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Abilify and energy

Discussion in 'General Treatment' started by erist, Dec 6, 2012.

  1. erist

    erist

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    Recently, I decided to try a very low dose of Abilify (.5-1mg/day as opposed to "standard" a/d dose of 5mg/day or anti-psychotic dose of 30mg/day) as an augment to the (useless) SSRI I have been on for a number of years trying to get at the fatigue and the depression.

    (Not going to wade into the mental health/ME entanglement debate here -- suffice to say I think mind/body/spirit are all connected and that in me at least, there is some connection between the fatigue and the depression, though it remains a bit mysterious).

    Overall it has been the first thing other than the Methylation Protocol that I have noticed an immediate effect from (both good and bad) and very similar effects as well -- more energy, more appetite, much easier time getting up in the morning but also a lot of restless agitation, the wired/tired feeling, a general feeling of vibrating internally, burning skin, etc. Certainly the only psych drug that has ever had a dramatic effect on any of my symptoms.

    Note: I do not think that a response to psych drugs "proves" anything one way or another - undoubtedly there are nuero/immune issues going on for many people with ME and some psych drugs can effect those id both good and bad ways. (I'm also well aware that the AAPs are playing with fire in a way b/c of their metabolic effects, evidence for possible long term cognitive impairments, tardive dyskenisia, etc - but at this point I am searching for anything that helps, and I am quite comfortable using a very low dose)

    In any case, my pdoc rolls here eyes a bit and thinks maybe I am having a bit of a placebo response, but she also trusts me, so is willing to let me experiment. I am interested in exploring how/why Abilify seems to have very similar effects on me as the methylation protocol, and providing a place for anyone else that has tried aripiprazole to talk about effects.
  2. ukxmrv

    ukxmrv Senior Member

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    The test would be if the drug lasts for the long term or if it causes PEM and collapse.

    There have been several drugs that I have had that give that uphyped feeling which I call "false energy". I don't think that this is related to a mind/body debate at all except that it may have an effect on neurotransmitters that make you feel overstimulated.

    Steroids like Predislone give me that effect, Lyrica as well, I remember the "buzzing" energy from Amantadine.

    However, the big test for me is not that they stimulate us, but what happens with the stimulation. For me every single drug that has done this has caused a huge crash with PEM and then the stimulating effect wears off. We could all dose up on amphetamines, drink loads of coffee and use other means to force stimulation for a while.

    What is the difference between your PEM before and after the drug?

    How long have you been on that dose?
    GCODT likes this.
  3. erist

    erist

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    It is still relatively new. I have only been on it about a week and a half. My PEM has greatly improved over the past few years, unless I do something that trashes my nervous system like weightlifting. (or sometimes randomly for other reasons as well) I have not pushed it to test it. I don't even know if I will stay on it because the restlessness, even at this dose, is quite annoying. My biggest fatigue symptom is feeling like I am swimming up from the bottom of a dark loagoon every morning and taking multiple hours to be able to get out of bed many days. I am /not/ pushing it as a miracle drug, it's expensive and it's dangerous. Just noting an immediate effect that I've never had with anything else I've tried (except the methylation stuff)

    Provigil is the only other thing that has ever helped my mornings, but it was still too ampethamine-like for me (made me feel wired and gross) and didn't increase my capacity for sustained activity at all, or keep me from napping many days. (Interestingly enough, I have napped every single day since I started Abilify, after going a few months without needing any, but it has def increased energy in the non napping parts of the day! Also increased sense of taste, desire to do things, and giving me cigarette cravings when I haven't smoked in 3.5 years - dopamine, meh.)
  4. Hip

    Hip Senior Member

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    I have just ordered some Abilify (aripiprazole) myself, and when it arrives, will try a dose of 1 to 2 mg daily to see how it helps with my ME/CFS symptoms.

    I found one review of Abilify for ME/CFS here, where the ME/CFS patient took 2 mg of Abilify daily, and said this:

    "Abilify brought me back to life. I was so sick and within a week I was feeling worlds better. I can not even describe how much it had helped me. No side effects."​

    This sounds very promising.

    I already have a high opinion of atypical antipsychotic drugs used for ME/CFS treatment, as I have had good results from the atypical antipsychotic drug named amisulpride. I have been taking amisulpride for a year now, at daily doses of 12.5 to 25 mg.

    I find amisulpride boosts energy, reduces noise sensitivity, improves sociability, improves mood, reduces irritability, reduces anxiety, and treats anxiety psychosis symptoms (anxiety psychosis can arise if you have extreme anxiety disorder). I started a thread on amisulpride for ME/CFS here: Amisulpride — A Multipurpose Drug for ME/CFS.

