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> Abilify


Abilify Index | Brand and Generic Availability
Everything on Two Big-Ass Pages

Brand & Generic Names; Drug Class

US brand name: Abilify
Generic name: aripiprazole
Drug Class: Antipsychotics
More on Generic & Worldwide Availability

Abilify’s Approved & Off-Label Uses (Indications)

US FDA Approved Treatment(s)

Schizophrenia in adults & adolescents; Bipolar in adults & children over 10; as an add-on to antidepressants for depression in adults;

Popular Off-Label Uses

Schizoaffective disorder, bipolar depression, monotherapy for depression-spectrum disorder, delusional disorders without psychoses, OCD, Parkinson’s.

Details about Approved & Off-label Uses

Abilify’s Usual Onset of Action (when it starts working)

Faster than Seroquel, but slower than most other AAPs. I.e. 3–7 days, with 3 days more likely (but not always) when adding Abilify to an AD (or anything else) and 7 days more likely when using Abilify by itself.

Likelihood of Working

Given its activating nature, Abilify is probably more likely to work as an add-on to treat depression or bipolar disorder depression than as monotherapy for bipolar disorder.

I don’t yet have enough data for schizophrenia. This article shows 5mg a day takes 3-5 weeks to start working, and only enough better than placebo to get approved by the FDA. And that’s Seroquel territory of taking forever. More on Chances of Working for You and Comparisons with Other Drugs

How to Take Abilify

As with many APs, BMS recommends you just start at the target dosage. That’s 10–15mg a day for Schizophrenia, 15mg a day for bipolar (as monotherapy), and 10–15mg a day for bipolar (when taken with Depakote or lithium). The maximum dosage is 30mg a day, and you should wait at least two weeks before increasing the dosage.

The only application where you start at a low dosage a move up is when you add it to an antidepressant (AD) for depression. That’s when they recommend you start at 2–5mg a day, work up to 5–10mg a day, and the maximum dosage is 15mg a day, and you should wait at least a week before increasing the dosage.

Our suggestion to discuss with your doctor: if you’re not crazy enough to be hospitalized, follow the instructions for using Abilify with an antidepressant, even if you’re taking it by itself (or with another drug) for bipolar disorder or schizophrenia.

How to Stop Taking Abilify (discontinue / withdrawal)

With its long-ass half-lives, Abilify is a lot easier to discontinue than most meds, and severe rebound symptoms are less likely as well. Reduce your dosage by 5mg a day every 5–7 days. Every 3 days if you really need to withdraw faster than that.

More about Taking and Discontinuation



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Pros and Cons

Pros

  • As it sort of acts as a Parkinson’s/RLS med, so you’re somewhat less likely to get a couple of the more annoying AP side effects - most movement disorders and those involving prolactin.
  • The anticholinergic side effects are also less likely than other APs.
  • The long half-lives of of Abilify and its active metabolite mean you don’t have to worry about a dosing schedule, and you can even take a tablet every other day.

Cons

  • Since it kind of acts like a Parkinson’s/RLS med, you can get the oddball side effects of a Parkinson’s/RLS med, like pathological gambling.
  • That also means you can’t take another dopamine agonist to deal with AP-induced movement disorders. So if you do get EPS and want to keep taking Abilify, you’ll need to take a potent anticholinergic like Cogentin, and probably wind up getting anticholinergic side effects after all.
  • Abilify’s long-ass half-lives mean if you two don’t get along you can be stuck with the side effects for at least one, and possibly two weeks after you stop taking it.

Interesting Stuff your Doctor Probably didn’t Tell You

Abilify is the first third-generation antipsychotic (TGA) to hit the US market. TGAs are defined as being partial agonists at dopamine D2 receptors, and that’s what makes them act sort of like Parkinson’s/RLS meds. So, unlike Zyprexa, Abilify doesn’t just mask movement disorders by being a potent anticholinergic, it tries to prevent them from happening in the first place.

Best Known for

The Hiccups of Death. AKA the Abilify Burp.

In-Depth Pros & Cons

Abilify’s Side Effects

Typical Side Effects

  • Headache. Agitation, akathisia (the inability to sit still), anxiety, insomnia, restlessness; unlike almost all other APs, Abilify is more likely to make you hyper instead of turning you into a zombie.
  • The Abilify Burp - a type of mild-to-moderate gastric reflux. You’ll know it when you taste it. Abilify has so many GI-related side effects that you might as well be taking valproic acid or felbamate.
  • These side effects are in the “Usually temporary, but they’ll flare up, especially when you change your dosage” category.

Uncommon Side Effects

  • Blurred vision, mania (regardless of your being bipolar or not), teeth grinding & jaw clenching (but rarely progressing to TMJ like Lexapro), muscle aches, orthostatic hypotension (getting dizzy, feeling faint and nearly-to-actually passing out when you stand up).
  • Weight gain is a lot less likely than most APs, but Abilify can still hose your blood sugar, though.

Freaky Rare Side Effects

Rabbit syndrome. Bone pain. Waxing-and-waning catatonia.
Side Effect Details.
TMI at times


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What You Really Need to be Careful About

Losing glycemic control and developing diabetes 2 even if you didn’t gain an ounce of weight.

Black box and other warnings, pregnancy category, etc.

