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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by BRC on November 13, 2008, at 5:39:29
Hi,
I saw a commercial last night for Abilify. This ad stated that if your depression medicaion wasn't working that Abilify could help impove your symptoms.
I have two questions? (1) I thought Abilify was anti-psychotic and Bi-Polor med. I know that pych. meds are widely prescribed to treat problems that the drug otherwise was intended for. (2) Is Abilify in the same class of meds as Zyprexa, Geodon, etc? Does it work primarily on dopamine? Does it carry the same potentially damaging physical side effects as the other anti-psychotics.
I ask these questions b/c I meet for the second time with my new pdoc next week. I have pretty bad OCD intrusive thoughts and was told at one time that small doses of some anti-psychotic meds may help. But seeing a lot of patients taking anti-psychotics having tremors, tics, etc. I was scared to even try. But does Abilify usually cause these problems?
Sorry for all the questions :).
BRC
Posted by Maria3667 on November 13, 2008, at 8:09:56
In reply to Abilify to Help with Depression?, posted by BRC on November 13, 2008, at 5:39:29
Hi BRC,
Yes it can definately help with depression. At least it did for me. However it also caused severe anxiety for me, making me quit.
Yes Abilify is officially an anti-psychotic, but I've seen it prescribed for other ailments too, like Bipolar and depression. Side effects may still occur, eventhough usually not as heavy as with the older anti-psychotic meds. So I've gathered.
The mechanism by which it works is complicated. It's a dopamine agonist & antagonist at the sime time (different receptors though). The same goes for serotonine.
Hope this helps.
Take care,
Maria
Posted by desolationrower on November 13, 2008, at 9:24:38
In reply to Abilify to Help with Depression?, posted by BRC on November 13, 2008, at 5:39:29
> Hi,
>
> I saw a commercial last night for Abilify. This ad stated that if your depression medicaion wasn't working that Abilify could help impove your symptoms.
>
> I have two questions? (1) I thought Abilify was anti-psychotic and Bi-Polor med.Hi, yes antipsychotics sort of make everything less salient and so help with mania and psychosis and sometimes anxieties. They are also sometimes used for augmenting antidepressants. I know that pych. meds are widely prescribed to treat problems that the drug otherwise was intended for.
>(2) Is Abilify in the same class of meds as Zyprexa, Geodon, etc? Does it work primarily on dopamine? Does it carry the same potentially damaging physical side effects as the other anti-psychotics.
>Yes, they are all atypical antipsychotics. However they are all a bit different, even more so than the SRIs. Aripiprazole works as a dopamine partial agonist, which means it doesn't ocmpletely block it they way other antipsychotics do. It is also not quite as strong blocking serotonin 2a. It has less weight gain or sexual problems than most antipsychotics. if you go to this page and scroll down there is a chart of the side effects. Any antispychotic can cause tardive diskinesia (odd uncontrolable movements - the "thorazine shuffle") although sometimes it goes away and the newer medicines have much lower risk.
> I ask these questions b/c I meet for the second time with my new pdoc next week. I have pretty bad OCD intrusive thoughts and was told at one time that small doses of some anti-psychotic meds may help. But seeing a lot of patients taking anti-psychotics having tremors, tics, etc. I was scared to even try. But does Abilify usually cause these problems?
>
> Sorry for all the questions :).
>
> BRC
>Yes, sometimes they help with OCD, at least when they augment an SRI - i assume you are on something like paroxitine or clomipramine right now and it isn't doing the job? Arpiprazole is newer so there haven't been any studies i'm aware of, just some case reports that it helps OCD. Personally i dislike the antipsychotics and think they should be more of a lst resort, trying even things that don't have as much evidence because the risk of some side effects increases with time so long-term use is a bit scary, so personally i'd rather give lower risk things a try before settling on an antipsychotic. Still, the side effect risk isn't as high as if you needed a high dose like for schizophrenia.
