Have any of you had experience with switching from Abilify to Seroquel?

For those with limited time, etc., please feel free to skip the background info and pick up on the paragraphs below the last set of double lines



Briefly, our 16yr old (PDD-NOS) had been placed on Abilify for 2 and one-half years when he becoming very irritated and angry. The first time he was placed on it, it was in conjunction with Luvox. At first, things improved for quite some time, but as the Luvox began reaching close to therapeutic doses (and they did a very slow titration, can't fault them for bringing it up too fast), he began manifesting, what I would call, disinhibition - something we'd only see with SSRI's. The odd, inappropriate and totally-uncharacteristic behaviors began spilling over at school and we withdrew him from all medications.

His PsyMD had warned that the return of the anger would probably have us to return DS to the Abilify, which it did.

He was on it for 2yrs or so without any mood stabilizers and it seemed to work well, for the most part. Saw no side effects, to speak of, till the end.

It was decided to take him off the Abilify for a number of reasons, the primary one being what I suppose would be the onset of a type of impulsivity (becoming manic-like about those things he impulsively decides to do), which has become debilitating.

Trileptal was tried unsuccessfully during the period of a very slow reduction of the ariprozole over the course of the summer, before the Seroquel was started a few weeks ago.

Cross tapering Abilify (at 7.5 - 5mg; reduced from its 21+ mg level 10 weeks previously) Seroquel was started at 75mg during the final week of his taking Abilify and Trileptal, afterwhich it was eventual raised to 200mg over 2 or 3 weeks.



Cut to the chase. What DS experienced, in addition to the somnolence (one of the few pluses), out of control hunger, reduction in drive and interest was surprisingly an increase in anger. A marked increase. Levels of intensity that we'd previously not seen.

When it began spilling over in school and he began having altercations with other students, over-reacting with verbal threats, we decided to begin back-pedaling with the Seroquel. It didn't take too much of a reduction (to about 100mg) before he began experiencing difficulty sleeping, night-mania returns with a vengeance, etc.

Despite things looking dim with respects to Quetiapine, we were'nt ready to give up on it just yet. We had seen moments of epiphany in DS, something that was indeed, extremely rare with him. I'd always said that given the choice of having his teeth yanked out with a pair of pliers and no anesthesia or having a moment of quiet, thoughtful reflection, he would pick the former as being the less painful option.

Maybe, despite the PsyDoc taking a pretty conservative approach with respects to tapering, it still wasn't done slowly enough. So we began increasing, ever so slightly.

Now, within 60 - 75% of his previous max of 200mg/day, the hostility/anger/irritation (he says he will feel more 'autistic', easily irritated by small, irrelevant things) is beginning to heat up (it has never really dissipated, it is either only manageable or not manageable), the hunger for sugars and carbs is again, out of control but, this time, there is no epiphany, no reflection, he doesn't want to go to bed and when he does, I don't think he sleeps well.

Cheers!