☼ apple1989: From 5mg/2.5mg abilify and 50mg lamotrigine to the lowest dose I could.

[apple1989]

Hi, this is apple 1989. Man, 32 years old, schizophrenia. Had two psychotics breaks 10 and 9 years ago with positive sympthoms. Now only negative sympthoms (depression like) but functional (I have an easy job, girlfriend, socially adapted).

 

Taking 5/2.5mg alternating days abilify and 50 mg lamotrigine.

 

Reasons to taper: Very long time without positive sympthoms, and recently appeared akathisia some days, that scared me. 

 

To start I will make constant my abilify dosage and i am planning to retire it. I will post in the forum of "tapering" some questions.

 

I am very happy to have found this page.

 

Thank you!

 

********************************************

I have to do a question, it is right to start at 3.75mg of Abilify? (I was 5/2.5 alternating days)

 

I know this question would be in "tapering", but I can not write in that forum yet. 

 

thanks again.

[Altostrata]

Welcome, @apple1989

 

Are you also tapering lamotrigine?

 

Are you feeling withdrawal symptoms from reducing Abilify?

 

Ordinarily, we strongly discourage alternating dosages to taper. As Abilify is one of the few psychiatric drugs with a long half-life, you may not feel withdrawal from alternating dosages at relatively high dosages.

 

On 3/23/2021 at 1:38 AM, apple1989 said:

To start I will make constant my abilify dosage and i am planning to retire it. I will post in the forum of "tapering" some questions.

 

This is a good idea, as you will want to be cautious about tapering Abilify so as not to stir up symptoms that may be diagnosed as psychosis. Yes, 3.75mg might be a good place to settle.

 

Please see Tips for tapering off aripiprazole (Abilify)

[apple1989]

Hi @Altostrata, thank you.

 

At this moment, I am not tapering lamotrigine.

 

About my withdrawal symptoms are none at this moment. I would say I am better because I was alternating 5/2.5 and now I am taking 3.6mg constantly (I planned 3.75 but the needle have four divisions: 3.0 3.2 3.4 3.6 3.8 4.0).

But I started this Tuesday (23nd March 2021 ) to do this, so I think is too early to confirm anything. I have switch from pills to "Abilify solution, oral 1 mg/mL 150-mL bottle"

 

I have to say before I started I have a kind of waves of deep depression and anxiety and I couldn't explain the cause. I suspect because a kind of withdrawal sympthoms due to the alternating. I will update.

 

Thanks again to you and this great community.

[Altostrata]

14 hours ago, apple1989 said:

3.6mg constantly (I planned 3.75 but the needle have four divisions: 3.0 3.2 3.4 3.6 3.8 4.0).

 

This is fine. Yes, your symptoms probably were from the fluctuating doses. Please let us know how you're doing.

[apple1989]

In case I forget updating, the server of the forum is sending me emails when somebody answer this post. So I will come back to update.

[apple1989]

Being now for two weeks at 3.6 mg abilify. Feeling slightly better, more stable mood. But I can't extract conclusions right now.

 

Maybe thinking about tapering also lamotrigine in short term, but just considering it right now

[apple1989]

Today I tapered a bit my dosage for first time! From 3.6 Abilify to 3.2 (10% aprox fo the dossage)

 

Today I didn't notice any changes in my mind, but I suppose I have to wait at least two weeks to see any effect.

[apple1989]

Hi again @Altostrata

 

I've reading your bio and some interviews and this is awesome. I feel really lucky that you have create this forum and your resesearch. This maybe saves my life literally

(I could barely work now, and very hypersensivity. I hope getting my concentration back)

 

I have a question for you and the community. 

 

I have been taking Abilify for about 10 years and lamotrigine just one year.

 

I am tapering Abilify right now, but I think I want also taper lamotrigine.

