Kecanoe-starting taper with Abilify

[Kecanoe]

My doctor reviewed some bloodwork with me in November; it shows that I am in big danger of metabolic syndrome.  Fasting glucose 107, A1C 7.5, cholesterol up 40 pts  (20 of them the 'good' cholesterol), fat around the middle, 31 BMI.  So I want off the Abilify.  I planned to talk to my psychiatrist about it at my January appt, but he cancelled.  My next appointment is in March and I really don't want to wait that long.  I want off. 

 

I am curious about tapering this with the long half-life.  Can I consider eliminating one dose per week?  Or should I stick with the 10% per day?  Also, I have been rapidly tapered off a bunch of AD in the past with no problems.  Is it likely that since I haven't had a problem in the past that it will still be easy to get off my current meds?

 

Also, I am wondering if Abilify is still available as a liquid.  Anyone know?

 

Thanks!

[KarenB]

Hi Kecanoe,

 

Is the list of drugs in your signature what you are on currently, or have you tapered some of these? 

 

Abilify is available as a liquid, and it is definitely best to taper according to the 10% monthly method.  So for your first reduction you'd take 4.5mg for a month.  Then you'd take 4.05mg for a month and so on, always calculating your reduction from the dose you are taking at the time.  Also:  Tips for Tapering Abilify

 

It's important to take the doses regularly, never skipping days. 

 

Omega-3 fish oil and Magnesium are often found to be very helpful during withdrawal.

 

It's good to have you here.  Please come back to this thread to discuss things further if you like - this can be your journal to record your tapering progress.

 

Karen

[Kecanoe]

My signature is my current list-and I see that I forgot to put Nuvigil prn on it.  I've tried a whole lot more.  Does stopping other meds abruptly add to the withdrawal or is it a sign that maybe withdrawal might not be so bad?

[Altostrata]

Welcome, Kecanoe.
 
Stopping other drugs makes your nervous system vulnerable to withdrawal. Going on and off drugs is wearing on the nervous system.
 
That is a ridiculous cocktail of drugs you're taking. Did one doctor prescribe all of them? What is the purpose of PRN: Xanax .25, Zyprexa 10, Ambien 5, Nuvigil?
 
Please put ALL the drugs you take in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and copy and paste the results in this topic.

[Kecanoe]

Yes, all prescribed by one psychiatrist.  I have Dissociative Identity Disorder and he wants to keep me out of the hospital.  Which I totally agree with.  He thinks different alters respond to different meds.  I don't know what I think about that.  But I have been successful at staying out of the hospital-all they do there is yank you off whatever you are taking and put you on a bunch of new stuff.  I am not into that.

 

Xanax: anxiety.  I take .25 maybe twice a month.  Not interested in getting addicted to that!

Zyprexa is for when I am too wound up to sleep.  More than 2 nights with less than 4 hours of sleep, I am supposed to take it.  Or I can take Ambien.

Nuvigil is supposed to be daily because I am so forgetful (from all the drugs).  I don't take it daily though.  More like once or twice a month. 

[Kecanoe]

Here's my report.  Ugly, huh?    nortriptyline bupropion

Applies to: nortriptyline, Wellbutrin (bupropion)

Talk to your doctor before using buPROPion together with nortriptyline. Combining these medications may increase the risk of seizures, which may occur rarely with either medication. In addition, buPROPion can increase the blood levels of nortriptyline, which may increase other side effects. You may be more likely to experience seizures with these medications if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumor or head trauma. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should avoid or limit the use of alcohol during treatment. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Major nortriptyline buspirone

Applies to: nortriptyline, BuSpar (buspirone)

Using nortriptyline together with busPIRone can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Major nortriptyline cyclobenzaprine

Applies to: nortriptyline, cyclobenzaprine

Using nortriptyline together with cyclobenzaprine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Major bupropion cyclobenzaprine

Applies to: Wellbutrin (bupropion), cyclobenzaprine

BuPROPion may rarely cause seizures, and combining it with other medications that can also cause seizures such as cyclobenzaprine may increase that risk. The interaction may be more likely if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumor or head trauma. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Major buspirone cyclobenzaprine

Applies to: BuSpar (buspirone), cyclobenzaprine

Using busPIRone together with cyclobenzaprine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Major bupropion aripiprazole

Applies to: Wellbutrin (bupropion), Abilify (aripiprazole)

