Cahan : Coming off of Vortioxetine and Abilify

[Cahan]

Hello all,

 

(This introduction precedes a main question written at the bottom.)

 

My present prescription is 1mg of Vortioxetine and .75mg of Abilify.

I have been coming off of both medications for the last few months.

On the days where I had (foolishly) halved my Abilify, I noticed a great increase in energy and became aware that the medication was totally sapping my energy. After a botched attempt to drop from 1mg to  1/2 a mg, I will never again decrease by more than 10% of either medication. 

 

Brain fog, disassociation, snapping at my loved one over nothing, paranoia and general fatigue have all been on the roster.

 

I decided to even out the dosage to .75

I am aware that this was still too much of a drop, but as I've been on it now for a week - I am willing to ride it out, and the withdrawal effects (though unpleasant) seem to be subsiding.

 

I am eager to find support and help here.

 

I have been on one or another cocktails of anti-depressants, mood stabilisers, or, now, antipsychotics and I have come to the recognition of the fact that they have stolen the last 13 years of my life from me. 

 

As stated I presently stand at :

 

.75 Abilify

1mg Vortioxetine

1mg Zopiclone (as needed)

 

The main question that I have is - is it safe to titrate both the Abilify and the vortioxetine when I have stabilised on my present taper?

 

 

[Altostrata]

Welcome, @Cahan

 

On 8/11/2023 at 7:43 AM, Cahan said:

Brain fog, disassociation, snapping at my loved one over nothing, paranoia and general fatigue have all been on the roster.

 

These appear to be withdrawal symptoms. At what point did they appear?

 

On 8/11/2023 at 7:43 AM, Cahan said:

.75 Abilify

1mg Vortioxetine

1mg Zopiclone (as needed)

 

How long have you been at these dosage levels? How do you feel now?

 

To help us out, follow these instructions Please summarize your drug and withdrawal history in your signature You may need to use a computer to do this.

[Cahan]

Hi @Altostrata thank you for the warm welcome and nice response.

 

To answer your question, they appeared about one week into the dosage reduction. I tried the 'full day, half-day' method and found that it only caused strong destabilisation. As the process had already been begun, I decided to stick at .75 and let it balance out. That was three weeks ago, and I still find a lot of flux.

I also believe that the abilify, for all its flaws, was holding negative elements of the vortioxetine in check. 

 

To answer your second question, I have been on said meds for over a year. I was initially at a higher dosage of each.

I went (on both Abilify and Vortioxetine) from 10mg to 5. 

From 5 to 2.5

From 2.5 to 1.25

From 1.25 to 1.

 

It was then that I, erringly, decided to drop to .75 on the Abilify. It's three weeks later and whilst it has stabilised to a degree, there's still a good degree of variance in mood. 

 

One of the things that I did notice was that when I halved to .50 I had a huge increase in energy and motivation. It became apparent that the meds were stifling me.

 

I have been reading the forum and am aware that you are not the biggest proponent of reducing two medications at once, but my intuition is telling me to reduce both at once as I feel that they have 'coupled' in their efficacy.

 

I will fill out my medication history now, and thank you again.

[Altostrata]

You were taking 10mg Abilify with 10mg vortioxetine?

 

Please add the dates you started each drug and the dosage in your signature.

 

16 hours ago, Cahan said:

they appeared about one week into the dosage reduction.

 

Reduction of which drug, from what to what?

 

I am confused about your tapering schedule. Can you give the dates of each reduction and the dose to which you reduced?

 

16 hours ago, Cahan said:

but my intuition is telling me to reduce both at once as I feel that they have 'coupled' in their efficacy.

 

Please stop tapering for now, additional reductions can compound the withdrawal effects. What times o'clock do you take your current drugs, with their dosages? 

 

 

[Cahan]

Hi, Altostrata

 

A part of my condition is a severe problem with memory, and I cannot remember the names or dosages of my medications. 

I will ask my doctor for a full medical printout, and attach those to the signature. 

I was never able to remember to take my medication properly for years, or at the same time, and I believe that this contributed to a fragile and unpredictable mental state.

 

To clarify :

 

• The drug that I most recently reduced was Abilify. I went from 1mg to half of that, alternating half doses and full doses on alternating days. Following a severe reaction that followed this about a week after, I decided to only reduce a quarter. I have been doing this since the 7th of August.
• At present I am taking my medication in the morning : 20mg Dexedrine. 1mg Vortioxetine. .75mg Trintellix. I take Zopiclone and a statin before bed.

 

 

[Altostrata]

Yes, we need at least approximate dates and dosages.

 

On 8/11/2023 at 7:43 AM, Cahan said:

As stated I presently stand at :

 

.75 Abilify

1mg Vortioxetine

1mg Zopiclone (as needed)

 

How long have you been taking Dexedrine, what dosage, and why?

 

You're taking Dexedrine with 1.0mg vortioxetine and 0.75mg Abilify in the morning? Why do you take these drugs together?

 

On 8/29/2023 at 6:17 AM, Cahan said:

The drug that I most recently reduced was Abilify. I went from 1mg to half of that, alternating half doses and full doses on alternating days. Following a severe reaction that followed this about a week after, I decided to only reduce a quarter. I have been doing this since the 7th of August.

 

How are you feeling, taking 1.0mg vortioxetine, 0.75mg Abilify, Dexedrine, etc. since August 11?

 

Please put ALL your current drugs in this Interactions Checker and post the report or a link to it in this topic.

[Cahan]

• Dexedrine I take at 60mg, max dosage. It works for me. Some days I need more, some days I need less.
• I take them together because the symptoms seem to hit the most around midday-early afternoon.
• I have been feeling varied levels of things. I think that I need to pick a consistent time to take the V+A. Emotions can be heightened, but I seem to be stabilising. Brain fog seems to be a recurring problem.

[Altostrata]

On 8/31/2023 at 4:32 AM, Cahan said:

Dexedrine I take at 60mg, max dosage. It works for me. Some days I need more, some days I need less.

 

Please explain more about this.

 

On 8/31/2023 at 4:32 AM, Cahan said:

I take them together because the symptoms seem to hit the most around midday-early afternoon.

 

For what symptoms are you taking this batch of drugs?

 

Did you ever take Abilify in the evening?

 

On 8/31/2023 at 4:32 AM, Cahan said:

I think that I need to pick a consistent time to take the V+A.

 

Have you not been taking vortioxetine and Abilify at a consistent time? It's important that you take your psychiatric drugs on a regular daily schedule, as they can cause odd symptoms when taken off-schedule.

 

On 8/31/2023 at 4:32 AM, Cahan said:

Brain fog seems to be a recurring problem.

 

Is brain fog your most prominent symptom right now? When is it worst?

 

Please put ALL your current drugs in this Interactions Checker and post the report or a link to it in this topic.