Abilify

[Orca]

I was wondering about the experiences of any nurses here with the anti-psychotic drug Abilify. I have had some experience with it, and the results of my early informal poll is that this drug is all blow and no go.

My wife works in an LTC facility where the staff psychiatrist is switching everyone to Abilify. Patients who had been well-managed for months, if not years, on other medications are now bouncing off the walls. I had a patient last night on my geropsych unit who was switched from Risperdal to Abilify. In the first 24 hours, she went from sleeping all night to being up all night and becoming ragingly psychotic, totally resistant to redirection and completely irrational in thought.

Abilify was hyped as being as strong as Haldol, without the side effects. My experience is that it works about as well as a glass of water. Do doctors have to change an effective drug regimen every time a new name hits the PDR? Comments?

[xofallingstarxo]

I just got put on Abilify for my bipolar disorder. However, I don't think I am bipolar, so, that could be why the medication doesn't seem to be doing anything. It's only 5mg, but, I am usually very sensitive to medication. I haven't noticed any difference in the way I act or think. The only think I have noticed is that I used to sleep a lot before I was on it, and now I've been waking up at 6am for no reason. anyone heard of that? I am also on Welbutrin xl.

[Orca, ADN, ASN, RN]

Wellbutrin can cause agitation in bipolar patients. I'm surprised that your doctor didn't change your antidepressant if bipolar disorder is suspected. From what I have learned about Abilify in the time since the original post is that sedation is minimal. It doesn't knock people out like some of the older antipsychotics can. Some need the additional sedation to maintain control, which may be why so many decompensate when they are switched to it.

Five milligrams of Abilify is a minimal dose. If you are bipolar, odds are this is not enough to be effective as monotherapy.

[rph3664]

It's also being used a lot for treatment-refractory depression when the next step is ECT, and in many cases it is working.

I have also heard that some people on the autistic spectrum have a dramatic improvement in their social skills on this medication, although it is certainly NOT a cure.

[42gameover]

We've had dozens of pts on abilify; some did benefit but most ended up being switched to another med. Since we're speaking anecdotally, I will say I've seen it help a few young adults with bipolar disorder (who were given the abilify to get psychotic sx under control, along with their other mood stabilizer/s), but as far as pure psychotic illness, it hasn't been overly impressive.

[rph3664]

What do you all think of Abilify IM? I've been told that Geodon IM becomes essentially worthless after the second dose, and have observed that it's been used a lot less in recent times.

[utrocks84]

I work on a geropsych unit and we use Abilify alot with Ativan for our agitated and aggressive patients. I don't think very much of it as a PRN IM in crisis management. Seems to work very slow if at all. Now I have had more success with Geodon although it also thats long to act. Haldol is the best but harder on Geri patients. I think it's absurd to get PRN orders any how for 0.5mg of ativan and Abilify. Give me a spit ball it works better.

[TerpGal02, ASN]

In my limited experience (as a patient mind you), doing my own research and antecdotes I've heard from others with experience in Abilify, its a love it or hate it drug. Either is works amazingly well for you, or it makes your symtpoms a WHOLE lot worse, especially in the bipolar. I took Abilify (for what my pdoc was calling treatment resistant depression at the time, later learned it was really bipolar II), and it sent me into dysphoric mania tailspin city. Not good. My SIL however is taking it for bipolar and is doing amazingly well on it. A lot of people find this to be a very activating drug, because in addition to the dopamine regulation that it and pretty much every other antipsychotic does, it also has some limited seratonin re uptake properties as well, which for many bipolars messing with seratonin=bad news. Plus the cost..................is UNREAL. It was on my insurance carrier's "tier 3" list, meaning I was shelling out $60 out of pocket, but when I looked at what the insurance paid, my jaw literally hit the floor.....$380!!!!!!!!!!! Needless to say, that was a VERY expensive "experiment" for me.

[alfa-sierra, BSN, RN]

Abilify as good as a glass of water? That's generous... I totally agree. In my neck of the woods, no psychiatrists worth their grains of salt, will prescribe it to really sick patients, except as garnish to embelish other primary antipsychotic agents such as Risperdal or Zyprexa. But the name has a good ring to it - notice the fact that unlike any others, the name of this drug is a verb, thus suggestion action, plus its connotation with "able" and "ability" implying efficacy. From a linguistic viewpoint, if nothing else, it is a capable placebo...

[StuPer]

I too have a poor opinion of Abilify, not least of which was the test trial data submitted to the FDA which showed it destroyed the cornea of albino rabbits, the company was ordered to do post approval testing to look at any implications for humans, but as far as I know it hasnt been done.

I had an opportunity to attend a sponsored meal at the end of a valauble conference a few years ago, and had great pleasure in laying into the Abilify presenter about the poor wabbits

StuPer

[42gameover]

I too have a poor opinion of Abilify, not least of which was the test trial data submitted to the FDA which showed it destroyed the cornea of albino rabbits, the company was ordered to do post approval testing to look at any implications for humans, but as far as I know it hasnt been done.

I had an opportunity to attend a sponsored meal at the end of a valauble conference a few years ago, and had great pleasure in laying into the Abilify presenter about the poor wabbits

StuPer

Wish I'd been there. Go you!

[Mish56, BSN, RN]

This thread was started in 2003!! It's almost as old as Abilify! I love the comment about the linguistic effects! We had a LOL session at work about the people who get to name this stuff, must be similiar to those who name nail polish, only with bigger $$ behind the outcome.

On a more serious note I was interested to hear from some members with 1st hand experience. Glad to hear it has some positive outcomes.

Here's my mantra..."no side effects...no main effects" :chuckle

I'll take that glass of water and spitball now....