Dodging Abilify

If you are interested in a physician's help but do not want to take a specific medication or class of medications, things will get a bit more complex, but you should eventually be able to find a specialist who will work within the confines of your requests. However, limiting your treatment options in this way is hopefully not done lightly. Most of the medications that we have to offer do nothing for most people who take them. Abilify is one example, but it's not really unique in this way.

If you are interested in a physician's help but do not want to take a specific medication, yet your physician is insistent, it's not helpful to lie to your physician to get out of it. I think it would make sense to seek a second opinion or transfer your care to someone with whom you can negotiate, rather than lying about trying a medication. What's worse (for you) is that when you've finally had enough of this physician's lack of success and you move your care elsewhere, your new physician will think you have already tried a medication that you have not in fact tried, and so they will form an incorrect view of what did and did not work for your condition.

In sum, be honest with your doctor about what you suffer, what you take, and what you want; if you feel that you cannot negotiate honestly with your doctor, keep looking until you find someone with whom you are willing to be open.

It did snow me, it made me depressed, in addition to not working while at work (or socializing at all) I would either leave work or hide in a conference room.

Normally the thing to do obviously is discontinue the drug and try another, but it's during these states, at least for me, that one loses focus, self-perception and the nerve and inclination to resolve the situation.

Your doctor might argue that what you're feeling is actually normal, what everyone else feels, and you just feel lousy because you're not manic as you had delightfully been before. Just give it three weeks, he says.

Maybe he's right, maybe he's not; maybe he doesn't want to deal with trying a different drug at least for a few more weeks to get you to calibrate to the one you don't like. But he's got an advantage in that debate which is that you are chemically subdued. Challenge him and put up a fair fight before letting yourself become convinced one way or the other. You might reach a compromise that works better, like sticking with the drug but at a lower dose.

Eventually my shrink put that together and we subbed in another atypical antipsychotic, Zyprexa, which, though like Abilify good for some people and bad for others, and risky, gets the job done, along others in the cocktail, nicely for me.

So when starting a drug, especially a neuroleptic or an antimanic, try to remember to be aggressive in monitoring yourself and be vocal when articulating what you think are your negative side effects stemming from the new drug. Don't just show up to your next session and say you're doing fine when you're not, even though a depressive spell makes that a tempting thing to do.

And for the rookies, in addition to the above, if you find yourself reluctant to complain about any new drug that has a sexual side effect like impotency or no libido, for God's sake, snap out of that and tell your doctor, otherwise you will not only not resolve those problems but you risk conditioning yourself to distrust medicine and psychiatry which can lead to noncompliance and possibly your downfall.

It takes some time, but if you're motivated and smart about it, you've got a good shot at rescuing your captured soul from manic depression, and without killing your soul, or yourself, in the process.

@carbocation: "If you are interested in a physician's help but do not want to take a specific medication or class of medications, things will get a bit more complex"

You don't understand the pressure the doctors are under to prescribe these things. A few years ago I was bit by a tick and a few months later I developed severe problems because of that tick bite. One of the problems was that my heart would sometimes race. The doctor put me on antibiotics to deal with the bacteria from the tick bite, but the doctor said I also had to take Paxil. I asked, why would I need to take Paxil to deal with a tick bite? She said the racing heart indicated anxiety, which needed to be treated. I said, if the bacteria causes anxiety, won't that antibiotics resolve that? She said yes, but in the short term I needed to take Paxil. I asked, if the problem is assumed to be resolving in the short term, and the episodes rare, isn't this a classic use-case for something like Atavan or Klonopin? We discussed it for a long time, and we went round and round in circles, but in the end she made clear that her decision in this matter was final: my choices consisted of taking Paxil or finding another doctor. Since this woman was a well known specialist in treating the kinds of bacteria that one can pick up from tick bites, I decided to take the Paxil. But it struck me as absurd then, and now, that I had to take Paxil to deal with a tick bite.