or feel like a human concrete block.

medication situation
-discontinued 50 mg Sertraline [gen. Zoloft] 1 week ago
-----> not doing me favors. it's side effects mimic atypical depression for me (lethargic, hungry, tired) so I stopped after a month.

-currently on 300 mg Lamictal at night
----->changed my life when I started it a year ago. It paved over a bumpy country road, if you will. trade-off, I know; but i've learned to let go of my concern with purity. which is why I'm ok with taking...

-Vyvanse 40 mg as needed. and right now i need it even though it's not helping like it usually does. it lifts the fog and activates.

-given sample pack of 2 mg Abilify, yet to start it.


past 3 weeks or so:

---> BINGE eating. what a nightmare.
---> Existential & Physical Lethargy: I am a human concrete block. It's the most agitating sensation I have ever felt. I want body to move; body will not comply. I want to rip my skin off but don't have the energy to do it. That makes me want to literally just cease to exist. The thought is not accompanied by sadness or pain. Just a desire to stop thinking. I WANT TO STOP THINKING ABOUT THINKING.
---> Apathy: were this simple apathy with no thought clutter, maybe I could deal. This is just awful. I can't shut my brain up and it's spewing nonsensical, disorganized festering garbage. I don't care about the elements of my life that I should.
--->Switching from rage to flaccid thinking. Impulse control? What impulse control?? Since I'm apathetic but angry at the same time, this is dangerous! I would say I'm scared but it's like I'm watching this from outside my own body.

I'm screwing up in school when, last semester, I was an academic perfectionist. In control of the food I put in my body, worried about cigarettes, making sure I ran a few times a week. Now I feel like I've slipped down a well and I can never get back to that. Sure, I was anxious. But I was productive, I cared, and I was on top of everything.

I'm a full-time waitress and taking five classes at a very good school which I commute to. As you can guess I need to be ON most of the time, and it's like somebody switched me OFF and I don't have the energy or desire to flip that switch back. Crying spells began a few days ago and now I'm just at a loss.

Atypical depression anyone? pretty damn sure, plus the irritability and rage from bipolar ii? I think they're very closely linked. sorry this is so long... it feels good to put it down. sorry if this is the wrong forum.
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#2 notfred

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Posted 09 October 2012 - 10:56 AM

I take that combo. No problems.
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I am in full remission (DSM IV 296.36) from Depression. Insomnia, ADHD-PI, Epilepsy, and the Pseudoparkinsonian tremor are well controlled.

 

Psyc Meds: Forfivo XL 450 mg (Wellbutrin XL), Aripiprazole 15 mg (Abilify), Eszopiclone 6 mg (Lunesta), Vyvanse 70 mg (Lisdexamfetamine), Levetiracetam 2,000 mg (Keppra), Propranolol ER 60 mg (Inderal)
PRN: Clonazepam 1-2 mg (Klonopin), Lorazepam 1-4 mg (Ativan), Alprazolam 1-2 mg (Xanax), Dextroamphetamine 10-40 mg (Dexedrine), Propranolol 20-40 mg (Inderal), Ondansetron 8-16 mg (Zofran)

Supps: Multi-vitamin/mineral, Vitamin D-3 2,000 IU, Omega-3-acid ethyl esters 4 g (Lovaza), Hemp seed oil 2 g, CoQ10 100 mg, L-Glutathione 200 mg

Dx: Depression, Insomnia, ADHD-PI, Temporal Lobe Epilepsy, Dyspraxia, Tremor

I also take allergy and diabetes + it's complications meds.

All doses are a daily total.


#3 Demento

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Posted 09 October 2012 - 11:15 AM

I have atypical treatment-resistant depression. I take Abilify + 2 mood stabilisers + stimulant among other meds. It has worked out well. Abilify is the only med that has been able to touch my apathy. While it is impossible to predict how different people will exactly react to a particular med, Abilify does not make me feel like a concrete block. Quite the opposite, it gives me energy and an interest in life again. And it works well in conjunction with my Ritalin.

