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Old 12-08-2012, 09:13 AM   #1 (permalink)
 
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Default The Abilify + Zoloft thread

Hello Everyone,

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.

Quote:
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
reuptake inhibition.
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.
jim_morrison and ricca91 like this.
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Old 12-08-2012, 09:21 AM   #2 (permalink)
 
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Another for Zoloft:

Quote:
Furlan, P. M., M. J. Kallan, et al. (2001). "Cognitive and Psychomotor
Effects of Paroxetine and Sertraline on Healthy Elderly Volunteers."
American Journal of Geriatric Psychiatry 9(4): 429-438.
The authors evaluated the cognitive and psychomotor effects of serotonin
reuptake inhibitors in healthy elderly volunteers. Paroxetine,
sertraline, and placebo were compared for 3 weeks of testing in a
double-blind study with behavioral testing at baseline and at the end of
each week. MANOVA models demonstrated no between-group differences;
however, mixed-model random regression analyses revealed that Day 14
plasma paroxetine levels correlated negatively with delayed verbal
recall and paired-associate learning scores. In contrast, plasma
sertraline levels correlated positively with Day 7 immediate verbal
recall, Day 14 tapping, and Day 21 delayed verbal recall scores
, and
negatively with divided-attention task scores on Day 21.
Plasma
paroxetine levels were associated with mild behavioral impairment at Day
14, with no other significant adverse effects. Plasma sertraline levels
were associated with mild and transient behavioral changes, as well as
early termination in several subjects.
The negative divided attention scores do make sense as I do become more focused with sertraline and as such sometimes I just forget about the world around me except the task at hand.
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Old 12-08-2012, 09:55 AM   #3 (permalink)
 
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Is 5mg the smallest possible dose of abilify?
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Old 12-08-2012, 09:57 AM   #4 (permalink)
 
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Quote:
Originally Posted by thundercats View Post
Is 5mg the smallest possible dose of abilify?

Nah you can even buy 2mg pills and split them in half. I started at 2mg.
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Old 12-08-2012, 10:06 AM   #5 (permalink)
 
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This means you could start with 1mg? If I really should take this I'd start super low.
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Old 12-08-2012, 10:07 AM   #6 (permalink)
 
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Yah you can start as low as you want. A lot of people actually start at 1mg.
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Old 12-08-2012, 10:09 AM   #7 (permalink)
 
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Could I also start with 500mg? I have a fine scale at home which allows you to measure 0.01 gr.
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Old 12-08-2012, 10:14 AM   #8 (permalink)
 
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Quote:
Originally Posted by thundercats View Post
Could I also start with 500mg? I have a fine scale at home which allows you to measure 0.01 gr.

You could just cut it in 4 pieces and get 500mg each. I have a pill cutter for stuff like zopiclone. I'll cut 1 piece into 4 and it works for me without going super high.
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Old 12-08-2012, 10:21 AM   #9 (permalink)
 
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But if I weigh 0.5 mg for example then I dont know how much active agent I get cause the pill also contains fillers. I mean a 5mg capsule also weighs more than 5 mg. This means you could only work by splitting into half.
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Old 12-08-2012, 10:24 AM   #10 (permalink)
 
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Quote:
Originally Posted by thundercats View Post
But if I weigh 0.5 mg for example then I dont know how much active agent I get cause the pill also contains fillers. I mean a 5mg capsule also weighs more than 5 mg. This means you could only work by splitting into half.

YEs, split in half, then split the half in half. Get it? All pills are uniformily distributed so you don't have to worry about one side having more or not.
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Old 12-08-2012, 10:28 AM   #11 (permalink)
 
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But what if it doesnt do anything below a certain dose? Like for example would 0.1mg do anything?
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Old 12-08-2012, 10:38 AM   #12 (permalink)
 
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No clue, probably not, but you can slowly move up week after week till you find the hot spot.
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Old 12-08-2012, 10:51 AM   #13 (permalink)
 
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My combo is Saphris 5mg and Lamotrigine 150mg. Don't take antidepressants anymore.
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Old 12-08-2012, 12:23 PM   #14 (permalink)
 
