New Med - page 2

This morning (I work straight midnights) our medical director prescribed a new antipsychotic, Abilify. Things were hectic, of course, so I didn't have time to read the insert. He had some freebies... Read More

  1. by   researchrabbit
    I worked on several aripiprazole studies in schizophrenia. I wasn't impressed, and I'm actually surprised it was approved (I guess the low side effect profile helps).
  2. by   maureeno
    I read the Abilify [aripiprazole] profile and was sad to see its own research show it to be weakly effective. Recently we saw a patient decompensate before our very eyes when switched mid-hospitalization to Ablify. I work on an involuntary unit whose many experienced nurses are increasingly frustrated by the 'drug of the month' mentality. The N's of the drug studies are small and the time periods too short. Testing drugs against placebos is not enough. In the case of Abilify, when tested vs. Haldol, it failed in every measure except the subjective, trained observer scale. After 30 years of mental health work the drug situation is making me crazy. Especially in an involuntary setting I think it is unethical to be basically experimenting.
  3. by   mumseyllama
    My mother-in-law (82 yo, dementia) was just placed on abilify as a switch from 0.5mg haldol which was prescribed for auditory hallucinations and paranoia. The nursing home providers feel it is effective for her.
    I haven't seen it used yet on my unit in a teaching hospital in VT. I, too, am distressed to see the drug-of-the-month-club culture.
    We just switched back to using haldol for chemical restraint rather than droperidol after the cardiac effects of that drug became apparent.
  4. by   Nutty RN
    I went to a seminar this week and the speaker was a physician who was treating a wide variety of patients with Geodon. This guy was using a max dose of 400 mg. I about fell off of my chair. I work with a much older doc who is very reluctant on trying anything beyond the norm. Anybody have any experience with Geodon in higher doses than 80 BID? We have one person on 80 TID. Will keep you posted on how she reacts.
  5. by   NurseBenz
    I have several teenagers at the school I work at on Abilify prescribed for the treatment of schizophrenia. They have only been on it for a few months.
  6. by   Dave ARNP
    I have been writing a fair amount of Abilify, and had marginal results with it. It usually ends up needing something to go with it.

    As far as Geodon IM... I used it for a couple of pts and had very poor results. (as in... NO results). I don't expect to give it again.

    David Adams, ARNP
    -ACNP, FNP
  7. by   Will Benson
    Geodon comes with mixed reviews. Onset of action for IM use is 30 minutes to 3-4 hours! Not real useful if you have to emergently medicate a client. That's why Haldol and Ativan are (sadly) still the drugs of choice for emergency medication.

    Abilify also takes a long time to work (half life is 48-72 hours).So if the half life is so long and you're giving DAILY doses of 5 - 15 mg, won't you (at least theoretically) have cumulative effects of the medicine if they are on it for a long period? I've only seen it work about half the time, anyway.
  8. by   zydis
    HI: I am an RNCS in MA. We have seen some very positive results with Abilify, especially in terms of remission of negative symptoms [of psychosis.] The major SE that clients have experienced is N/V... possibly b/c the dose was started too high. Should be started low and go slow.
    In terms of Geodon, I havent seen much improvement with the PO medication, but others have. I learned that BID dosing must be given with food in order to obtain full benefit. Can lose 40% efficacy if not given with food. I did find the IM useful in the emergency setting. Clients are not oversedated and can still be interviewed when in crisis, unlike when giving a chemical of say, Ativan and Haldol.
  9. by   TitaniaSidhe
    Originally posted by maureeno
    I read the Abilify [aripiprazole] profile and was sad to see its own research show it to be weakly effective. Recently we saw a patient decompensate before our very eyes when switched mid-hospitalization to Ablify. I work on an involuntary unit whose many experienced nurses are increasingly frustrated by the 'drug of the month' mentality. The N's of the drug studies are small and the time periods too short. Testing drugs against placebos is not enough. In the case of Abilify, when tested vs. Haldol, it failed in every measure except the subjective, trained observer scale. After 30 years of mental health work the drug situation is making me crazy. Especially in an involuntary setting I think it is unethical to be basically experimenting.
    I couldn't agee with you more. Well said.
  10. by   psychrn25
    We have been using abilify since it has come out. It is a wonderful drug, i've seen several lives changed for the better because of it. I have not personally seen many side effects of my pts that are on it. It's also very good for people that do not like to take meds or forget to take them since it is usually only given once a day. Geodon i like, but have not found alot of difference in the IM vs po. At first we were giving Geodon IM for emergency situation, of which i didn't like. It simply doesn't work as well in my opinion as older drug such as Ativan and Haldol, but is a good drug for positive symptoms of pyschosis.
  11. by   shankar
    my 13 year old son recently started Abilify about 2 weeks ago on 10 mg dose per day. He is having tremors and they have increased in the past few days. He also seems to have stiff neck. He went to school last week but today could not attend school fully. pl let me know if you have any experience or inputs.
    your input will be very helpful.
    thanks
  12. by   mamabear
    As I expected, our shrinks seldom prescribe Abilify. They hopped off the bandwagon after about a month
    Shankar: I'm sorry to hear your son is having so much trouble with Abilify I didn't know it was approved for use in children.
    And speaking of jumping on the bandwagon, has anybody had trouble with I.M. Geodon causing increased agitation? It seems to be more prevalant in women.
  13. by   shankar
    my 13 year old son recently started Abilify about 2 weeks ago on 10 mg dose per day. He is having tremors and they have increased in the past few days. He also seems to have stiff neck. He went to school last week but today could not attend school fully. pl let me know if you have any experience or inputs.
    your input will be very helpful.
    thanks

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