 

And I would like if this 3 month cycle during almost 3 years is maybe a good option:

 

Abilify(-10%) - Lamotrigine (-10%) - Lamotrigine(-10%)

 

*************************************************************************************

 

Month 1 - Taper Abilify (Example to 3.6 mg to 3.2) and hold Lamotrigine (50mg)

Month 2 - Hold Abilify (3.2) and taper lamotrigine (50mg to 45mg)

Month 3 - Hold Abilify (3.2) and taper again lamotrigine (45mg to 40mg)

 

Month 4 - Taper Abilify (Example to 3.2 mg to 2.9) and hold Lamotrigine (40mg)

Month 5 - Hold Abilify (2.9) and taper lamotrigine (40 mg to 36mg)

Month 6 - Hold Abilify (2.9) and taper again lamotrigine (36mg to 32mg)

 

And so on...

***************************************************************************************

 

[apple1989]

Updated signature.

 

Is it recommended to taper one medication first, or alternating?

Or even both at same time?(that frightens me a bit)

[Altostrata]

What are your worst symptoms that you attribute to your drugs? 

 

Abilify is a drug with far higher risk of adverse health consequences compared to lamotrigine. The dosage you're taking of lamotrigine is low. If I were you, I'd taper Ability, at least down to 1mg, then reassess your symptom pattern.

[apple1989]

Hi again Altostrata

 

One of the worst symptom I atribute to Abilify is losing my concentration. I am not 100% sure about it, but 6 days ago (at 23rd April2021) I lowered my dosage of Abilify 10%(to 3.6mg to 3.2 mg) and I have notice quite a nice change on my attention reading books and working. I also notice a change in my levels of energy, but I can't confirm this, because before has happened and maybe is just a good time.

 

The other one is big mood swings, from normal state to a deep depression state. When I was alternating 5mg/2.5mg a day I had high mood swings. Somedays I was in a deep depression. When I switched to a constant dossage (23rd March2021 - 3.6mg Abilify) and in two weeks (about 1st of this month April2021) I notice that my mood has not fallen so deep. And it is much more stable. I've been able to work at least at medium level every day. (Before stabilizing dossage, I couldn't barely work some days)

 

Maybe too soon to notice improvements, but wow, I really feel it and I hadn't changed anything but Abilify this two months

 

Lamotrigine, 50mg, I notice a bit of dry skin and  specially dry mouth at night. I sleep with a humidifier and I feel nice. Also I am a bit concerned about my gums, because they have turned very dark and I think is due lamotrigine(but I don't know really). I will go to dentist next Tuesday, on May.

 

As I read your advise and as my concentration and my performance at work have slightly improved in this month(I lowered only Abilify) I will stick to lowering Abilify as long as I could. I am aware about prodromes sympthoms and my therapist, my pdoc and specially my girlfriend are really aware of me so I think I would not have problems tapering this drug.

 

Thanks Altostrata!

 

PS: is my birthday really soon and I usually buy books. Do you have anyone written by you, Altostrata? I would like to thank you in some way or support this project. Also I bet you have a lot of knowledge and I'm interested in learning about this topic.

[Altostrata]

Good to hear you are feeling better already having reduced Abilify a little. 

 

I have not written any books, but thank you for the thought. I will put the Donations button up again soon.

[apple1989]

Hi everybody

 

This Sunday, 23th of May, I have lowered another 10% of Abilify

 

From 3.2mg Abilify --> 2.9mg Abilify

 

****************************************************************************************************

 

I felt great on Monday but, on Tuesday(48h later) and today I feel a bit depressed: apathy, anhedonia...

 

I have had this sympthoms before a lot of times, and stronger, but I have never suspected what was the real cause. 

 

Now I really suspect of the way I've taken my meds before: months where I raised and lowered my meds without criteria, alternating days (2.5mg/5mg) for a long time (and to get 2.5 I split the pill cutting it "by eye", intuitively)

 

I want to post this as a kind of 'record', a dialy paper, a reminder (I don't know how to say it in English). Next month at 23 of june, when I will lower to 2.6mg I will see if I have this kind of sympthoms 48h later. Let's see...

 

I hope I feel great again in some days.

*********************************************************************************************************************

 

Anyway, thanks for this forum, my dosage have never been so lower and I've never felt as good and stable as I feel right now.

 

Have a nice day.