Half-Life & Clearance

Half-lives: 75 hours for Abilfy, 94 hours for its active metabolite. Clearance: 20 days!
Pharmacokinetics Information Overload

Half-life is the average time it takes for you to process half of the drug’s active ingredient. If a drug has a half-life of around 24 hours and you take a dose of 100mg, you’ll have roughly the equivalent a 50mg dose after one day, a 25mg dose after two days, and so on. The rule of thumb is: multiply the half-life by five and you get how long it is for the dose you took to be cleared from your bloodstream, so there’s nothing swimming around to attach itself to your brain and start doing stuff1. That’s called “plasma clearance.” Complete clearance is a complex equation based on a lot of factors which may or may not: be published in the PI sheet, include personal data like your weight, or even completely figured out by corporate and independent researchers. It usually winds up being 2–5 days after plasma clearance no matter what2, but can take weeks. Sometimes a drug will clear from your brain and other organs before it clears from your blood. If we’ve found the complete clearance, or how to calculate it if it requires things like your weight and what your piss looks like, you’ll find that on the pharmacokinetics page.

How aripiprazole Works

the current best guess at any rate
Abilify is a moderate antagonist at the dopamine D3 receptor and a potent antagonist at the serotonin 5-HT2A receptors.

Like Seroquel, Geodon, and Clozaril (clozapine), Abilify is a partial agonist at serotonin 5-HT1A receptors, but what makes it special (in the US, for now) is also being a partial agonist at the dopamine D2 receptors. Blocking 5-HT2A, and having a positive effect on 5-HT1A and D2 are responsible for fewer movement disorder and prolactin problems, and all those agitating/antsy/activating side effects.

More than You Probably Ever Wanted to Know about How a Drug Works
AKA mechanism/method of action, pharmacodynamics

Ratings, Reviews, Comments, PI Sheet, and More

Abilify Comments

In case you don’t watch enough TV, Bristol-Myers Squibb (BMS) is pushing Abilify as an add-on for your antidepressant (AD). The ads use wearing a bathrobe all day as a metaphor for depression. Depression is a far more socially acceptable form of brain cooties than bipolar disorder and schizophrenia, so it’s no surprise that you’ll see way more ads about ADs than mood stabilizers. And recent approvals are always heavily advertized.
Extended Comments
As if I didn’t go on long enough already.

Abilify Ratings & Reviews, and Consumer Comments & Experiences

Rate Abilify

Give your overall impression of Abilify on a scale of 0 to 5. Detailed ratings and reviews are available on the Abilify Ratings & Reviews Page.

Get all critical about Abilify

3.5 stars Rating 3.0 out of 5 from 129 criticisms.
Vote Distribution: 23 – 7 – 17 – 14 – 35 – 33


Rate this article

If you’re still feeling judgmental as well as just mental3, please boost or destroy my self-confidence by honestly (and anonymously) rating this article on a scale of 0 to 5. The more value-judgments the better, even if you can criticize my work only once.

Get all judgmental about the Abilify (aripiprazole) Synopsis

4 stars Rating 4.0 out of 5 from 51 value judgments.
Vote Distribution: 1 – 3 – 2 – 3 – 22 – 20


Full US Prescribing Information / PI Sheet

Allegedly Useful Links. Mostly official sites, PI sheet-equivalents4 from countries other than the US, and reviews from other consumer review sites.

Drugs.com’s drug-drug and drug-food interaction checker

It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on the Faecesbooks.


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Abilify Index | Brand and Generic Availability
Everything on Two Big-Ass Pages

1 Based on Julien's calculations from A Primer of Drug Action, the half-life multiplied by five is the generally accepted estimate of how long it takes a single dose of any given drug to be eliminated from the blood stream/plasma of someone with a normal metabolism. That's also the rough estimate for steady stage if they can't get, or won't provide a number for that.

2 For crazy meds. I have no idea what the average complete clearance is for other types of medications. For all I know there are drugs that utterly vanish from your system in under five passes, and others that won't let go of your squishy bits for years after you stop taking them.

3 Thank you! I'll be here all weak. Be sure to tip your content provider. And don't try the veal, it's cruelicious!

4 These include: Canada's Product Monographs (PM), New Zealand's Medicine Data Sheets (MDS), the EU's European Public Assessment Reports (EPAR), and the Summary of Product Characteristics (SPC) used in Britain, Ireland, and many other places.


If you have any questions not answered here, please see the Crazymeds Abilify discussion board. I welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why I write these damn things. I’m frustrated enough as it is. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds.


Last modified on Wednesday, 26 March, 2014 at 01:04:00 by SomeMedCriticPage Author: JerodPooreDate created Tuesday, 29 November 2011 at 11:57:45

Abilify by JerodPoore is copyright © 2011 JerodPoore


Abilify, and all other drug names on this page and use throughout the site, are a trademark of someone else. Look on the the PI sheet or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing.




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Almost all of the material on this site is by Jerod Poore and is copyright © 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, and 2014 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.



All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
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Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
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Crazymeds is optimized for the browser you’re not using on the platform you wish you had. Between you and me, it all looks a lot cleaner using Safari or Chrome, although more than half of the visitors to this site use either Safari or Internet Explorer, so I’m doing my best to make things look nice for IE as well. I’m using Firefox and running Windows 72. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazymeds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazymeds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
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1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.

3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?
[begin rant] I rent a dedicated server for Crazymeds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had a forerunner of QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]

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