Talk to your doctor before using buPROPion together with ARIPiprazole. Combining these medications may increase the risk of seizures, which may occur rarely with either medication. In addition, buPROPion can increase the blood levels of ARIPiprazole, which may increase other side effects. You may be more likely to experience seizures with these medications if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumor or head trauma. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should avoid or limit the use of alcohol during treatment. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate nortriptyline aripiprazole

Applies to: nortriptyline, Abilify (aripiprazole)

Using nortriptyline together with ARIPiprazole may increase side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipation, irregular heartbeat, confusion, and memory problems. Side effects may be more likely to occur in the elderly or those with a debilitating condition. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate buspirone aripiprazole

Applies to: BuSpar (buspirone), Abilify (aripiprazole)

Using busPIRone together with ARIPiprazole may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate cyclobenzaprine aripiprazole

Applies to: cyclobenzaprine, Abilify (aripiprazole)

Using cyclobenzaprine together with ARIPiprazole may increase side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipation, irregular heartbeat, confusion, and memory problems. Side effects may be more likely to occur in the elderly or those with a debilitating condition. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

[Kecanoe]

When I went to drugs.com interaction checker, I found an old list from 2014.  At that time I was on Nortriptylene, Buspar, Xanax, (still on those 3) and also Cymbalta, trazodone, protriptylene.  The last 3 I quit (w guidance from pdoc) with a few days to a week at half dose, then off completely. 

[Kecanoe]

I used to take .25 Xanax every night to help with sleep but I decided I didn't want to do that any more.  So now I switch around between Ambien, Xanax, hydroxyzine when I can't sleep.  With Zyprexa when I those don't work.  Fortunately I don't have insomnia very often.

[Kecanoe]

Well, crap.  Reading further on this forum, I guess I should mention that I take rabeprazole also for GERD.  And the GERD came after I started the psych drugs.  GI dr was aghast at what he saw with endoscope.  Sigh.I guess I talk to him about going off that.

[Altostrata]

We don't have any elephants here because our anti-elephant charms work so well.

 

I strongly suggest you get second and third opinions. I doubt there's any basis to your psychiatrist's theory, and he's prescribed you a dangerous cocktail of drugs without regard to the interactions. In fact, he sounds like a nut to me.

 

Wellbutrin is well known to cause insomnia, nervousness, anxiety, etc. Why were you put on Wellbutrin?

 

If you went off it, you may not have to take PRN Xanax .25, Zyprexa 10, Ambien 5, Nuvigil.

 

What is the Abilify supposed to do for you?

 

Are you dopey during the day but wired at night? What is the schedule for your drug-taking?

 

I would wait on going off the rabeprazole until you have reduced a couple more drugs.

[KarenB]

Wow Kecanoe,

 

That's some drug list.  I'm going to let Alto handle this one, with her vast knowledge.  You'll be able to do it - we've had people here in all kinds of crazy poly-drugging situations - just slowly work through the options, and you'll get a plan together. 

 

Karen

[Kecanoe]

Wellbutrin is for major depressive disorder. 

 

Abilify is because the AD weren't working; as an adjunct.  It replaced Lamictal

 

Schedule: am I take abilify, Wellbutrin, buspar, rabeprazole

      2 pm wellbutrin

bedtime: nortriptylene, buspar, rebeprazole, cyclobenzadrine

 

To be honest, I don't notice much of a reaction to any of my meds; probably because I am so medicated.  I often miss the afternoon dose of Welbutrin and don't feel any different.  I've tried taking Abilify both in the am and the pm and don't notice any difference there either.  And I don't know that the nuvigil makes any difference, that's why I don't take it very often. 

 

Do you know anything about hydroxyzine?  It's an antihistamine and anti-anxiotic.  It helps me sleep and I've got it in my head that it is a better choice than Ambien, Xanax or Zyprexa. 

[Altostrata]

Which drug did you start first? Which second, and what for? Etc.

 

I am sorry you're having problems sleeping. It's because you're overdrugged.

[Kecanoe]

Let's see what I remember.

Nortriptylene was first: started that in 2008 because I was having gut trouble after contracting Malaria.  Then dosage upped because I was depressed.

