Abilify (aripiprazole) is one of the most successful drugs in the pharmacy. Last year this medication had sales of over $5,000,000,000, making it the # 2 medication on the top 10 hit parade of best selling drugs (in dollars).
One of the reasons for such popularity might be the amazing direct-to-consumer advertising campaign for Abilify. Perhaps you have seen the commercials on television.
In one, a cartoon woman complains that although her antidepressant works hard to help with her depression, it just wasn’t up to the task. She still “struggled to get going, even get through the day.” So, the cartoon character is seen confiding to her doctor that she has been “stuck for a long time.”
The cartoon doctor recommends adding a cartoon Abilify (in the form of a big letter A with eyeballs) to the poor inadequate cartoon Rx pill antidepressant. Now the cartoon woman is seen smiling together with a smiling Abilify and a smiling antidepressant pill. They leave the cartoon doctor (who is also smiling) with the hope that the combination would make her feel better soon. Her only regret: “I wish I had talked to my doctor sooner.”
Then, in the classic voice-over, we hear about some of Abilify’s side effects:
“Abilify is not for everyone.
Call your doctor if your depression worsens or if you have unusual changes in behavior or thoughts of suicide…
Elderly dementia patients taking Abilify have an increased risk of death or stroke.
Call your doctor if you have high fever, stiff muscles and confusion to address a possible life threatening condition or if you have uncontrollable muscle movements as these can become permanent. High blood sugar has been reported with Abilify and medicines like it and in extreme cases can lead to coma or death.
Other risks include increased cholesterol, weight gain,, decreases in white blood cells which can be serious, dizziness on standing, seizures, trouble swallowing, and impaired judgment or motor skills.”
While this long list of scary side effects is being read by the announcer we see our cartoon woman interacting with her smiling cartoon character colleagues at work and then serving lemonade to her smiling cartoon family at a backyard barbecue. It’s hard to worry about life-threatening drug complications when everyone seems to be having such a good time.
Abilify was developed as an antipsychotic medication to help people with schizophrenia. For such patients it may be quite appropriate and help them maintain functionality. But it is a powerful medication with many serious side effects. To better understand how this drug and other “atypical antipsychotics” (Risperdal, Seroquel, Geodon, Zyprexa) affect people we offer some stories from real patients who have posted their comments to this website, without the distraction of smiling cartoon characters.
“I was on a low dose of Abilify for a year and a half. The drug was discontinued but I still developed tardive dyskinesia of the mouth that has persisted for over a year. It is debilitating.
“My psychiatrist who prescribed it was so surprised that I developed this. He said he never had anyone else with it.
“How can he be so clueless? I can only guess that with time, he will find more people who develop serious side effects as well. The TV ad lists the side effects casually, as if they are minor, or will go away if the drug is stopped. Please warn others!”
PEOPLE’S PHARMACY RESPONSE:
Tardive dyskinesia (TD) can be incredibly debilitating. It results from drug-induced damage to the brain and can cause uncontrollable muscle movements such as lip smacking, tongue protrusion and grimacing. Some people develop rapid eye blinking or other involuntary movements. Most of the antipsychotic medications can cause this, and we are surprised that your psychiatrist was unaware of this potentially irreversible neurological complication.
Chica shares her experience:
“I was put on a very low dose of Abilify yet had severe weight gain and developed diabetes. I wasn’t on this drug for more than 3 months. I am very disappointed and Abilify didn’t help relieve my depression either.”
Bryan provides this account of TD & akathisia:
“I was diagnosed with bipolar disorder and was placed on a mood stabilizer and antidepressant. The psychiatrist indicated that Abilify would be helpful to add to my regimen to assist towards reaching the desired therapeutic effect.
“I began to pace and was unable to sit still. I literally walked the halls for three days straight. I was desperate for relief and felt in order to keep myself safe I needed to be hospitalized during that time.
“The symptoms persisted long after the medication was taken away. I also had uncontrollable movements with my tongue and slurred speech. None of these side effects were discussed with me.
“May I strongly encourage that you develop a strong alliance with your psychiatrist. If you feel your doctors are not proactive and forthright about the effects of your meds, find a health professional who is. Your quality of life could be adversely and permanently affected.”