[apple1989]

today, on 29 may. And yesterday 28 may. 6 and 7 days after lowering dosage. From 3.2mg Abilify to 2.9mg. Holding lamotrigine on 50mg

 

Experiencing waves of a kind of anxiety and feeling restless. I'll write in Spanish as I have difficult to think.

 

I'm going to resist one week more, If withdrawal symphtoms hadn't disappeared, I would going back to 3.2mg and taper more slowly.

 

Probably next "lowers"/"downs" will be more subbtle, maybe 5%

 

I am thinking about taking benzos in this waves.

 

I will update. Greetings.

 

**************************************

 

Hoy, 29 de mayo y ayer, 28. 6 y 7 días después de la segunda bajada de abilify. Desde 3.2mg a 2.9mg.

 

Estoy viviendo una serie de síntomas parecidos a la ansiedad y a la inquietud, vienen por oleadas.

 

No sabría describirlo muy bien pero es una sensación muy desagradable. Voy a ver si aguanto otra semana más, a ver si me siento mejor.

 

Las siguientes bajadas seguramente las haga más lentas, del 5% o del 10%

 

Estoy considerando tomar benzos en estas oleadas

 

Os iré informando. Un saludo

[apple1989]

Yesterday 31th of May and today, 1st of June. I am feeling better. I didn't sleep well, maybe due it's a hot weather in spain right now. But I don't feel so much anxiety and restless right now

[apple1989]

18th of june 2021. Still with 2.9mg Abilify (I usually do reductions at 23rd of each month, but I think I will postpone next reducction)

 

Have a bad week right now, Since Sunday 13th having a bad depression.

 

Started on Wednesday with Omega3 (2 capsules have 700mg dha+edp, taking 4 capsules so I think 1400mg ) and E-Vitamin (400IU)

 

Also today started eating broccoli with mustard. And more green vegetables in general.

 

https://livingwithschizophreniauk.org/no-eating-broccoli-will-not-cure-schizophrenia/

 

If solves problems with thinking skills (I have trouble focusing attention) for me is just enough good.

 

 

[apple1989]

Today, I'm going back to 3.2mg Abilify. Since I went down to 2.9mg I feel a bad depression and anxiety.

 

I also refuse the Omega3 and Vitamin-E . I'd prefer not more pills (Omega3 is not aproved by FDA, I can't trust quantities of omega3 in labels, they had no control. I think.)

 

I will down from there to 3.1mg Abilify, 3.0 and so on, next months...

[apple1989]

Difficult times this days.

Anxiety gets worse, but I've realized that comes from the AP: it's a secondary effect called "akathisia". 

 

I think to solve this problem I have to down abilify, I think is not a withdrawal problem, it is too much antypsychotic med.

 

Akathisia usually appears in me when I have too much AP in my body; so I going down to 2.7mg. It's an important reduction (from 3.2 to 2.7) but I am a bit desperate because akathisia is too strong.

[apple1989]

2.7 and akathisia is gone, I feel quite good today.

[apple1989]

Update: psychotic symptoms promted with 2.7mg Abilify.

 

Back to 3.6mg and stabilized in that dose, at least for a long time

 

*******

 

Actualización: con 2.7 mg he estado muy estable (irritabilidad, ansiedad) y hasta he tenido un inicio de sintomas psicóticos. 

 

Vuelvo a 3.6mg y me estabilizo en esa dosis, al menos por mucho tiempo.

 

*****************************

 

Althought I didn't achieve a lower dosage, at least I can see that I have a illness that I have to care

********

Aunque no he alcanzado una dosis más baja, al menos he podido comprobar que tengo en cierto modo una enfermedad de la que tengo que cuidar.

Tenía la hipótesis de que anteriormente había tenido síntomas por bajar demasiado rápido, pero esta vez he bajado con la regla de 10% cada mes (incluso más despacio) y con menos de 3.6mg de Abilify no estoy bien. 

 

Relativamente me quedo tranquilo en ese aspecto, es cierto que tengo una medicación de por vida, pero ya no me da tanta rabia tener que tomar los medicamentos, que de algún modo me protegen.

