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Dr_Anderson
Dr_Anderson, Doctor
Category: Mental Health
Satisfied Customers: 335
Experience:  Psychiatrist
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I was diagnosed with a psychosis - a title i hate. I have been

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I was diagnosed with a psychosis - a title i hate. I have been on sulpiride for over 15yrs due to a high prolactin level I was advised to try abilify - I have been taking this medication for 10 weeks now dose increased to 20mg but I still feel it does not work as effectively as the sulpiride 200mg at controlling feelings of sensitivity and my functional and confidence levels. the plus side is with the abilify I have lost a stone in weight and my breasts feel a lot better. this has helped with my body image issues. I just dont know if after 10 weeks it is long enough to make a decision on its effectiveness and if tweaking the dosage further could help? The other problem is on the abilify i suufer with broken sleep managing approx 7hrs in a 4hr and 3hr split sleep. I would appraciate advise re what i should expect from this medication at this point. Thanks.

Dr_Anderson : Greetings, and thank you for your question.
Dr_Anderson : Typically for Abilify, you will see therapeutic effects within a few weeks, so 10 weeks is long enough to tell if the 20 mg is strong enough. Given the side effects have been much
Dr_Anderson : more tolerable on the Abilify, it sounds like a good fit. So, trying a higher dose, up to 30 mg, would be reasonable.
Dr_Anderson : For the sleep, try either breaking the dose up into twice daily, or switch it to a different time of day (like morning to night or. Vice versa)
Dr_Anderson : If the increase of the dose does not seem to control your symptoms after about 8 weeks, it may be necessary to switch to a different agent. Given the side effects you have had from your other medication, I'd consider Latuda or Saphris. Latuda is not very sedating, and is only once daily dosing. Saphris can be taken once pe day but it is meant to be taken twice daily. It also tends to be sedating.
Dr_Anderson : As for the diagnosis itself, I'm sorry it has give
Dr_Anderson : given you troubles. On one hand, it feels bad to have a "label" put on you. You are a person, after all, not a diagnosis!
Dr_Anderson : On the other hand, what I like to tell my patents is who cares what we call it, as long as you get and stay well. So, for you, hopefully the Abilify will do what it needs to to control your symptoms. But if not, the above options would be reasonable to try.
Dr_Anderson : Best wishes to you, and please let me know if I may be of further assistance! Please do not rate this until you feel your question has been answered to your need!
Dr_Anderson : Regards,
Dr_Anderson : Dr. Anderson
Customer:

Hi thanks for the info. does latuda and saphris go by another name. i like the sound of latuda i ideally want none sedating none weight gaining lower prolactin. The NHS have never mentioned these meds. I was considering a private consultation with a psychiatrist would u recommend this? as the alternatives offered by NHS Dr include queatipine and haliperodol!!


The dose of abilify has been increased over the last ten weeks to 20mg I take in the morning I tried taking the dose in the evening with no real change to my sleep pattern and felt more vunerable during the day.

Dr_Anderson and 2 other Mental Health Specialists are ready to help you
Greetings, and thank you for the follow-on questions. Sorry for the delay! I'm in a low reception area at the moment.

Latuda's generic name is XXXXX XXXXX Saphris is asenapine. From looking at the website, Latuda may not be available in the UK. Saphris also goes under the trade name Sycrest.

Quetiapine is a good medicine, but it has a wicked weight gain potential. Haloperidol is old school, still a very good medicine, but for the potential for TD. Given that you had good success with sulpiride, clozapine may also be a good option (we don't have sulpiride here "across the pond" in the U.S.). It is actually the "gold standard" in the atypical class. The down side is frequent blood monitoring (weekly for the first 6 months, then every 2 weeks for the next 6 months, then monthly thereafter). Given these options, it sounds like a second opinion may be in order!

Since you have tried the Abilify all at once, I'd consider splitting the dose (10 mg a.m., 10 mg p.m.) and see if that helps with your sleep, especially if you go up to 30 mg daily.

Hope this helps! Please let me know if I may be of further service.

Regards,

Dr. Anderson
Customer: replied 4 years ago.

Since changing the medication over ten weeks ago I still feel functionally less well ie able to cope than when on the sulpiride. The psyches think this is because I lack confidence in the abilify and due to the length of time I was on sulpuride. I have been off work almost 3 months and time is precious realistically how much longer should I give this medication so that a) i feel functionally well and b) most importantly feel able to do my work? One thing I have noticed about the abilify is I am more anxious.


i would also like to ask is abilify a commonly used med in the US?

Greetings!

Typically, 12 weeks at any dose is good enough a period of time to tell if it will be helpful. This does not necessarily mean the medicine has reached its peak effectiveness in that time, but it does give the medication enough time to "declare" if it will be helpful. For example, if it is the 3 month mark and a person notes no significant change with their new medication, it is safe to say the new medication is not going to be of benefit.

Abilify, as an atypical agent, is fairly commonly used in the U.S., and so is Zyprexa (olanzapine), Seroquel (quetiapine), Risperdal (risperidone), and to lesser degree Geodon (ziprasidone), Fanapt (ilioperidone), and Invega (paliperidone).
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