Abilify (Aripiprazole)

Or as I call it, "my favorite antipsychotic" : ) Haha...Yep, this is the one that makes me the LEAST craz-zay!!

Used For: Schizophrenia and bipolar disorder (both acute mania and as a mood stabilizer). It is sometimes added onto other antipsychotics in an attempt to reverse the weight gain that they cause.

I take Abilify for schizoaffective disorder (a tandem of schizophrenia + bipolar disorder) so it is also used for that. Though I should point out that I also take mood stabilizers and antidepressants often in addition to Abilify.

Do Not Use If: There are no absolute contraindications for aripiprazole.

The only reasons I potentially stopped using Abilify was when the constipation the drug gave me got so bad (this eventually went away and I began having normal bowel movements) and when it made my lips twitch (this also went away with time for some reason)

Tests to Take First: None are required

I never took any tests before starting Abilify.

Tests to Take While You Are on It: A physical examination called the AIMS test should be performed by the psychiatrist or nurse practitioner at least every six months to detect early signs of tardive dyskinesia.

I've been on Abilify for over two years now and I have never taken anything called an "AIMS test." In fact, I had never even heard of this test until I started typing out this webpage, though maybe I will an "AIMS test" done soon as long as I get to keep my pants on during it! Just kidding. I had never had any warning signs of TD accept for the lip twitching I mentioned up above which eventually went away.

Usual Dose: Patients are started on a single 10 or 15 mg tablet, usually in the morning. This is the effective dose for many patients, although some people will do better at 30 mg a day.

I've been on doses of 15 mg, 30 mg, and 40 mg. 40 mg of Abilify is the highest dose I've ever heard someone be on before other than 40 mg of Abilify + another antipsychotic dose such as Seroquel, Zyprexa, Risperdal, etc. Some people have probably been on a 5 mg dose of Abilify too would be my guess.

How Long Until It Works: Some decrease in psychotic symptoms, like hallucinations and delusions, may be seen in a matter of hours to days, but the full benefit may take several weeks.

For me, Abilify worked best when I woke up during the middle of the night a few hours after I took it. This means I woke up feeling completely cured of mental illness for the tiny amount of time I was awake, meaning no paranoia, no negative symptoms, and being fully conscious with a selective attention that was perfectly in tune. I know this because on the night I fell asleep after taking Abilify, I woke up and I could hear both the TV and CD player that I had accidentally left on at even volume which is irregular for me, and that moment was absolutely awesome when it happened. I loved it. Yay selective attention on Abilify. However, after this glorious night Abilify eventually started working at a normal consistency which wasn't quite as good as being "completely cured of mental illness" though it does works fairly well at kicking symptoms in the groin still.

Common Side Effects: Headache, insomnia, and agitation can occur. In some people this is mild, and in others it is quite bothersome.

I too experienced a little insomnia and agitation on Abilify, but it is so mild and so rarely experienced (like once every six months or so), that it doesn't bother me at all. But I have heard of these symptoms as well as headaches being pretty damn annoying side effects for other people. Also, two side effects that I should point out that bothered me the most on Abilify were the constipation (it seriously hurt to take a sh*t for a while there) and lip twitching, meaning I would pucker my lips and stuff uncontrollably, but for whatever reason both of these side effects seem to have disappeared and not come back.

Less Common Side Effects: As mentioned above, it is possible that aripiprazole will cause tardive dyskinesia, but the risk of this is much less than with older antipsychotic drugs like Haldol and Prolixin.

A slight increase in appetite is another side effect you may want to look out for on Abilify, though I must point out that both Abilify and the antipsychotic Geodon will alter your appetite very little, if any, especially in comparison to some of the other antipsychotics like Zyprexa and Seroquel based on my experience.

What to Do About Side Effects: Lowering the dose can help. Sometimes a calming medication is needed, such as the atipical antipsychotic drug Seroquel or a benzodiazepine antianxiety drug like Klonapin.