    Anyway, when my Abilify arrives, it will be interesting to compare its benefits to those of amisulpride.

    These two drugs may even work well together (especially as amisulpride raises levels of the hormone prolactin, which is undesirable; but Abilify lowers prolactin, so this should nicely cancel out).

    It is interesting that you say Abilify makes you restless; I find that amisulpride at higher doses makes me feel content, but unfortunately a little inert: that is to say, amisulpride has the effect of reducing my motivation and reducing my focus on doing things.


    By the way: I would not worry about the fact that your are using an antipsychotic drug (in terms of the mental health ME/CFS debate). Atypical antipsychotics are not just used for psychosis and schizophrenia: atypical antipsychotics are also used off-label for other conditions, such as: depression, ADHD, anxiety disorder, bipolar disorder, PTSD, OCD, dementia, etc (reference: here).

    Atypical antipsychotic drugs alter levels of neurotransmitters in various part of the brain; the only thing that really matters is whether the changes these drugs make to neurotransmitter levels translates to a benefit for ME/CFS patients; it is of no importance at all that these drugs are labelled as antipsychotics — that is just part of their function.

    In any case, the doses of these drugs used for ME/CFS treatment are much, much smaller than the dose used for psychosis and schizophrenia.
  5. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    Hip, thats cool if it helps i think go for it.

    I dont know much about that drug but is it suppose to be somewhat activating??

    In general that class of drug is generally sedating??

    Abilify has a long half life 75hrs, could it be used every few days?

    Looking into it on wiki it appears to agonise dopamine which can help lift mood and energy. seroquel is in the same class of meds but it supposedly antagonises some of the dopamine receptors which give it sedating affects. The pharmacology of these meds is hard to work out, i think one has to try them and find out, would be the only way?

    I agree these antipsychotic meds can be used other ways, and they should be called dopamine agonist/antagonists not antipsychiotics. I think its another way the psychobabblers can try to turn what they do into science.

    I occassionally use a very low dose of seroquel for sleep 25-50mg and its commonly prescribed off label for chronic severe insomnia. it does help with that but on its own it does make sleep slightly irritable(cant find the right word for it) with vivid dreams nothing bad just sort of like day dreaming not quite deep enough. I find adding a very small amount of valium to this helps alot with this and i sleep really well.

    I think one has to look past the name of the meds and look at its pharmacology just like 5htp or tryptophan as psychobabblers would call them antidepressants by the way they work? I would prefer to call it neurological medicine not psychiatric medicine.

    keep us updated on how u go,
    good luck.
    luv the cfs/me road map, great work.
  6. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    That feeling u describe of trying to get up out of bed and swimming up from the bottom of the lagoon, sounds alot like adrenal fatigue. It would be interesting to see what your morning cortisol level is?
    I still wake up like this in the morning, i roll over and put pregnenolone cream on which helps raise cortisol levels as well as other hormones. After a short lie in i seem to be ontop of the lagoon swimming along.

    cheers!!
  7. Hip

    Hip Senior Member

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    I guess with Abilify's 75 hour (= 3 day) half life, the effects of an Abilify tablet is going last for say up to 2 days, then tailing off slowly. So it would be a good idea to start with low doses when you first try Abilify, in case there are any adverse effects and symptoms, as these adverse effects will be lasting for several days due to this exceptionally long half life.

    I am actually very pleased with the atypical antipsychotic I am currently taking, amisulpride. But it always worth trying another similar drug like Abilify, just in case it works better still.

    I am taking such a low dose of amisulpride (12.5 mg daily — a ¼ of a 50 mg tablet), that there is very little in the way of unwanted side effects, and plenty of very useful benefits and advantages, including a nice mood boost from amisulpride, and noticeably more energy.

    The only slightly negative effects I get from amisulpride are a bit of restless sleep, and more vivid dreams, just like you with Seroquel (quetiapine); but this only happens if I take amisulpride later in the day. If I take amisulpride in the morning, my sleep at night is absolutely fine. The other negative side effect I have found with amisulpride is a slightly loss of motivation, but this is nothing serious. And you can always stop taking amisulpride for a while whenever you want, and your normal motivation will return.
  8. Hip

    Hip Senior Member

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    Interestingly, though, I find amisulpride increases my social motivations; that is, amisulpride increases my desires to engage in social activity.

