Posted by med_empowered on March 29, 2008, at 10:59:51
In reply to what does abilify do???, posted by Robyn222 on March 29, 2008, at 0:59:10
Abilify is supposedly the first (and so far, only) "3rd generation" antipsychotic. Insted of just blocking D2 receptors in the brain (thats how all antipsychotics work--it results in reduced agitation and anxiety at lower doses, apathy and movement disorders at higher doses), Abilify blocks the D2 receptor but also acts as a partial agonist, mimicking the actions of your body's own dopamine (I think that's right--maybe someone could correct me if I'm wrong?)
I think it does similar stuff at some serotonin receptors. Basically, its supposed to be the cleanest antipsychotic around b/c there doesn't seem to be a huge tardive dyskinesia risk (I did a search and found 2 cases--still, these things take time, so be careful) and b/c Abilify has minimal effects on blood sugar, body mass, etc. Its pretty good stuff, except for the start up anxiety that a lot of people experience. My own shrink says that lower doses are worse for the start up anxiety than higher doses--then again, maybe "edge" is what helps depressives at low doses, and the tranquilizing effects are good for bipolars at higher doses. Who knows?
The weirdest thing about Abilify (I think) is the dosing. Some people take 2.5mgs/day for depression or...whatever. Some people take 30mgs/day. The highest dosage I found in a case report was 60mgs/day for psychotic depression. Nobody seems to know how high/low to go with the Abilify; with depression, I imagine a "start low, go slow" approach would be best so you keep the dose minimal. Speaking from personal experience with agitation, the approach seems to be to sledge hammer you with a pretty high dose ASAP.
As for the movement disorders...you're right to be worried; nobody really knows how often the atypicals (especially abilify, since its so new) will cause TD. In general, people with mood disorders get TD more often than people with straight up schizophrenia. Women get TD more often than men, and older people and children get it more often than people who are young-to-middle aged adults. Early onset EPS (muscle spasms, akathisia, etc.) can be a bad sign; this might mean that you're more inclined to getting TD down the road, at least with this particular medication.
There's a test, the AIMS (Abnormal Involuntary Movement Scale) that your shrink can do periodically. Basically, they take a baseline to see what pre-existing tics, if any, you have, and then they re-test you every couple months, especially once the dose is stable. If anything TD-ish pops up (ESPECIALLY if you have movements in the facial area), its time to talk about discontinuing the medication, or at least lowering the dose. You can also switch; apparently, some people find that TD that develops on one med resolves on another (I seem to recall reading about Seroquel being used a lot for this, in low doses).Good luck..I hope you find the med(s) that are right for you!
poster:med_empowered
thread:820456
URL: http://www.dr-bob.org/babble/20080316/msgs/820493.html