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Abilify

I have tried every atypical antipsychotic. I am currently on Geodone because that was the one with the most tolerable side effects. I get bad agitation, shake to the point I had one person assume I had Parkinson's disease, and have lost a considerable amount of weight to the point I am down to a size four when I should be closer to a size six. Needless to say I really want to get off the Geodone. I also have Chronic Kidney Disease so taking more meds would be a bad idea. I am wondering about Abilify instead of Geodone. What is your experience with this drug? Does it work as well as the atypicals? It should for how much it costs. I also take lamotrigine 200mg/day and trazodone 50mg for sleep.
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1308134 tn?1295187619
MEDICAL PROFESSIONAL
I am sorry to hear about your experiences with atypicals. My experience with them is that response to them is pretty individual (meaning that you might do well on one and not on another and it is hard to predict from the clinical trial data). Also, depending on the type of condition being treated the proper dose varies a lot (for instance, most folks with bipolar type 2 respond to much lower doses than folks with bipolar type 1 - although that also varies.

I don't really having enough information to personalize my reply in any way (I don't know anything about your history of mood episodes and how they relate to each other - meaning how different episodes lead to each other, for instance does depression lead to hypomania, or vice versa).

Abilify and Geodon are pretty different in terms of pharmacology. Abilify is in a category of its own as a partial dopamine (D2) antagonist. That means that in parts of the brain where the level of dopamine is low it boosts activity and in parts of the brain where the level is high (for instance, where mania and psychosis may be activated) it lowers activity.

Geodon is more of a "typical" atypical in the sense that it is a pure D2 antagonist and what makes it "atypical" is that it also is a serotonin (5HT2) antagonist. However, unlike other atypicals it has activity similar to the antidepressant Effexor (serotonin and norepinephrine reuptake inhibition) and buspirone (partial antagonist at 5HT1a).

Phew, you don't need to understand all of that to understand my response but just in case you are interested in the pharmacology I thought I would discuss it.

Abilify is a perfect example of the notion that doses are very different depending on the type of mood disorder. For bipolar type 2 a typical dose would be 2.5 to 5 mg, for bipolar type 1 a typical dose would be 15 to 25 mg a day.

The data on Abilify's effectiveness generally find it to be somewhat less effective than other atypicals, at least in the acute phase of treatment. However, some people do amazingly well on it.

It doesn't cause as much weight loss as Geodon... it is pretty close to weight neutral... although some people tend to gain weight on it slowly (say 2 to 5 pounds a year), but this is very different from Zyprexa or Seroquel that can cause dramatic increases in weight...Generally this can be managed with small changes in exercise and diet.

I start everyone on the medication at very low doses and titrate it upwards (except if someone is acutely manic) because it can cause a disturbing (but not dangerous) side effect called akathisia (feeling the need to move)... and since I started titrating up slowly I have not seen that side effect. It doesn't tend to cause other types of parkinsonian symptoms, however.

Hope that helps.
Helpful - 0
Avatar universal
Thank you very much for your reply. I truly appreciate it. It was interesting to know that Geodone has some similar properties to Effexor and buspirone. I didn't know that.

I am bipolar 2 and I ultra rapid cycle so would probably need the lower dose which is good.

It is so hard to know what to do. Stay with the side effects you know, or try something else and hope for a better result.

Thank you again for your input. It is appreciated.
Helpful - 0
Avatar universal
Hi,

I am not a doctor but I have been on abilify along
with zoloft for over 6 years now and am doing
really well on it.  The zoloft was working pretty
well for my depression/anxiety but it wasnt
until we added the abilify that all my symptons
disappeared.  I love this med and I also have
not had any side effects from it.  Just wanted
to share,

best wishes,
starr363
Helpful - 0

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