 

 

******************************************************************************

 

Maybe with a 5% of reduction things would have gone better, maybe I try in a future.

 

Es posible que si hubiera bajado con un 5% no hubiera pasado así, quizá pruebo más adelante

[apple1989]

I'm thinking now on tapering lamotrigine, maybe I can taper that med.

**************

Ahora estoy pensando en que podría intentar bajar la lamotrigina. 

[apple1989]

I am thinking wether the strong anxiety I had tapering abilify maybe it's due to not lowering also lamotrigine, as that med gives me anxiety

[apple1989]

On 4/30/2021 at 5:42 AM, Altostrata said:

Good to hear you are feeling better already having reduced Abilify a little. 

 

I have not written any books, but thank you for the thought. I will put the Donations button up again soon.

 

Altostrata, I have started bupropion 150mg due to a profound depression. But my anxiety is really worse.

 

I read that Abilify, Lamotrigine and Wellbutrin (bupropion) can cause more anxiety. (Before reading it in reddit, I thought that lamotrigine lowers anxiety, but some people say no)

 

Can I quit cold turkey Wellbutrin if I only been taking it one week? Thank you

[apple1989]

Also I am thinking in lowering lamotrigine, as I think Wellbutrin helps me in other ways. But I don't notice that lamotrigine is helping me

[Altostrata]

Anxiety is a common adverse effect of bupropion. What symptoms were improved by bupropion?

 

What times of day (o'clock) do you take each of your drugs, with their dosages? How do you feel before and after each dose?

 

Did you ever feel an effect from lamotrigine? What was it?

[apple1989]

My symptoms improved by bupropion are more energy to get things done and a slightly improve of anhedonia(My diagnosis is schizophrenia, negative symptoms)

 

Times of day:

 

08:00 -> 150 mg bupropion, 25 mg lamotrigine

23:00 -> 3.6mg abilify, 25 mg lamotrigine

 

I've been prescribed lamotrigine for that depresive symptoms, I think they improve a bit, but just a bit. Now I'm thinking in tapering it off; maybe that helps with anxiety.

 

[Altostrata]

Bupropion can be a stimulating drug. Abilify can be somewhat stupefying, that's how it works.

 

What do the symptoms you identify as depression feel like? You may also have gotten this lowering Abilify too fast.

 

On 7/18/2021 at 10:21 AM, apple1989 said:

Difficult times this days.

Anxiety gets worse, but I've realized that comes from the AP: it's a secondary effect called "akathisia". 

 

I think to solve this problem I have to down abilify, I think is not a withdrawal problem, it is too much antypsychotic med.

 

Akathisia usually appears in me when I have too much AP in my body; so I going down to 2.7mg. It's an important reduction (from 3.2 to 2.7) but I am a bit desperate because akathisia is too strong.

 

Yes, when you take too much antipsychotic, akathisia may result. How often do you get the symptoms you identify as akathisia? In my opinion, avoiding akathisia from Abilify is very important. 

 

We need to see if lamotrigine is also causing problems. Please put ALL your drugs in this Interactions Checker and post the report or a link to it in this topic.

[apple1989]

11 hours ago, Altostrata said:

Bupropion can be a stimulating drug. Abilify can be somewhat stupefying, that's how it works.

 

What do the symptoms you identify as depression feel like? You may also have gotten this lowering Abilify too fast.

 

 

Yes, when you take too much antipsychotic, akathisia may result. How often do you get the symptoms you identify as akathisia? In my opinion, avoiding akathisia from Abilify is very important. 

 

We need to see if lamotrigine is also causing problems. Please put ALL your drugs in this Interactions Checker and post the report or a link to it in this topic.

My PDOC told me yesterday the same of Bupropion and Abilify, they are both a kind of dopaminergic agonists. He recommend me to lowering bupropion taking it alternating days. (150mg alternating), but I will ask him for 75mg everyday, but I don't know If that dosage is available in my country (Spain)

 

Symtoms I identify are a heavy anhedonia and apathy. That is partially solved with bupropion, specially apathy.

 

But I agree with you, I tapered Abilify too fast. There were several days that I experience strong akathisia, during a trip to the South of my country(too hot days) and I lowered dosage before the month I usually taper.