-d/r
Posted by Phillipa on November 13, 2008, at 10:54:25
In reply to Re: Abilify to Help with Depression?, posted by desolationrower on November 13, 2008, at 9:24:38
I too find the thought antipsychotics a bit too much will stick with benzos for now. Have you tried one? Phillipa
Posted by desolationrower on November 13, 2008, at 12:52:34
In reply to Re: Abilify to Help with Depression?, posted by Phillipa on November 13, 2008, at 10:54:25
http://www.beforeyoutakethatpill.com/2008/11/abilify-me.html
[quote]
So what do the studies actually show?In the first study of Abilify, 362 patients were randomly assigned to Abilify or placebo for six weeks after a failed trial of antidepressants. There was a -8.8 v -5.8 change on the Montgomery Asberg Depression Rating Scale (MADRS), a difference of 11.5%. 23% of patients on Abilify versus 5% on placebo had akathisia, a potentially very disturbing side effect where you feel like you are jumping out of your skin or cannot sit still. Restlessness was seen in 14% v 3%. Fatigue was also more common. Berman RM et al J Clin Psychiatry 2007; 68: 843-53.
In the second study of Abilify, 381 patients who had failed at least one antidepressant medication trial were treated for eight weeks with an antidepressant followed by the addition of Abilify or a placebo for six weeks. Abilify showed an -8.5 change on the 26 item Montgomery Asberg Depression Rating Scale (MADRS) versus -5.7 for placebo, a difference of 2.8 points, a difference of 11%. 26% of patients on Abilify versus 4% on placebo had akathisia, and 10% versus 1% had restlessness. Marcus RN et al, J Clin Psychopharm 2008; 28(2):156-165
.Conclusions? Abilify is more likely to make you want to jump out of your skin than it is to cure your depression. An 11% improvement over placebo is not that great and is set off by the fact that Abilify has a lot of nasty side effects and doesn't work better than other treatments of refractory depression like lithium (which also can have nasty side effects). I don't watch TV ads because I have TiVo but I can only imagine how it was presented by BMS [/quote]
-d/r
Posted by Emily Elizabeth on November 13, 2008, at 21:09:54
In reply to Re: Abilify to Help with Depression?, posted by desolationrower on November 13, 2008, at 9:24:38
Just wanted to add that abilify was amazing for my (unipolar) depression. I went through so many meds and nothing helped the way abilify did. I have no side effects which I tie to abilify (I also take lithium and lexapro). My vote is to try it!!
Best,
EE
Posted by B2chica on November 14, 2008, at 8:28:07
In reply to Abilify to Help with Depression?, posted by BRC on November 13, 2008, at 5:39:29
Abilify is an antipsychotic. and typically used for bipolar.
however i'm on zyprexa (another AP) and i mostly use it for my depression, though it also keeps any mania at bay.yes same class as zyprexa and geodon.
Abilify is a Dopamine partial agonist(DA2) and antagonist for DA3
it also is an agonist for 5-HT1a and antagonist for 5-HT2a.
all the AP's that you mentioned carry about the same chance of side effects, such as TD. however this class of AP are MUCH better than the old ones such as haldol or thoridazine.zyprexa helped me with OCD but i think i needed to be at 10 for that (course i had other psychosis going on too)
i think it only gave me slight tremors in my hands at 10mg. at least i don't notice anything right now.i have heard that abilify can really help with anger and bad mania. where as zyprexa and geodon seem to be Rx more if you're dealing with depression as number one issue. Well i take that back i think zyprexa is also used as a PRN for bad mania.
i am prone to ticks (meaning i get them whether or not i'm on meds. and zyprexa has never induced them in me. now the adderall that i just started did. but they went away after two days.
******************
sorry i have no experience on abilify. only zyprexa and geodon.BEST WISHES
and ASK AWAY, this is certainly the place to do it.
b2c.
Posted by emme on November 14, 2008, at 16:04:29
In reply to Re: Abilify to Help with Depression? » BRC, posted by B2chica on November 14, 2008, at 8:28:07
Abilify has worked longer for my depression than any antidepressant.
emme
Posted by Zyprexa on November 14, 2008, at 19:41:05
In reply to Abilify to Help with Depression?, posted by BRC on November 13, 2008, at 5:39:29
Abilify is an Atypical antipsychotic, in the same class as zyprexa, etc. It gave me tics, more like jittery hands I could not control. Went away when I stoped it. It didn't help with my psychotic simptoms. I found it to be more of an anti-depressant. Which I think is the reasoning for that ad. They are trying to remarket it. It seems to work for some with bi-polar and not for others.
This is the end of the thread.
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