Having said that, I found that Abilify didn't do much for me until I got to 10 mg. At 2 mg and 5 mg, all I got was horrible anxiety, and I almost gave it up because of it. Now I am glad that I stuck it out. But that may just be me and my reaction to it.

Abilify is the only med that I can say literally changed my life. I cannot say enough about it. However, it tends to be a really love it or hate it med, and it doesn't work out for all people.

Edited by Demento, 09 October 2012 - 11:21 AM.

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#4 Nurse Ratched

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Posted 09 October 2012 - 01:07 PM

Seems like a smart add-on.
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Current Meds:  Seroquel XR 300 mgs, Vistaril 100 mgs prn

Former meds: Topamax 200 mgs, Risperdal 2 mgs, Wellbutrin 300 mgs, Klonopin .5 mgs, Paxil, Zoloft, Effexor, Remeron, Elavil, Abilify, Lamictal, Geodon, Zyprexa, BuSpar, Xanax, Depakote, Trazodone, Ambien, Lithium,  Doxepin,  Cogentin, Haldol, Saphris, Latuda, Neurontin, Lexapro, Ambien


#5 Jerod Poore

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Posted 09 October 2012 - 01:09 PM

past 3 weeks or so:

---> BINGE eating. what a nightmare.
---> Existential & Physical Lethargy: I am a human concrete block. It's the most agitating sensation I have ever felt. I want body to move; body will not comply. I want to rip my skin off but don't have the energy to do it. That makes me want to literally just cease to exist. The thought is not accompanied by sadness or pain. Just a desire to stop thinking. I WANT TO STOP THINKING ABOUT THINKING.
---> Apathy: were this simple apathy with no thought clutter, maybe I could deal. This is just awful. I can't shut my brain up and it's spewing nonsensical, disorganized festering garbage. I don't care about the elements of my life that I should.
--->Switching from rage to flaccid thinking. Impulse control? What impulse control?? Since I'm apathetic but angry at the same time, this is dangerous! I would say I'm scared but it's like I'm watching this from outside my own body.

Abilify, Geodon, Risperdal/Invega, Saphris, pretty much any antipsychotic would be a good choice to start with. Other than lowering my seizure threshold to the point of having one every night and on the verge of having another during the day, I liked how Abilify helped me deal with similar issues of lethargy, apathy, and confused thinking.

I'm screwing up in school when, last semester, I was an academic perfectionist. In control of the food I put in my body, worried about cigarettes, making sure I ran a few times a week. Now I feel like I've slipped down a well and I can never get back to that. Sure, I was anxious. But I was productive, I cared, and I was on top of everything.

I'm a full-time waitress and taking five classes at a very good school which I commute to. As you can guess I need to be ON most of the time, and it's like somebody switched me OFF and I don't have the energy or desire to flip that switch back. Crying spells began a few days ago and now I'm just at a loss.

Be careful not to confuse being functional with hypomania. Your new normal may not be as productive as you'd like it to be anywhere from a few weeks to...whenever they come up with an effective treatment for bipolar disorder that doesn't involve medication. You know, like gene therapy.

Atypical depression anyone? pretty damn sure, plus the irritability and rage from bipolar ii? I think they're very closely linked. sorry this is so long... it feels good to put it down.

The depressive phase of bipolar II is frequently atypical. It's a variant of a single condition, not two.

sorry if this is the wrong forum.

That's why God invented the move topic function.
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Current meds: lamotrigine 200mg, topiramate 400mg, buspirone 60mg, protriptyline 60mg, EPA 600mg, lorazepam 1mg PRN
Past meds (likely incomplete): Abilify, clonazepam, desipramine, diazepam, Gabitril, lithium, methylphenidate, Neurontin, Paxil, prochlorperazine, Provigil, Prozac, Risperdal, Seroquel, Serzone, Strattera, Trileptal, Zyprexa

#6 bengaltiger

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Posted 10 October 2012 - 12:00 PM

I'm a full-time waitress and taking five classes at a very good school which I commute to. As you can guess I need to be ON most of the time, and it's like somebody switched me OFF and I don't have the energy or desire to flip that switch back. Crying spells began a few days ago and now I'm just at a loss.