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You may of said this already but what was wrong with Abilify and Wellbutrin? I still may give it a shot im always a ***** and stubrun when starting new drugs. Do you think it worthwild to try it together? I need some restlessness. Wellbutrin doesn't provide any of that. But any SSRI can probably give me that. I guess i still got depression maybe caused from a lack of activity. The only downsided to Wellbutrin is you shouldn't drink on it some SSRI are maybe more alcohol or alcohol withdrawal friendly. But in the end alcohol will just add to restlessness. I think 450mg might of been able to work if i didn't drink on it.
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Old 12-08-2012, 12:45 PM   #15 (permalink)
 
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@Gotanxiety, way too expensive to have both abilify and wellbutrin. Both are only brand name. Wellbutrin about 50 bucks and 120 bucks for abilify. That's 170 for a month. Sertraline is like 15 bucks for a month.

Next my best results were from Remeron/Zoloft. Abilify is very similar to remeron so I went with Zoloft to have the closest possible comparison. I will see in a few weeks how it goes. I also have always liked Zoloft it's the only SSRi that I respect.
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Old 12-08-2012, 01:03 PM   #16 (permalink)
 
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How bout abilify + zoloft + remeron?

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Old 12-08-2012, 01:08 PM   #17 (permalink)
 
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Sertraline + abilify study. I like how this combo improved social role function.

Quote:
Adjunctive low-dose aripiprazole with standard-dose sertraline in treating fresh major depressive disorder: a randomized, double-blind, controlled study.

Lin CH, Lin SH, Jang FL.
Source

Department of Psychiatry, Chi-Mei Medical Center, Tainan City, Taiwan.

Abstract

OBJECTIVES:

Second-generation (atypical) antipsychotics have been accepted as an adjunctive medication in patients with treatment-resistant depression. This clinical trial evaluated the efficacy and safety of low-dose aripiprazole combined with regular-dose sertraline for acute major depressive episode in non-treatment-resistant depression outpatients.
METHODS:

The study patients were 18- to 65-year-old outpatients fulfilling the criteria of major depressive disorder in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The patients were randomly assigned to 2 groups: one with sertraline 50 mg/d plus aripiprazole 2.5 mg/d and the other with sertraline 50 mg/d plus placebo. After baseline assessment, the subjects were followed up at weeks 1, 2, 4, 6, and 10. The primary efficacy was the score change of the 17-item Hamilton Rating Scale for Depression (HAM-D17), and secondary efficacies were the score of Short Form 36 Health Survey, Clinical Global Impressions-Severity, and Clinical Global Impressions-Improvement. This study also monitored patients for movement disorder using Simpson-Angus Scale and Barnes Akathisia Rating Scale.
RESULTS:

Twenty-one patients were assigned to the aripiprazole group and 20 to the placebo group. Because of high dropout rate, only data of the first 4 weeks were analyzed. The aripiprazole group exhibited significantly better efficacy than the placebo group in mean total score changes of HAM-D17 from the baseline to weeks 1, 2, and 4. The item "work and social activities" of HAM-D17 showed significant improvement at week 2, and the item "somatic symptoms (GI)" showed significant improvement at week 1. The aripiprazole group exhibited significant improvement in "social role function" section of Short Form 36 Health Survey at week 4. The mean total score of Clinical Global Impressions-Severity showed marginally significant improvement in the aripiprazole group. In Clinical Global Impressions-Improvement, patients in the aripiprazole group had scores of less than 2 (much improved) at weeks 2 and 4, and the scores of the placebo group were greater than 2.4 (indicating a minimal improvement). No patients had akathisia during the trial period.
CONCLUSIONS:

The primitive data showed that adjunctive low-dose aripiprazole could augment the efficacy of regular-dose sertraline in fresh major depressive disorder. A large-scale study is needed to confirm this finding.
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Old 12-08-2012, 01:08 PM   #18 (permalink)
 
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Quote:
Originally Posted by thundercats View Post
How bout abilify + zoloft + remeron?
Wouldn't make sense to have both abilify and remeron. Just would make you sleepier from the remeron.
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Old 12-08-2012, 01:16 PM   #19 (permalink)
 
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Who cares about social role function? I only care about how I feel.
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Old 12-08-2012, 01:18 PM   #20 (permalink)
 
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Because that's one of the scores that you do much better on when you feel better :P
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