12-08-2012, 10:13 AM
Join Date: Feb 2012
The Abilify + Zoloft thread
I ended my wellbutrin XL thread as I am now off it. I have been on Abilify/Zoloft now and am enjoying this combination thus far.
Wellbutrin was decent, but very slow acting. It took a few months to notice minor improvements in anhedonia. Adding Abilify to the equation did in 2 weeks what Wellbutrin couldn't do in a few months. At this point due to money and just general experience with drugs I decided to switch the Wellbutrin to Zoloft.
Abilify is sort of what people are considering the panacea of drugs as it can be used for so many different conditions.
I could quote many studies to show its effect but if I could just explain in short what it does I can do it with this graph:
Basically as you can see it's a dopamine stabilizer. If you have high dopamine it brings it to the middle, if you have low dopamine it brings it to the middle. This is in contrast to other antipsychotics which as the graph shows bring dopamine to 0. I find this one particularily good because you don't want to have low dopamine nor do you want to have too high dopamine. This leads to this drug being used for many and many different conditions. When combined with other drugs the dopamine will probably become a bit higher than the current study shows in the graph but still not excessive.
Zoloft is an SSRI but it is the only SSRI that has shown to not impair cognition during treatment. Vigilance remains normal and the likely culprit is Zoloft's ability to increase dopamine. Some argue it will only happen at higher doses but experience says otherwise. Rats also show an increase in dopamine even without saturating the SERT transporters.
Riedel, W. J., K. Eikmans, et al. (2005). "Specific serotonergic
reuptake inhibition impairs vigilance performance acutely and after
subchronic treatment." Journal of Psychopharmacology 19(1): 12-20.
Subchronic treatment with the selective serotonergic reuptake inhibitors
(SSRIs) fluoxetine, venlafaxine and paroxetine, but not sertraline, were
previously shown to specifically impair vigilance performance. The
current study was designed to compare the vigilance effects of
subchronic treatment with the SSRIs sertraline and citalopram in healthy
volunteers, according to a placebo-controlled, double-blind, three-way
cross-over design. Twenty-four healthy subjects, aged 30-50 years, of
whom 21 completed the study, underwent three treatment periods of 2
weeks in which they received sertraline (50 mg on days 1-8, 100 mg on
days 8-15), citalopram (20 mg on days 1-8, 40 mg on days 8-15) and
placebo. Treatment periods were separated by 14 days washout periods.
Vigilance performance was assessed through a 45-min Mackworth Clock Test
at days 1, 8 and 15 of each treatment period. It was found that
citalopram impaired vigilance performance acutely after the first 20 mg
dose and subchronically after 40 mg daily doses. By contrast, no
vigilance impairment was found during sertraline treatment. Sertraline
is the only SSRI studied so far with no detrimental effects on
vigilance. This may be due to the affinity of sertraline for the
dopamine reuptake site. Because citalopram is the most specific SSRI
showing this effect, it is concluded that the SSRI-induced decrement of
vigilance performance is specifically associated with serotonergic
So with that said I am on 5mg abilify and 50mg Zoloft. I have been on abilify approaching 3 weeks and Zoloft for 3 days. Even only after 3 days I am noticing that i'm definitely more focused and less anxious. My sleep has also improved, mostly just don't wake up as much in the middle of the night. With wellbutrin i slept well but would wake up a few times to go pee. I'll keep my experiences on this thread as well as add any studies I feel will be helpful. I have quite a few that I will be working on putting in here.
MDD/ANHEDONIA/ANXIETY: Parnate 60mg in the morning
Sleep: melatonin 0.75mg /benadryl 12.5mg / zopiclone 1.75mg