I experience a kind of psychotic symptoms one night when I was at 2.7mg (I am at 3.6mg); so I think I just was too frightened.

 

I usually experience Akathisia for about one day each 2 o 3 months. It's weird I think I experience a kind of anxiety. 

 

So, when I feel good again in a row for two weeks, I will start tapering again. Maybe 5% each month

 

Results of interactions:

https://www.drugs.com/interactions-check.php?drug_list=1430-0,233-109,440-0&types[]=major&types[]=minor&types[]=moderate&types[]=food&types[]=therapeutic_duplication

 

Two questions Alto:

 

- why avoiding akathisia is important? I know it is really uncomfortable, but I didn't know can have more consequences.

- can you taper two meds at same time? I started tapering lamotrigine (I think bupropion helps me a lot, but I am not sure about lamotrigine)

 

Thanks Alto. You're effort is really important for us.

[Altostrata]

10 hours ago, apple1989 said:

He recommend me to lowering bupropion taking it alternating days. (150mg alternating)

 

This is a terrible idea. Did you start bupropion only a few days ago? If so, you can simply stop taking it.

 

10 hours ago, apple1989 said:

I usually experience Akathisia for about one day each 2 o 3 months. It's weird I think I experience a kind of anxiety. 

 

 

Do you sometimes skip taking Abilify or take it on an irregular schedule?

 

Akathisia is a warning that your nervous system is being over-stimulated or otherwise upset.

 

We recommend tapering only one drug at a time, so you can identify your reactions from tapering. When you taper 2 drugs at once, you won't know where reactions are coming from. If you get a bad reaction, you won't know which drug is responsible. This can get so complicated, we can't even begin to help you.

 

You are not taking much lamotrigine, and Abilify is a far more dangerous drug.

 

10 hours ago, apple1989 said:

Symtoms I identify are a heavy anhedonia and apathy.

 

These are typical adverse effects from psychiatric drugs such as Abilify and lamotrigine. They are supposed to slow you down and dull you. Or, they could be withdrawal symptoms from your prior drug reductions.

 

See Tips for tapering off aripiprazole (Abilify)

 

 

[apple1989]

 

11 hours ago, Altostrata said:

 

This is a terrible idea. Did you start bupropion only a few days ago? If so, you can simply stop taking it.

 

Yes, I've taken it only one week. But I have a kind of dilemma:

 

- Anhedonia for me is unbearable (I barely function with it, my life stops when I have such a profound anhedonia)

- Maybe Abilify and Lamotrigine are causing me anhedonia (specially abilify I think), but I have to taper it really slow (8 years taking abilify, 1 taking lamotrigine)

- Bupropion relieve a bit anhedonia and apathy(I function better with it). Specially I feel I can stand being around people, which is important for me (I live with my girlfriend)

 

My question is: Is a good idea add Bupropion while I taper Abilify? I could face anhedonia while I quit the Abilify.

Then I would taper bupropion and, as I don't have abilify, maybe I can feel pleasure again without any meds

 

 

 

11 hours ago, Altostrata said:

Do you sometimes skip taking Abilify or take it on an irregular schedule?

 

Regular schedule, 3.6mg at night right now

 

 

 

Thanks again, Alto.

 

 

[Altostrata]

Your prior history includes a period when you took Abilify irregularly, but you have been feeling better since you've been taking a consistent dose. When was the last time you had a spell of akathisia?

 

On 4/28/2021 at 1:16 AM, apple1989 said:

Also I am a bit concerned about my gums, because they have turned very dark and I think is due lamotrigine(but I don't know really). I will go to dentist next Tuesday, on May.

 

Did you ever find out what caused this symptom? You thought it might be an adverse effect of lamotrigine. Why was lamotrigine added to Abilify? What was the effect of lamotrigine when you added it?

 

What is it you want to do? You said your anxiety had increased with the addition of bupropion, as well as your energy. This makes sense, because the drug is known to be stimulating. So you have to decide whether you want this degree of stimulation. Adverse effects are dosage-related; you might wish to take a lower dosage of bupropion to avoid the anxiety. If you stay on bupropion for more than a month, you will need to taper it if you decide to go off.