If you're lucky, a side effect will go away with time, likely after two weeks to two months approximately based on my experience with meds. But yea, lowering the dose is also always an option, as is quitting the drug all together if the side effects are that bothersome. Then there's attempting to counter a side effect with yet another psychiatric drug. I've done 'em all...in the nude of course. Wait, I WAS NOT in the nude now that I think about it. I'm silly : )

If It Doesn't Work: You will probably need to try a different antipsychotic drug. Risperidone or Zyprexa are possibilities. Clozapine is another choice.

Don't forget about good ole Seroquel as another alternative option too : ) And by the way, if you're anything like me, you will be able to tell if an antipsychotic works or doesn't work. Like for me, Abilify, Seroquel, Geodon (though not all the time), and Zyprexa WORKED whereas Risperdal DID NOT WORK. I'm still not sure why I had such a bad experience on Risperdal though, it works great for some people.

If It Does Work: The question of how long people with schizophrenia should stay on an antipsychotic medication has never been answered completely. Most say that after a first episode, it may be possible to try to stop the medication after six months to a year, but the risk of developing another psychotic episode is great. Because ziprasidone (is this a typo by the author?) is well tolerated and seems to have a very low risk for weight gain or tardive dyskinesia, most doctors recommend that their patients with schizophrenia or bipolar disorder who respond to the medication stay on it for an indefinite period of time.

I'm obviously not a psychiatric as I haven't graduated college, nor have I ever even tried living life as a schizoaffective human being without taking antipsychotic medications regularly ever since I started taking them back in late 2003, however, if you're anything like me then to stop taking antipsychotics thinking, "I'm starting to feel good now, maybe I can go without these...??" would be a bad idea... Think of it this way, how many times have you seen a story on the news of a mentally ill person who commits a violent crime shortly after they completely stop taking their medication? Too often my friends. I am not, however, saying lowering a dose of an antipsychotic is out of the question once a person becomes more stable like for example from 40mg of Abilify to 30mg of Abilify or from 20mg of Abilify to 10mg of Abilify.

Cost: Generic Abilify is not available and hence it is an expensive medication.

I am fortunate enough to have my co-pays practically covered completely with some co-pay card that I got, and I don't even know how I got it to be honest. Yes, I know how lucky and stupid I sound for saying that, but I am just saying maybe you can get one too if you're struggling with paying for expensive non-generic Abilify-type drugs. Also, if you're diagnosis is "schizophrenia," "schizoaffective disorder," or something else very severe (unfortunately having a diagnosis of "bipolar disorder" or something similar but not quite "schizophrenia" won't help you out as much here) then my guess is you will have an easier time getting benefit checks every month. And don't feel guilty if you end up receiving benefits on account of it being drilled into your head that other people deserve it more because trust me, you would rather be completely free of mental illness and get paid nothing every month than be in a position of getting a check for a few hundred bucks twelve times a year but being stuck with the burden of being "full blown crazy" for the rest of your life unless some anti-full blow crazy miracle medicine is developed some time in the future.

Special Comments: Abilify has a unique mechanism of action. All of the previous antipsychotic medications, both typical and atypical, block the D2 receptor in the brain for the chemical dopamine. Abilify, on the other hand, actually stimulates the D2 receptor. Given the fact that studies have shown that increasing dopamine activity in the brain causes psychosis, it seems counterintuitive that an antipsychotic drug should stimulate a dopamine receptor. The trick is that there is also evidence that if dopamine levels are too low, negative and cognitive symptoms may result. Animal studies suggest that Abilify increases dopamine activity when the brain's own dopamine activity is abnormally low and blocks dopamine activity when it is too high. At the same time, it, like Geodon, has a very favoring side effect profile compared to other atypicals, with very little weight gain or the neurological side effect called EPS. Once again, however, are questions about effectiveness. Abilify tends to be an activating drug, so some patients get agitated from it, while others get better. It is very hard to predict for whom it will work, not work, or cause worsening. This is a very interesting drug that requires more time to know exactly where it fits in for the treatment of schizophrenia and bipolar disorder.

The only special comments I have about Abilify are...umm...this drug works great!! Very effective and a very low side effect profile. Hooray...

This Abilify page was typed on February 16, 2008.
Back to the "my meds" page.