Tried Lexapro briefly, didn't like side effects.  I was having serious suicide thoughts.

added Buspar for anxiety and depression and Xanax for anxiety

Went inpatient, off Nortrip and Buspar; add Cymbalta still for depression.  Formally diagnosed with MDD and DID.  I was a real mess at that time

added Trazadone for sleep.  Took that for a while, but didn't feel like it was helping

started taking .25 xanax every night for sleep

Off Cymbalta and back on Notrip due to side effects and my gut needed the nortrip  Back on Buspar because it helps with anxiety and depression and I am ok with side effects. 

Then tried a bunch of things.  Amitriptylene, protriptylene, Lamictal, None of them helped.  Off Lamictal cuz had a rash.

Added Zyprexa, Ambien as needed for sleep

added cyclobenzaprine because it helps with deep sleep.

Added Welbutrin cuz still depressed and low energy.  Off Protrip and Amyitrip.

Added Abilify cuz AD not working

Stopped daily dose of xanax, now take a few times a month.

Added Nuvigil cuz can't remember things or concentrate. 

 

I have a hx of alcoholism (28 yrs sober) so I don't like taking xanax or nuvigil so I don't take them very often now. 

Right now I want off Abilify. 

 

The only meds that I take that I think make a difference are the Nortrip (for gut-and I would like to see how I do off that, but not a priority).  Xanax definitely helps with anxiety.  Ambien with sleep.  Zyprexa helps when my DID is making me feel awful.  Cyclobenzaprine seemed to make a difference in staying asleep.  Not sure if it still helps or not.  Again that is not a priority for me.  Welbutrin, Abilify, buspar, I think make no difference. 

 

I feel better mentally now than I have for the last 6 or so years.  But I don't think its the meds-I think it is the psychotherapy. 

[Altostrata]

Was it the same psychiatrist who diagnosed you with MDD and DID and prescribed all those drugs?

 

Do you think being ill with malaria and being treated with malaria drugs may have affected your mood at the time?

 

Are you interested in going off other of your drugs?

[Kecanoe]

The diagnosis came from a psychologist; I have one psychiatrist who I have been seeing for this whole time.  I had a inpatient stay in 2011 where I was taken off most of my meds and started on others. 

 

The Malaria was definitely a triggering event.  Up to that point I functioned well and was generally happy.  My husband and I were seeing a counselor for garden variety issues: we're both recovering alcoholics and we seem to need a tune-up every 10 years or so.  But nothing like the depression and dissociation I experienced later, ever. 

 

Not sure if the meds, being so sick (and having Drs tell me that I was fine for 6 months while I had Malaria-long story there), husband's revelation of sexual addiction, the accidental death of a friend's child at our house...  Basically a perfect storm I now believe.

 

I do want off all the meds; but in reading this site and others leads me to believe that this will take a really long time.  2 years per drug?  Yikes.  So for the moment I am focused on Abilify.  I've been on it the shortest and I like the side effects the least.

 

Would you suggest a different order?

 

Thanks for your help and time

 

Kathy

[Altostrata]

At this point, Abilify is as good a place to start as any. It could very seriously affect your blood sugar.

 

After you mentioned malaria, etc., I am dubious about any of the psychiatric diagnoses you've received. That is my own personal opinion, I'm not a medical professional of any type.

 

You may have had adverse reactions to malaria drugs and antibiotics that started you on this spiral of drugs and adverse reactions. Read this: http://www.nbcnews.com/health/fda-strengthens-warnings-malaria-drug-6C10783686

 

Your psychiatrist's theory of "one drug per symptom" is very common among bad doctors.

 

Given your history of going on and off drugs, it's no wonder you don't feel happy and peppy. You have been drugged to the gills. Cyclobenzaprine at night alone could keep you stupefied all day long.

[ChessieCat]

Hi Kecanoe,

 

I'm really pleased that you have found this site - welcome.  Please understand that it is very normal to feel confused and overwhelmed when you first join.  All of a sudden we seem to realise the situation we are in and it can make us feel impatient for things to change.  However we need to Keep it Simple, Slow and Stable (check this link out) in order to have the best outcome.

 

The other things we can feel when we arrive here is relief!!!  To know that we aren't alone and that we can be supported.  The members here are very supportive and helpful.  Don't hesitate to ask any questions.  Also, to search the site, it's best to use Google and search "survivingantidepressants.org" + whatever topic you are looking for.