 

See Tips for tapering off buproprion (Wellbutrin, SR, XR, XL)

 

If your original problem was symptoms identified as psychosis, bupropion will not help you with that.

 

You are talking about adding a drug, bupropion, to counter effects of other drugs. This is a common practice in psychiatry. Increasing the drug burden can increase risk of adverse effects such as akathisia. Please put ALL your drugs in this Interactions Checker and post the report or a link to it in this topic.

Rather than adding drugs, we would advise reduction of the drugs causing the undesirable effects (anhedonia, sluggishness).

 

Abilify is the highest-risk drug you're taking, known for causing akathisia, movement disorders (sometimes permanent), weight gain, diabetes. It would make sense to reduce that first. As you have a history of symptoms identified as psychosis, you will want to avoid unmasking those symptoms by very gradually tapering Abilify. It appears a 10% reduction was too much for you, but a 5% reduction may work better. See Tips for tapering off aripiprazole (Abilify)

[apple1989]

1 hour ago, Altostrata said:

You are talking about adding a drug, bupropion, to counter effects of other drugs. This is a common practice in psychiatry. Increasing the drug burden can increase risk of adverse effects such as akathisia. Please put ALL your drugs in this Interactions Checker and post the report or a link to it in this topic.
 

 

Thanks Alto, I think I am going to stop bupropion. Today for example I have felt really anhedonic so I think it's not worth it.

Anhedonia is bad, but akathisia is the worst condition I've ever faced.

1 hour ago, Altostrata said:

Your prior history includes a period when you took Abilify irregularly, but you have been feeling better since you've been taking a consistent dose. When was the last time you had a spell of akathisia?

 

Two months ago, at first week of July 2021

 

1 hour ago, Altostrata said:

If your original problem was symptoms identified as psychosis, bupropion will not help you with that.

It give me a bit of energy. But I am seriously thinking about stopping it, because the difference doesn't worth and I am afraid of enhacing the side effects of Abilify

[apple1989]

1 hour ago, Altostrata said:

Did you ever find out what caused this symptom? You thought it might be an adverse effect of lamotrigine. Why was lamotrigine added to Abilify? What was the effect of lamotrigine when you added it?

 

 

Eventually I found out this symptom (dark gums) was a different problem. Now it is solved after going to dentist.

 

Thanks again Alto

[Altostrata]

On 8/22/2021 at 2:08 PM, apple1989 said:

Two months ago, at first week of July 2021

 

Did you get the symptoms of akathisia when you increased Abilify from 2.9mg to 3.2mg or 3.6mg?

[apple1989]

7 hours ago, Altostrata said:

 

Did you get the symptoms of akathisia when you increased Abilify from 2.9mg to 3.2mg or 3.6mg?

No, I didn't.

 

I am at 3.6mg Abilify for about month and a half and I didn't experienced akathisia.

 

Nice question, because I experienced it in a trip to the south of spain to see part of my family (there weather is hotter and with more humidity). Maybe I've experienced anxiety due changing my routines or even a withdrawal symptom from Abilify, as I was lowering it.

 

Anyway, I would like to taper Abilify, but I have to do it really slow. My girlfriend says that when I do changes I seem very irritable.

 

It is possible a 10% in a month too fast? even going to 3.6mg to 3.2mg? In that case, It will take me years to get ridd off Abilify.

 

Next try maybe 5% in a month, or 10% every two months? or maybe 5% in two months? 

 

What will you try Alto, what is your experience? Better reduction in percentaje or spacing it more time?

 

Thanks again.

 

 

[Altostrata]

17 hours ago, apple1989 said:

It is possible a 10% in a month too fast? even going to 3.6mg to 3.2mg?

 

Yes, it's possible a 10% reduction is too much for you. You might do better with smaller reductions. Once you find what kind of reduction you can tolerate, you might be able to make small reductions a little more frequently than once a month. 

 

Try not to worry about how long it will take, you should feel better as the dosage decreases.