Abilify

  1. 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?
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  2. 21 Comments

  3. by   NoClueRN
    I've only seen 2 patients on Abilify and both were mid 30's, chronic schizophrenics with minimal personality disorders. Abilify worked especially well in the male patient, he had more energy, more ability to focus & concentrate, and became much more helpful on the unit (getting other patients to come to groups, cleaning up after himself etc). His blood pressure did go up a bit and thats a s/e which will warrant monitoring. And time will tell if this medication truly holds him or if somehow he was just cycling up. The psychiatrist on our unit tends to mix meds and low dose Zyprexa was being used in conjunction with the Abilify. I dont remember much about the female patient, she wasnt someone who was a 'frequent flier' on the unit.
  4. by   sanakruz
    3 clients on abilify.
    Man in his mid 30's schizoprenic, lots of insight supportive family living somewhat independantly in the community on Abilify for 3 weeks with return of symptomstaunting voices with increase in paranoia and delusions about be abducted by aliens)- begged to get off the abilify
    Customer #2- 50ish inmate at county jail, residivistic alcoholic who is going to prison for 14th DUI.Begging for Xanax because he cant face the thought of going to prison again- He was encouraged to give the med a try. but ultimately got his way with Xanax
    #3 18 y/o girl, schizoprenic for about 3 years living with family that needs respite, managed to finish high school but now kinda aimless- Doing well.
    I like to see my clients on Geodon because not so much weight gain and subsequent insulin resistance
  5. by   maureeno
    that was the consensus of nurses on our involuntary unit when sadly a pt was switched, since the sample was so small [n=1!] I've searched about and read about aripiprazole...
    the usual reports of 'miracle drug' but seems like sleeplessness is not uncommon. also often seems to take weeks to be effective.....
    http://www.webcom.com/net/namibucks/new_drug.htm

    sure is sad to see pts' meds changed for the newest miracle......
    how many miracles have we seen go bad?
    could we organize as nurses and work for drug approvals to include mandatory efficacy tests within the same catagory?

    ever wonder, especially those in LTC, if a part of the money spent on drugs would be better spent to increase staff ? should I need LTC, I'd like to be treated by human beings who are not over-worked, rushed and tired; I'd rather have more touching and less pills....
  6. by   Orca
    It sounds like most of the experiences here mirror my own.

    I like the idea of including efficacy tests. However, it seems that medications are prescribed on the basis of who has the best advertising agency (otherwise, why would prescription drugs be advertised on television?), or which company spends the most time and money wining and dining doctors.

    I can think of no other explanation for the widespread use of Zyprexa in the prison where I primarily work, when our cost for a 60-dose bottle of 20mg tablets is $927. Some inmates are on as much as 35mg per day, a dose cost of around $25-30 for a single drug (and most are on several).
  7. by   molecule
    makes you think about how health care costs might be contained, yes?
  8. by   Nurse2bSandy
    Abilify is one of the meds that our son is now on. I had to fight to get anyone to pay attention to me and try it on him. I had seen some research... not advertisements... on it before it was approved and watched and waited for approval. Risperdal was effective with him but he put much weight on and the prolactin increase caused not only breast changes but genital shrinking too. Not something that guys are happy about. We have noticed no real difference in the positive affects of either, but already he has dropped weight and breast size has decreased dramatically.
    I don't know that it will be the answer, but we have been happy with it so far.
    I'm anxious to read if anyone else has had some positive experiences with this?
  9. by   the new girl
    Geodon is a joke... as far as Abilify, we have been using it in Peds. I'm not seeing anything dramatic however. I think it is a shame that these drugs are prescribed as soon as they are on the market, BECAUSE of the marketing.
  10. by   sanakruz
    Update on Abilify-
    CANT GET MEDI-CAL TO PAY FOR IT! NO SIR!
    (Medi-cal is CALIFORNIA's medic-aide)
    The clients on it are doing well,all out-pats.
    Any other state aid program balking? I'm really curious.
  11. by   MelisaRN
    We are starting my son on Abilify (first dose tonight), he is very aggressive. He's on Propranolol and Paxil along with it. Hoping this will work. Arkansas Medicaid paid for it.
  12. by   voodoosgirl
    Hi, my first time posting. I have a resident in a group home for adults with mental illness who has had great control of symptoms on Clozaril but unfortunately her WBC's drop to dangerous levels and it has to be d/c'd. (3 trials-same results) Her Dr has started her on Abilify (all other antipsychotics have been tried and don't work well for her) A rough 3 weeks at first BUT no hospitalizations which is traditionally how it goes for her. Negative symtoms are apparently controlled and AH are increased but tolerable with support and low dose benzos. She has not maxed out the Abilify dose yet so we are hopeful this will work. This person has intractable schizophrenia with a history of violent outbursts, intense paranoia and command voices.

    Regarding payments....Maine Medicaid is broke...so they have a long list of "preferred medications" they only way they pay for newer, more expensive meds is through prior authorization, which is client specific. Lots of paperwork for the DR office and poor care for the clients.
  13. by   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.
  14. by   Orca
    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.

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