I hear you on being "on" all the time. Unfortunately, it wrecked me. Not sustainable.
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#7 kksdy31

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Posted 09 July 2013 - 06:15 AM

I am currently going through EXACTLY the same "med adventure" right now.

I was on 200mg lamictal and 50 mg vyvanse for 6 months. I agree, lamictal helped stabilize my mood and made me feel happier in general. I also agree that vyvanse didn't really do what it was supposed to, but kept me up and alert enough to get by.

I fell into a major depressive episode 6 months ago after my ED started to get out of control again, leading my boyfriend of 3 years broke things off. I stopped functioning at school, (also 19 semester hours, working in a restaurant), perusing my interests, and socializing with my friends. I was formerly a 4.0 student, very nutrition/fitness conscious, and actively involed. My binge eating was becoming worse and worse, I didn't even bother to purge, which was pretty significant for me after dealing with restricting/over exercising/purging for 2+ years.

I started on 50mg Effexor XR, but stopped after 6 weeks of no improvement. Switched to Zoloft at 20mg, then increased to 40mg and increased lamictal to 400mg after another month of no improvement.

This was THE WORST period of apathy, binge eating, lethargy, and total emotional disconnect. I gained 25 lbs. in 10 weeks. I was a walking zombie, and starting to consider suicide more and more as my only escape. I stopped seeing my therapist of 2 years because I was so angry about my lack of progress.

Stopped taking Zoloft and lamicand switched to Luvox, starting at 25mg, and increasing to 50mg in 2 weeks. My depression was still unchanged. I made a suicide attempt (tried to OD) about a month ago. Since then the "zoloft fog" has disappeared, but binging and apathy has not improved. My psychiatrist switched me to Abilify last week, starting at 2mg, and added back lamictal at 200mg. I'm still taking vyvanse, but this is mostly just to prevent me from sleeping all day.

I am at my last hope for Abilify. Through the last 2 years, I have been on Prozac, Effexor (twice), Zoloft (twice), celexa, and Luvox to no avail. My option after this is a stay in a hospital for full time treatment/supervision.

PLEASE tell me how the Abilify, lamictal, vyvanse combo worked for you. Did your depression improve, and have you escaped binge eating?

I know this is really long, but I have yet to find anyone with symptoms so similar to mine. I hope you are feeling relief and doing better!!

THANK YOU!
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#8 kksdy31

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Posted 09 July 2013 - 06:22 AM

Forgot to add, I had never been formally diagnosed, because I never fit anything in the typical sense and have yet to respond well to medication. Anxiety, BP-NOS, Cyclothymia, ADHD, BPD,and depression were all possibilities at different points in time. I now have a MDD diagnosis, but only after my suicide attempt, at which point I think my psychiatrist realized that things were not "going to get better" despite his continued promises.
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#9 nclaire83

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Posted 06 May 2015 - 01:29 PM

I am currently going through EXACTLY the same "med adventure" right now.

I was on 200mg lamictal and 50 mg vyvanse for 6 months. I agree, lamictal helped stabilize my mood and made me feel happier in general. I also agree that vyvanse didn't really do what it was supposed to, but kept me up and alert enough to get by.

I fell into a major depressive episode 6 months ago after my ED started to get out of control again, leading my boyfriend of 3 years broke things off. I stopped functioning at school, (also 19 semester hours, working in a restaurant), perusing my interests, and socializing with my friends. I was formerly a 4.0 student, very nutrition/fitness conscious, and actively involed. My binge eating was becoming worse and worse, I didn't even bother to purge, which was pretty significant for me after dealing with restricting/over exercising/purging for 2+ years.

