View Full Version : Should I switch my AAP from Abilify to Latuda?


Warhawk
10-18-13, 03:14 PM
Hello, y'all!

Diagnosis:
[296.35] Major Depressive Disorder, Recurrent, In Partial Remission
[300.02] Generalized Anxiety Disorder
[301.13] Cyclothymic Disorder
[314.00] Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type

Yesterday, I was prescribed Adderall (#60 amphetamine salts 10mg. PO ) for the first time by my PDOC. She also prescribed me Aplenzin 522mg. (brand-name bupropion in the form of its hydrobromide salt [not hydrochloride] equilavent to Wellbutrin XL 450mg.) that I've had before and well-tolerated. I was taken off it to try Pristiq. Bupropion had no side effects which is good but it might be because it didn't do anything all in the past. I've taken three doses of it, and I would assume I took a sugar pill. She says that it might be good for my ADHD, however.

Thus, I am now taking:

Abilify (aripiprazole) 10mg. for 296.35; 301.13
Adderall (amphetamine salts) 20mg. [10mg. BID] for 314.00
Aplenzin (bupropion hydrobromide) 522mg. for 314.00; 295.35
Lamictal (lamotrigine) 200mg. for 301.13
Nuvigil (armodafinil) 250mg. for 314.00
Neurontin (gabapentin) 1,800mg. [400mg. QID] for 300.02
Pristiq (desvenlafaxine) 50mg. for 296.35

The Abilify (aripiprazole) makes me gain weight. One reason, I believe, she prescribed me the Adderall and bupropion was to help counter this weight gain. We were going to try Topamax as an adjunct mood stabilizer for its weight-loss properties as well. I love Abilify, it is the most effective medicine I have ever taken, but I can't deal with the weight gain; I've made many lifestyle changes, but they can't seem to conquer the metabolic effects of aripiprazole.

I've read that lurasidone has the lowest weight-gain of the atypical antipsychotics (AAPs). From Wikipedia:

"low propensity for QTc interval changes, weight and lipid-related adverse effects ... was found to produce the second least (after haloperidol) weight gain, the least QT interval prolongation, the fourth most extrapyramidal side effects and the sixth least sedation (after aripiprazole)."

I've never gotten EP or sedation symptoms from Abilify so I'm hoping Latuda is no different. The weight loss thing sounds crucial.

We chose aripiprazole because it still allows for some endogenous dopamine due to its partial agonism which I also hoped theoretically would mean that it'd allow ADHD stimulants to work better than with other AAPs. How well does Latuda work with stimulants? I've read case reports which suggest they will be attenuated similarly to Abilify but still exert therapeutic value.

Also, according to Wikipedia:

"Lurasidone may be useful for treating the cognitive and memory deficits seen in schizophrenia ... and was found to be superior in doing this to all of the other antipsychotics examined ... Lurasidone has activity at several serotonin receptors that are involved in learning and memory, and unlike most other antipsychotics, lacks any anticholinergic effects (which are known to impair cognitive processes and memory). These properties may underlie its improved effectiveness in treating these symptoms relative to older agents."

I definitely need pro-cognitive effects since I suffer from ADHD. It also has FDA approval for bipolar I depression and I suffer from a form of bipolar depression myself.

Lurasidone even shares aripiprazole's partial agonism at 5-HT1A which is good. It seems similar in every way except that it causes less weight gain. I don't see any reason to not try it instead?

What do you guys think about anything? Thanks!

clydethompson
01-07-14, 04:04 PM
I've been on abilify but couldnt tolerate it (so I might be a bit biased) and on saphris gained 20lb in two weeks. Personally I would highly recommend trying latuda, its the gentlest AAP I have ever been on.

When I was on it in combination with amphetamines I didn't notice any decrease in efficacy, but that was long ago.

I've found it helpful for bipolar depression, I thought it was a rubbish claim at first but I went back on it and it does help.

overall its worth a try, Iv been on an entire class of drugs and then some and this is one of very few id recommend