    I find that it it not just the fatigue of ME/CFS that draws you away from socializing; there seems to be an increased need for peace and solitude in ME/CFS, with too much social activity perturbing the mind. I sometimes feel my mind has been almost "mentally raped" after too much social activity. I think this feeling of being "mentally raped" is actually caused by a weakened "mental firewall" — that is to say, a weakness in the mind's sensory stimuli filter, which allows stimuli to enter into consciousness, when they really should have been filtered out. This weakened "mental firewall" I think is also the reason for noise sensitivity in ME/CFS.

    I am pretty sure this "mental firewall" itself is located in the reticular formation of the brainstem. The reticular formation's functions are known to include filtering out irrelevant or repetitive stimuli, so that the rest of the mind is not overloaded with unnecessary information. So for example, for a normal healthy person, if they hear a car alarm go off in their street, at first this noise rouses their consciousness attention, but then they soon forget about it, and after a few minutes, it does not enter consciousness anymore. This filtering out is called habituation, and is the reticular formation's "firewall" springing into action, and blocking irrelevant, repetitive stimuli from reaching consciousness and thereby overloading the brain.

    However, I find that in ME/CFS, repetitive noises such as car alarms are constantly aggravating, because you do not seem to habituate to the noise, and so the noise continually deeply penetrates into your conscious mind and becomes unpleasant; this repetitive noise is not properly filtered out by your "mental firewall".

    I suspect a weakened reticular formation "firewall" is the norm in ME/CFS, and this leads to the feeling of being overwhelmed or "mentally raped" when exposed to too many stimuli, as you tend to get in hectic social situations. These stimuli are penetrating deep into the mind, whereas they should have been stopped by the "firewall", stopped by the brain's bouncer at the door: the reticular formation.

    Anyway, what I have found is that amisulpride seems to make this "mental firewall" stronger, so that you are more able to cope with the maelstrom of social environments; and with amisulpride I find that sounds and other sensory stimuli are not so mentally intrusive.

    It will be interesting to see if Abilify has the same beneficial effects.
  9. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    Sorry hip i thought u were taking abilify, but its amisulpride?
  10. Hip

    Hip Senior Member

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    I am currently taking very low dose amisulpride (and have been taking it for a year now), but I have also ordered some Abilify to try.

    Both these two drugs are atypical antipsychotics, and both seem to be of benefit in ME/CFS. SInce I am getting good results with amisulpride, I decided to try Abilify as well, to see what this has to offer. I will report my results when my Abilify drugs arrive, and I have had a chance to test them. Soon I will be an expert on using atypical antipsychotics for ME/CFS!

    If you want to read about my experiences with very low dose amisulpride, see my thread here.

    I would particularly recommend amisulpride for ME/CFS if you have anhedonia depression as a comorbid condition to your ME/CFS (which I have). Amisulpride is very helpful for treating anhedonia.
    heapsreal likes this.
  11. erist

    erist

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    Well I went off the abilify to better test what it was doing and about a week later I started being unable to get out of bed in the morning for many hours (2-3 usually) again. I went through like a week of that (amazing how QUICK I got used to being able to get up in the morning again, even after many years of not) and now added back in Abilify at .5mg a day. Currently having startup restlessness, hope it stabilizes into better wakefulness soon. It truly has effected me more than any other thing I've tried other than methylation, and at such a small dose (5mg is considered the low dose for depression and I am doing 1/10th of that).

    Other things of note: anhedonia better on it, orgasms blunted but pretty much eliminated the terrible post-orgasm faitigue/flu I usually get, will check back in once I am at a steady state dose and start up effects have diminished to se if I am still getting good effects from it.

    As a sidenote, my partner was interested in what a small dose of it would do to a person that didn't have fatigue issues and she took up to 2mg a day for 2 weeks and felt nothing except slightly increased appetite (and even that was questionable) - no good or bad effects from it. (I'm nearly 100% sure that ANYONE would feel a higher dose of any of the atypicals though. I use conventional doses of seroquel about 3-4 times a year for breakthrough terrible panic and insomnia and it feels similar to getting hit upside the head with a very large baseball bat)

    I don't think there is much risk of tardive dyskinesia or metabolism issues at such a low dose, but it should be noted that these are /not/ benign drugs. TD and diabetes are not side effects to play with.
    Hip likes this.
  12. erist

    erist

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    After 4, 5? months of pretty good eneger I hit a crash and am currently in it. Tired for past 2-3 weeks. POTS flaring. Etc. Could just be stress. Could be because there was an interruption in methylation protocol. Bumping up abilify slightly to see if it helps. Anyone else found this thread that is trying AAPs for energy?

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