I started on 50mg Effexor XR, but stopped after 6 weeks of no improvement. Switched to Zoloft at 20mg, then increased to 40mg and increased lamictal to 400mg after another month of no improvement.

This was THE WORST period of apathy, binge eating, lethargy, and total emotional disconnect. I gained 25 lbs. in 10 weeks. I was a walking zombie, and starting to consider suicide more and more as my only escape. I stopped seeing my therapist of 2 years because I was so angry about my lack of progress.

Stopped taking Zoloft and lamicand switched to Luvox, starting at 25mg, and increasing to 50mg in 2 weeks. My depression was still unchanged. I made a suicide attempt (tried to OD) about a month ago. Since then the "zoloft fog" has disappeared, but binging and apathy has not improved. My psychiatrist switched me to Abilify last week, starting at 2mg, and added back lamictal at 200mg. I'm still taking vyvanse, but this is mostly just to prevent me from sleeping all day.

I am at my last hope for Abilify. Through the last 2 years, I have been on Prozac, Effexor (twice), Zoloft (twice), celexa, and Luvox to no avail. My option after this is a stay in a hospital for full time treatment/supervision.

PLEASE tell me how the Abilify, lamictal, vyvanse combo worked for you. Did your depression improve, and have you escaped binge eating?

I know this is really long, but I have yet to find anyone with symptoms so similar to mine. I hope you are feeling relief and doing better!!

THANK YOU!

 

Hi,

Not sure if this is still relevant for you, but if you receive this (or if others have experience here), can you please tell me how the combination specifically of vyvanse, lamictal, and abilify worked out for you?

 

I have been on 200 mg of Lamictal and 25 mg of seroquel for years,  and 70mg of vyvanse for fewer years, primarily for major depressive disorder and mood swings related to bipolar type 2.

 

 Adding the vyvanse almost three years ago saved and changed my life.  Mood swings still occurred now and then but nothing too major and mostly hormone-related irritability/rage, and no symptoms that weren't preexisting prior to starting vyvanse. However over the past 10 - 12 months, the state of my depression has become abysmal and I am not functioning.  My dr. suggested a slew of options of meds to add, but stressed getting bloodwork done to check for thyroid issues that could be the cause.  Long story short, we decided to add abilify, and i just started at 5 mg today. 

 

But in the cab on the way home, while i read tons of success reports related to mood improvement, I also saw a lot of experiences with weight gain.  This is a huge concern of mine with starting this drug.  But I'm wondering if this side effect is any more common than with the lamictal or seroquel that I have already been taking for years, and if the vyvanse may work to counteract any possible weight gain.

 

All that aside, I'd still like to know your overall experience with the combination of the three drugs above (lamictal, vyvanse, and abilify).

 

Many thanks!


Edited by nclaire83, 06 May 2015 - 01:38 PM.

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#10 argentuban

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Posted 31 May 2015 - 10:22 PM

I take 10 mg of Abilify and 200 mg of Lamotrigine (100 in the morning and 100 at night). The only negative side effect, if you can call it that, is that my pupils get wide as saucers. I even have lost weight, but this varies with people. Abilify is supposed to be decidedly less problematic for weight than Zyprexa, which I used to take.


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#11 volor.flexx

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Posted 01 June 2015 - 01:14 AM

The combo should be fine, a stimulant + Abilify isn't uncommon as ADHD and Bipolar disorder seem to co-occur a lot. They seem to compliment each other and can even make the other work better. You shouldn't get any sedation on the combo. Abilify tends to be on the stimulating side and tends to be weight neutral.
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dx: ADHD, Narcolepsy, Panic Disorder, OCD, BPII, PTSD

rx: Concerta 72mg, Ritalin 10mg, Klonopin 2mg, Saphris 5mg, Brintellix 20mg




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