![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Alexanderfromdenmark on November 19, 2009, at 4:58:13
SLS
what are the appropiate dosages for abilify to treat the negative symptoms of scizophrenia?
Posted by SLS on November 19, 2009, at 5:51:55
In reply to Abilify for anhedonia, posted by Alexanderfromdenmark on November 19, 2009, at 4:58:13
> SLS
>
> what are the appropiate dosages for abilify to treat the negative symptoms of scizophrenia?That's a great question. The dosages most commonly used for schizophrenia are between 20-30mg. However, that includes positive symptoms. If one is treating depression, 5-10mg is probably more appropriate. If one is treating symptomatic schizophrenia, and no other antipsychotics are on board, I would start Abilify treatment at 20mg without titrating. Then, you could attempt to lower the dosage to 10mg once symptoms are well controlled. This is how the doctors I know have utilized Abilify.
- Scott
Posted by Alexanderfromdenmark on November 19, 2009, at 10:18:20
In reply to Re: Abilify for anhedonia » Alexanderfromdenmark, posted by SLS on November 19, 2009, at 5:51:55
Does Abilify increase dopamine transmission in those dosages?
Posted by conundrum on November 19, 2009, at 13:47:36
In reply to Re: Abilify for anhedonia, posted by Alexanderfromdenmark on November 19, 2009, at 10:18:20
Hey alexander, Its me Meta, I answered your post on the neurotransmitters board with my new username, I dont' know whether you saw this or not. Sorry for being off topic.
Posted by desolationrower on November 19, 2009, at 21:45:26
In reply to Re: Abilify for anhedonia » Alexanderfromdenmark, posted by conundrum on November 19, 2009, at 13:47:36
a DA agonist seems like it would make more sense unless you have psychosis on board
especially since aripiprazole is super $$
-d/r
Posted by SLS on November 20, 2009, at 4:58:28
In reply to Re: Abilify for anhedonia, posted by desolationrower on November 19, 2009, at 21:45:26
> a DA agonist seems like it would make more sense unless you have psychosis on board
>
> especially since aripiprazole is super $$
>
> -d/rThe only problem with that is that most people develop a tolerance (poop-out) shortly after beginning DA agonist treatment. I don't know, but perhaps there is a downregulation of presynaptic receptors. Using low-dose amisulpride would probably solve that problem, though. Low-dose Abilify might work as well. That would be an interesting combination. I have never seen it done.
- Scott
Posted by SLS on November 20, 2009, at 8:30:20
In reply to Re: Abilify for anhedonia, posted by SLS on November 20, 2009, at 4:58:28
On second thought:
> > a DA agonist seems like it would make more sense unless you have psychosis on board
> >
> > especially since aripiprazole is super $$
> The only problem with that is that most people develop a tolerance (poop-out) shortly after beginning DA agonist treatment.This seems to be true.
> I don't know, but perhaps there is a downregulation of presynaptic receptors.
This happens, but it is probably not the mechanism behind the "poop-out" effect. I guess downregulation at the postsynaptic makes more sense.
> Using low-dose amisulpride would probably solve that problem, though. Low-dose Abilify might work as well. That would be an interesting combination. I have never seen it done.
I'm thinking that this might still be a good strategy to employ when using a DA agonist. It would prevent the reduction in DA turnover that occurs with these drugs.
- Scott
Posted by desolationrower on November 20, 2009, at 17:14:28
In reply to Re: Abilify for anhedonia, posted by SLS on November 20, 2009, at 8:30:20
my guess is the initial effects aren't the same as the chronic benefits
-d/r
Posted by Conundrum on August 27, 2010, at 6:22:23
In reply to Re: Abilify for anhedonia, posted by SLS on November 20, 2009, at 8:30:20
I've been on abilify for a couple weeks around 2.5 mg. It makes me want to get things done but doesn't seem to help with anhedonia. That is, I get things done, but I don't really like doing them. I even play music but don't really like it that much. It also does not help with concentration. Its like a cup of coffee that lasts 24 hours and makes me wake up at the a$$crack of Dawn.
It seemed to help a bit more when I was on 45 mg mirtazapine. My pdoc wants me to stop mirtazapine since it didn't work that well on its own and since both drugs can cause weight gain. It just takes longer for abilify to do that.
Maybe a higher dose will help, or adding something like selegine would help since I'm not BP. Seems like there is a missing adrenergic component. Abilify is one of the AAP that doesn't increase norepinephrine in the PFC. The reason I suspect an adrenergic deficieny is that I found pristiq increased, for awhile, colorfulness in the world and sexual sensitivity, where normal SSRIs make both worse.
I am grateful that abilify is making me want to do more things. My room is getting cleaner and my finances are more in order. I wonder how cymbalta would be?
Posted by SLS on August 27, 2010, at 7:00:17
In reply to Re: Abilify for anhedonia, posted by Conundrum on August 27, 2010, at 6:22:23
> I've been on abilify for a couple weeks around 2.5 mg. It makes me want to get things done but doesn't seem to help with anhedonia.
This has been my experience as well. I have taken Abilify up to 20mg and still have the same degree of anhedonia.
I didn't know that Abilify did not increase PFC activity. Where can I find out more about this?
Thanks.
- Scott
Posted by Conundrum on August 27, 2010, at 7:37:43
In reply to Re: Abilify for anhedonia » Conundrum, posted by SLS on August 27, 2010, at 7:00:17
It does increase dopamine in the PFC but not norepinephrine, unlike some other antipsychotics like olanzapine. I think both NE and DA are necessary to combat anhedonia. Just my opinion. Seroquel might be better, since its metabolite, nor-quetiapine, is a norepinephrine is a reuptake inhibitor.
Here is more info on abilify's PFC effects.
http://www.ncbi.nlm.nih.gov/pubmed/16023290
Aripiprazole increases dopamine but not noradrenaline and serotonin levels in the mouse prefrontal cortex.Zocchi A, Fabbri D, Heidbreder CA.
Centre of Excellence for Drug Discovery in Psychiatry, GlaxoSmithKline Pharmaceuticals, Neuropsychopharmacology, Via A. Fleming 4, 37135 Verona, Italy. alessandro.a.zocchi@gsk.com
AbstractAripiprazole, a novel atypical antipsychotic drug, can significantly increase dopamine (DA) levels in the prefrontal cortex of rats, but only at low doses below 1mg/kg. The aim of the present work was to test the effect of aripiprazole (0, 0.1, 0.3, 3 and 30 mg/kg, i.p.) on extracellular levels of monoamines in the prefrontal cortex of freely moving C57BL/6J mice. Concurrent horizontal locomotor activity was also assessed. Aripiprazole produced a significant increase in dialysate DA levels after the administration of a low dose of 0.3mg/kg. Lower (0.1 mg/kg) or higher (3 and 30 mg/kg) doses failed to affect extracellular levels of DA. In addition, none of the doses tested in the present study produced significant changes in extracellular levels of noradrenaline (NA) and serotonin (5-HT). For the sake of comparison, clozapine (0, 3 and 10 mg/kg, s.c.) was also tested under similar conditions. Clozapine produced a dose-dependent increase in both dialysate DA and NA levels without affecting extracellular 5-HT. Locomotor activity was significantly decreased by both clozapine and aripiprazole. These data further support the hypothesis that selective activation of dopaminergic neurotransmission in the prefrontal cortex may contribute to the therapeutic efficacy of aripiprazole.
PMID: 16023290 [PubMed - indexed for MEDLINE]
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.