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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by iforgotmypassword on October 26, 2009, at 15:52:07
i am having the antidopaminergic effect of just wanting to stay in bed and am extremely uncoordinated.
i am at 1mg. only for a few days. i "loaded up" with 2mg, given the long half life of the drug. i take a drug that is a 3A4 inducer, but i do not know to what degree, it has been implicated in instances of liver trouble, so i guess it may be considerable. it is cyproterone taken 50mg b.i.d., i don't know if this may change things.
Posted by shasling on October 26, 2009, at 23:07:44
In reply to slow titraters of abilify, dose benefit noted by?, posted by iforgotmypassword on October 26, 2009, at 15:52:07
I found abilify needed to be fairly slowly titrated, I went up to 10 mg and felt great.
Posted by iforgotmypassword on October 27, 2009, at 16:57:37
In reply to Re: slow titraters of abilify, dose benefit noted by?, posted by shasling on October 26, 2009, at 23:07:44
*article on 3A4 and differing aripiprazole metabolism in response to drug co-administrations below!
Thank you for your input. Unfortunately, slow titrations are quite difficult for me, as I am so low functioning, it is very hard to steadily keep taking medication at the proper rate without forgetting, losing organisation. Unless something helps me function, trials are difficult. I have some trouble with the functionning of my current medication because of it (vocal instability, trouble stopping unwanted hair growth, eerily fluctuating appearance in other ways, it is quite a severe issue for me). This medication (the antiandrogen) has since been increased partly as a result, I cannot manage a lower dose with how forgetful I am. When I forget my lamotrigine tho, I tend to lose co-ordination in a specific unsettling and exaggerated/wobbly way. It is odd, but it can remind me to take my meds.
HERE IS AN ARTICLE I FOUND THAT I FIND INTERESTING AND MAY BE OF INTEREST TO OTHER PEOPLE:
______ _ _ _ _ _ _ _ _ _
Influence of comedication on serum concentrations of aripiprazole and dehydroaripiprazolehttp://www.ncbi.nlm.nih.gov/pubmed/19142178
______ _ _ _ _ _ _ _ _ _The main quote that interested me: "Coadministration of a CYP3A4 inducer resulted in approximately 60% lower mean C:D ratios of aripiprazole, dehydroaripiprazole, and the sum of aripiprazole and dehydroaripiprazole (P < 0.05, P < 0.01, and P < 0.01, respectively)."
Lamotrigine, and other meds/factors, are also mentioned.
I think I will go to 5mg, and quit focusing on 1-2mg. So many variables though, these are tough decisions. Further, I may switch antiandrogens from cyproterone to spironolactone, which while I understand is still an inducer, I am taking a guess, it should be less so (basing this on my assumption that there is a less of history of liver related crises being reported. I feel as if I probably would have heard this over the years.) So I may end up going to high relative to my "final" med setup. I suppose it will be easy to quit aripiprazole for days and note when effect seems to wane and estimate effective dose from that, or some similar strategy.
Sorry this is a bit long. I hope I made this readable to give the most accurate picture of my case, and how it may relate to others, whether someones' existing experience that they can share or someone who may as I did, find that abstact useful. I imagine many people should take it into account. I will try to find the full text.
Posted by iforgotmypassword on October 27, 2009, at 21:58:55
In reply to 3A4 inducers, finding seems very notable » shasling, posted by iforgotmypassword on October 27, 2009, at 16:57:37
Yikes. Embarrassing. Another one of my occasional jittery, long hyper-inclusive messages; but this time I seemed to make more sense. Today I was also using Adderall XR, to try and clean my place so it could pass an inspection :( , sadly I am that neglectful of myself and my surroundings, and it takes so much mental energy to get myself to throw things out. Today, I had to use 2x the dose to get myself meaningfully doing things. Still, may be a bit more "focused" and less crazy when taken with aripiprazole, though it may just be mostly an NRI in this case? I figure that may be the case as most autoreceptors are already being stimulated; do D2/3 account for most or all dopamine autoreceptors, or not at all?
This is the end of the thread.
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