PEOPLE’S PHARMACY RESPONSE:
It sounds as if you experienced something called akathisia as well as tardive dyskinesia. Trying to explain akathisia to someone who has not experienced it can be challenging. It is characterized by an inner restlessness that won’t stop. Your description of having to walk the halls continuously just begins to get at this devastating side effect. Other people report pressure on their knees that forces them to pace nonstop or jiggle their legs for hours or even days. It is incredibly debilitating. As mentioned above, symptoms of tardive dyskinesia (uncontrollable muscle movements) can be permanent.
This from Stan:
“Abilify was a horrific drug for me. Used as an adjunct to my antidepressant regimen at the time, it seemed to ‘dumb me down’ severely, and was detrimental to my memory and cognitive abilities. Didn’t work for me. This may be a less reported side effect.”
Jewel’s experience with Seroquel for insomnia:
“I am a 40 year-old female. After suffering a rare stress-induced heart attack I was given Seroquel. I wasn’t asked of course or told what it was.
“I was very stressed and agree I needed the rest for sure, however I was out of it on this medication. Someone from smoking cessation came to talk to me and I would have thought it was a dream but he left paperwork beside my bed.
“I was amazed as I have never had a medicine that just literally paralyzed me physically and mentally. Had they admitted me to a facility and continue on Seroquel until I died I would have opened my mouth and took the pill and did as instructed. My ability to think and/or say no was gone. I am a single mother of 3 and they actually sent me home with a script for this stuff. No way was I going to continue taking it.”
A tragic death reported by E.N.
“Risperdal killed my mother. In 2002 she was in her mid-eighties and in assisted living. The psychiatrist on call put her on Risperdal [risperidone] because she was “argumentative.”
“My mother was also a type 2 diabetic and had been on oral meds for that condition for over 20 years. She was only on Risperdal for a short time, maybe two months, when she tested very high for sugar one day. She was given an injection of insulin that evening and not checked on for several hours. At that time, she was “unresponsive” and taken to the hospital where she died a short time later, never having regained consciousness.
“The doctor said she died of natural causes. In researching her meds, I came upon the information about Risperdal being dangerous for diabetics.”
There is a black box warning about Risperdal (and other antipsychotic medications):
“Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. RISPERDAL® is not approved for use in patients with dementia-related psychosis.”
ABILIFY (ARIPIPRAZOLE) SIDE EFFECTS
- Digestive tract distress, heartburn, nausea, vomiting, constipation, incontinence
- Weight gain, increased appetite
- Headache, dizziness, lightheadedness
- Anxiety, agitation, restlessness, tremor, akathisia: uncontrollable urge to move or pace
- Insomnia, fatigue, sedation
- Dry mouth, excessive salivation, drooling
- Blurred vision
- Arthritis, muscle pain
- Elevated cholesterol
- Fever (a potentially life-threatening symptom requiring immediate medical attention)
- Tardive dyskinesia, uncontrollable muscle movements, lip smacking, grimacing, neck twisting
- Stroke, transient ischemic attack (TIA)
- Low blood pressure, especially when standing, dizziness
- Diabetes, elevated blood sugar
- Irregular heart rhythms, palpitations,
- Pancreatitis, gall bladder problems
- Blood disorders
- Low sodium, high potassium
- Worsening depression, suicidal thoughts
SUDDEN DISCONTINUATION SYNDROME (WITHDRAWAL): A Dirty Little Secret!
The track record of psychiatry has been abysmal when it comes to studying sudden withdrawal from commonly prescribed medications. It took years for researchers to discover that when patients suddenly stopped benzodiazepines such as alprazolam (Xanax), diazepam (Valium) or lorazepam (Ativan) they often experienced very unpleasant withdrawal symptoms. Ditto for antidepressants like citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), sertraline (Zoloft) and venlafaxine (Effexor).
Stopping atypical antipsychotics suddenly may also lead to withdrawal symptoms, but this phenomenon has not been well studied. Some possible reactions that have been reported include nausea, vomiting, dizziness, anxiety, agitation, confusion, uncontrollable muscular movements and sweating.
Because withdrawal from antipsychotic medications is underappreciated, there are few guidelines given to physicians on how to wean patients off such drugs. The FDA has not been very helpful. No one should ever stop such drugs suddenly, though. Please discuss this potential complication with a health professional before beginning this journey.
What has your experience been with medications like aripiprazole (Abilify), risperidone (Risperdal), quetiapine (Seroquel), ziprasidone (Geodon) or olanzepine (Zyprexa)? We recognize that such medications can be very valuable, especially for patients with schizophrenia. Others, however, may find such drugs difficult to handle. Please comment below so that other people can benefit from your story.