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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4612
Experience:  MD Psychiatry
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Hi Dr, im on 45 mg Remeron and 150 mg Effexor with 5 mg Abilify

Resolved Question:

Hi Dr, im on 45 mg Remeron and 150 mg Effexor with 5 mg Abilify in the am. I am also taking 3 Rivortril per day . 5 mg.
I have major depression and anxiety. Which of these meds need adjusting for late afternoon palpitations and pins and needles in my toes, also mood lifting? I have been on this combo for 3 months now. Still fragile!! Please comment. Thanks Cindy
Submitted: 5 years ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 5 years ago.

Hi there,


Welcome to Just answer !


Well, i believe there are some changes required in your drug regime...i am mentioning below some changes which you can discuss with your doctor and get them done..


1) to stop abilify , because it can cause such side effects like tingling , pins and needles and palpitations...and anyways , i wonder why abilify which is an anti psychotic drug was added in the first place , it does not have any use in your case ..


2) divide effexor 150 mg into two doses of 75 mg dose each . One 75 mg dose taken in morning and other 75 mg dose taken in the evening .


3) rivotril 0.5 mg that you are taking 3 times a day, needs to be taken 2 times a day instead of 3 times a day... as rivotril is usually taken only 2 times a day because it suits its half life.


4) The rest drugs need to be taken as it is .. no changes..


Kindly discuss this with your doctor and get it done.. Hopefully this will take care of your present symptoms while taking care of your depression and anxiety..


I hope this helps..


Wish you all the best..


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Customer: replied 5 years ago.
Hi doc, can I just stop the abilify and will dividing the Effexor slow release effect my sleep. Which is a problem. Also abilify was added to speed up the anti depressant action.
Expert:  Dr. Kaushik replied 5 years ago.

Well, if possible you shall divide the tablet of abilify 5 mg into half and take half tablet for 5 days and then stop the drug completely..


No, i do not think effexor xr 75 mg twice a day will not effect your sleep , and anyways you will be taking 0.5 mg of rivotril at night , which your will take care of sleep.In fact you may also increase the night time dose rivotril to 1 mg help in aiding your sleep.



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