 

You might find these couple of things helpful.  If we understand what happens when we take these drugs it can help us be patient and hopefully calmer during our recovery process:

 

Video: Healing from Antidepressants: Patterns of Recovery

 

Brain Remodelling

 

CC

[Kecanoe]

Finally saw my psychiatrist and he wants me off Abilify asap.  He recommends doing 1/2 dose for a week then stopping completely.  Metabolic syndrome is the reason for stopping so abruptly.  I am confused about what to do.  Don't want metabolic syndrome nor withdrawal. 

[ChessieCat]

Hi Kecanoe,

 

As you probably already realise, the way your doctor recommends you to get off Abilify is not what is recommended here.

 

So the mods are able to offer suggestions, could you please put the dates (for the ones you have been on longest month/year or just year would be okay) of when you started on your different meds.  You say you started Abilify last, but we don't know when that was.

 

It will depend on how long ago you started Abilify whether you can do a faster taper than the 10% recommended by SA.

 

Also, do you have metabolic syndrome OR is the doctor concerned about you getting it in future.  That will also be a factor in how quickly you can/should taper Abilify.

 

My suggestion would be to answer these questions and then wait for the mods to offer their suggestion/s about how to get off.

[Kecanoe]

Fixed my signature line.

 

Dr's words were something like "concerned because you are showing signs of metabolic syndrome".  My A1C and fasting blood glucose were high, my BMI is high, my cholesterol has risen 40 points, I am fat around the middle. 

 

Sigh.  I don't think pdoc will support a 2 year taper; he did order blood work retesting the above so we'll know if things are getting worse. 

[ChessieCat]

I can't remember who it was, but recently I read a post where as the person reduced their drug all of their blood test results improved.

[Kecanoe]

Thanks, Chessie.  That is reassuring.  Maybe I will taper down to 2.5 and do recheck on bloodwork.  That would at least buy me some time on the tapering

[Kecanoe]

I contacted my GP and he says that I do have metabolic syndrome and he agrees that I need to get off Abilify.  I went ahead and cut my dosage in half, not knowing what else to do.  I am doing ok with it so far but rather apprehensive.  I can't remember when I started taking the Abilify, it was some time last summer.  So I've been on it about 9 months.  I would welcome any suggestions.

 

I was already taking Magnesium so I have continued taking that.  I also take a monthly B-12 shot, which I will continue along with vitamin D.  I figure that the best course of action at this point is to not make changes in my supplements.  What do you think about adding fish oil? 

[KarenB]

Adding fish oil would be a good idea.  You can always start low and increase if you are concerned. 

 

Dropping abilify by half may not be a great idea, as you have been on it already for more than 3 months (when exactly in 2015 did you start it?).

 

Tips for Tapering Abilify recommends tapering by 10% each month.  If things are getting rough with w/d symptoms, you may wish to go back up to 4.5mg and settle there.

[Kecanoe]

I can't remember when I started Abilify-one of the side effects that I hope goes away is the memory/brain fog.  I've been on and off so many medications.  Sigh.

 

Thanks for the reply, Karen.

[Kecanoe]

Talked to pdoc.  He's not in favor of me tapering slowly.  So I have 30 5mg doses of Abilify and won't get any more.  Any thoughts about how to proceed?  Yikes!

[KarenB]

Actually, your best option may be to find another doctor to prescribe what you need.  There are lots around.

 

Luckily you are the one who makes the decisions about you, not your pdoc.  Time to choose a new employee...

[kiki2015]

I recently saw a psychiatrist a few weeks ago, through my GP. I was on 2ml of ability. He told me I could just stop it. So I have not taken it for the past 2 weeks. I had been suffering muscle paralysis which may be tardive dystonia, now I am convinced I have it. Now I just cannot pick up a pen, I feel so brain damaged. My neck is constantly twitching to the side. I think it had to do with how I was told to withdraw. I was told to alternate the medication from 15 to 10 mg for two weeks. Then after a few months 10 to 5 mg. My brain just froze, this was two years ago. I have been going to my GP for the past 2 years explaining my symptoms, absolutely nothing has been achieved, whatsoever. I have been thinking of making a complaint to the general medical council. But that may make matters worse. My tardive dystonia symptoms are so evident, to everyone why can' t they see it.

[Kecanoe]

Well, I did a rapid taper off Abilify per Dr because I had metabolic syndrome and he was concerned about diabetes.  Fortunately I seem to have done well with it.  I am now tapering off Welbutrin.  No symptoms so far.  Having some trouble sleeping but that predates going on meds and went on during meds as well.  Only way I can be sure of a good night's sleep is to take Ambien.  And the last thing I need is more drugs!