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Abilify- Stanford Clinic Patients

leokitten

leokitten

Senior Member
Messages
1,595
Location
U.S.
Martin aka paused||M.E. said:
What could be the benefit? Less side effects? Long live?
Click to expand...

No benefit other than achieving a lower steady state concentration of drug compared to 0.25 mg/day without reducing the dose anymore. 0.25mg is likely the smallest dropper dose that can be reliably measured.

So 0.25 mg/48 hrs will result in a lower steady state concentration compared to 0.25mg/24 hrs.
 
Martin aka paused||M.E.

Martin aka paused||M.E.

Senior Member
Messages
2,291
leokitten said:
No benefit other than achieving a lower steady state concentration of drug compared to 0.25 mg/day without reducing the dose anymore. 0.25mg is likely the smallest dropper dose that can be reliably measured.

So 0.25 mg/48 hrs will result in a lower steady state concentration compared to 0.25mg/24 hrs.
Click to expand...
Thank you!
 
R

RL_sparky

Senior Member
Messages
379
Location
California
Apologies if already posted.
https://med.stanford.edu/content/dam/sm/dbds/documents/data-studio/abstract.20201118.pdf

" In a retrospective study, we reviewed the medical records of 101 patients who met the criteria for an ME/CFS diagnosis according to three separate case definitions (Fukuda, CCC, and IOM) and who received off-label Aripiprazole. Medical records were included for individuals evaluated in the clinic at least twice, representing periods before and after the use of the medication. The age range was from 18 to 84 years old (mean 51 y), with a gender distribution of 67% female and 33% male, and the duration of illness was from 1 to 54 years (median 10 years). The daily oral dose of Aripiprazole ranged from 0.2-2.0 mg/day (mean 0.94 mg/day). During each clinic visit, patients were asked to rate their symptoms on a scale of 0-10. Of the 101 patients taking Aripiprazole, 75/101 (74%) experienced an improvement in one or more categories: fatigue, brain fog, unrefreshing sleep, and frequency of post-exertional malaise (PEM) episodes. Twelve individuals (12%) had no observable difference in symptoms at the maximum dose of 2 mg, and 14 individuals (14%) reported worsening of symptoms or onset of side effects that led to discontinuation of the drug. These results suggest that Aripiprazole may effectively reduce symptoms of ME/CFS and warrants further investigation in a randomized clinical trial. "
 
JES

JES

Senior Member
Messages
1,323
As has been pointed out before, Abilify has somewhat unusual pharmacodynamics in that it acts as a partial agonist of D2 receptors and it seems this is the case especially at lower dosages. This makes me wonder if the dosage could also be the key to avoid the loss of effect phenomenon.

Because of the long half-life, the effect from a decrease/increase in dosage would take quite a while to show up. Let's say Abilify stopped working a couple of weeks after the last increase of dosage, could it be that it actually stopped working because the steady-state concentration became too high for it to be effective for ME/CFS? It may be a bit of a long shot, but it seems to me like a possible hypothesis.
 
Martin aka paused||M.E.

Martin aka paused||M.E.

Senior Member
Messages
2,291
JES said:
As has been pointed out before, Abilify has somewhat unusual pharmacodynamics in that it acts as a partial agonist of D2 receptors and it seems this is the case especially at lower dosages. This makes me wonder if the dosage could also be the key to avoid the loss of effect phenomenon.

Because of the long half-life, the effect from a decrease/increase in dosage would take quite a while to show up. Let's say Abilify stopped working a couple of weeks after the last increase of dosage, could it be that it actually stopped working because the steady-state concentration became too high for it to be effective for ME/CFS? It may be a bit of a long shot, but it seems to me like a possible hypothesis.
Click to expand...
As I said before, I was on 4mg for months without changing the dose
 
J.G

J.G

Senior Member
Messages
162
JES said:
As has been pointed out before, Abilify has somewhat unusual pharmacodynamics in that it acts as a partial agonist of D2 receptors and it seems this is the case especially at lower dosages. This makes me wonder if the dosage could also be the key to avoid the loss of effect phenomenon.
Click to expand...
This is correct. Abilify was originally developed to treat illnesses characterised by dopaminergic excess, such as schizophrenia. Standard doses of Abilify (15-30mg) block "dopamine receptors strongly enough to bat away the excess dopamine that causes psychosis". (See here.) The situation in MECFS is the opposite in that signs point to a continual dopamine shortfall due to impaired synthesis. We don't need to "bat away excess dopamine". Microdose Abilify may be enough to get the partial agonism we're after that helps normalise D2/D3 signalling.

I think it's natural for pwME to try and crank up the dosage when Abilify seems to work, hoping that more of it will lead to even bigger improvements. But dopaminergic dysregulation is just one aspect of ME pathophysiology, so I think the gains are capped. Stanford's conservative dosing regimen may be designed to prevent adaptive tolerance while staying in the / our (optimal?) partial agonism window.
 
Last edited:
Butydoc

Butydoc

Senior Member
Messages
790
leokitten said:
No benefit other than achieving a lower steady state concentration of drug compared to 0.25 mg/day without reducing the dose anymore. 0.25mg is likely the smallest dropper dose that can be reliably measured.

So 0.25 mg/48 hrs will result in a lower steady state concentration compared to 0.25mg/24 hrs.
Click to expand...
A tuberculin syringe that has 0.1 cc increments can easily be used for small increments. I started with 0.1cc and increased to 0.2cc without difficulty.
 
leokitten

leokitten

Senior Member
Messages
1,595
Location
U.S.
Butydoc said:
A tuberculin syringe that has 0.1 cc increments can easily be used for small increments. I started with 0.1cc and increased to 0.2cc without difficulty.
Click to expand...

Sorry, I should’ve stated with the dropper provided with the oral solution there are markers for each 1/4 ml but less than that might be difficult to get the same everyday.
 
JAH

JAH

Senior Member
Messages
497
Location
Northern California
hmnr asg said:
And is such a low dose actually helping? how long have you been taking it? could you please share a bit of your experience with this dose of abilify?

Thank you!
Click to expand...

I really don’t have much to offer- just been on the medication for a week.
Been poring over this thread, because I knew I had chance to try it and just wanted to chime in about the dosage, since there were some questions about that.

my case is severe, so it’s not easy for me to read or post. But when I can, I will update folks on how I’m doing, and thanks so much to everyone who has shared their experiences with Abilify. I’ve learned so much from you guys!

J
 
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