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Abilify Review: Effective for Mental Disorders?

Abilify Review: Effective for Mental Disorders?

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Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s). We recommend that patients follow their doctor’s guidance in regard to prescription medication.

Abilify is one of the most commonly-prescribed antipsychotic medications. The generic name for this drug is aripiprazole, and we’ll use these two terms interchangeably throughout the article because they refer to the same chemical compound.

In this article we’ll review the medical research on Abilify to determine if it’s likely to be safe and effective, to highlight some of the side effects, and to compare the various types of Abilify.

Does Abilify Work?

Abilify has been shown to be effective for managing a variety of mental conditions, including schizophrenia, mania, and bipolar disorder. It’s approved by the Food and Drug Administration (FDA) for all three uses.

A medical review of Abilify for schizophrenia published in the well-respected Clinical Therapeutics journal examined 11 individual trials on the topic.

The study authors found that Abilify was effective as a monotherapy (use of one drug alone) to treat schizophrenia in both short-term and long-term trials. One of the studies lasted up to 52 weeks, and symptoms were controlled throughout. The drug was even found to be effective for treatment-resistant schizophrenia, which is defined as schizophrenia that did not respond to multiple other drugs.

A similar meta-study examined the efficacy of Abilify for treating acute mania. Ten individual trials were included in the review.

Abilify was found to be effective for reducing mania symptoms short-term (3 and 4 weeks from start of treatment) but not long-term (6 weeks from start of treatment). The medication was equally effective to two other commonly-prescribed drugs for mania, lithium and haloperidol.

Abilify is effective on average for mania, but it appears that the clinical backing is weaker than its efficacy for treating schizophrenia.

An extensive review of Abilify for bipolar disorder was published in 2017, which analyzed the results from 20 separate trials on the topic.

The review found that Abilify was effective for some characteristics of bipolar (acute mania, psychosis) but not others (depressive symptoms). It was concluded to be effective overall because it improved patient wellbeing when compared to placebo.

Clearly, there exists extensive medical data to suggest that Abilify can treat the mental conditions it’s approved to treat. Otherwise it wouldn’t have been approved by the FDA.

This doesn’t mean that it will be effective for all patients or lead to full remission of symptoms in all patients, just that it improves the condition compared with not taking the drug.

How Does Abilify Work?

Abilify is effective because it stabilizes dopamine and serotonin levels in various regions of the brain according to the StatPearls resource. These neurotransmitters are essential to proper cognitive functioning, and often exist in sub-optimal levels in patients suffering from mental conditions.

More specifically, Abilify is a receptor agonist at the D2 and 5HT-1a receptors and an antagonist at the 5HT-2a receptor. An agonist is a compound that activates receptors to produce a biological response, while antagonists do the opposite: they bind to receptors and reduce their response.

Relative to more commonly-diagnosed mental conditions like anxiety and depression, the understanding of the medical community of exactly what causes schizophrenia and bipolar disorder is still early-stage.

Abilify Side Effects

Most psychiatric medications come with a risk of side effects, and Abilify is no different in this regard. 

According to research, the most common side effects of Abilify are restlessness, drowsiness and nausea. 

The FDA also published a concerning warning letter in 2016 covering the impulse-control problems associated with Abilify use. The agency explained in the letter how Abilify’s warning of problem gambling as a rare side effect wasn’t comprehensive enough, and that compulsive eating, shopping and sexual habits were also a risk.

Abilify also has a black box label warning which details how it may increase suicidal behaviors and actions.

Clearly the side effect profile of Abilify is substantial, and something that patients should seriously discuss with their doctor prior to treatment. Medications for more severe conditions tend to have more severe side effects, and this is one of the most serious side effect profiles of any pharmaceutical medication we’ve reviewed to date.

Injectable Vs. Oral Abilify

Abilify comes in multiple formats: oral (pills) and an intramuscular injectable form. The injectable version of Abilify is called Abilify Maintena.

The main benefit from the injectable version seems to be that it’s longer-acting. A clinical trial comparing the two types of the drug found that the injectable was no more effective than the oral tablets, but that it had a longer duration. 

Intramuscular injections carry their own set of risks independent from the drug used, so we recommend that patients talk with their doctor about taking the oral version of Abilify unless there is a strong reason to take intramuscular instead.

Abilify Dosage

The dosage of oral Abilify tablets prescribed tends to range from 5 milligrams (mg) to 30 mg daily according to previously-linked research. 

Intramuscular Abilify dosage ranges from 441 mg to 1064 mg.

The dose used for treating bipolar and schizophrenia tends to start at 10 or 15 mg and work up to 30 mg, while a lower dose of 2-5 mg is often prescribed when Abilify is used as an adjunctive (additional) drug with a different drug for the main treatment.

It’s important that patients on Abilify speak with their doctor about dosage if they’re not receiving benefits from the treatment, because in some cases increasing the dose (within the safe range) can make the treatment more effective.

Abilify Generic Vs. Brand Name

As referenced in the intro paragraph, the generic form of Abilify is called aripiprazole. This is the same chemical compound as Abilify; the latter version is just branded because the pharmaceutical company that develops a new drug owns the naming rights.

An extensive medical review comparing the effectiveness of branded and generic drugs found that overall there was no difference, which is unsurprising given that the active ingredients are the same.

For this reason, we recommend that low-income patients speak with their doctor about aripiprazole rather than Abilify if they’re considering treatment with this drug. Generic drugs often cost significantly less, especially for patients without medical insurance who are paying out-of-pocket.

Does Abilify Cause Weight Gain?

One potential side effect that patients are often concerned about with Abilify treatment is potential weight gain. A medical study analyzed whether Abilify use was associated with weight gain on average and found that it was.

Patients taking Abilify alone did gain weight throughout the course of the study, but there was no control group so it’s impossible to conclusively say that Abilify caused the weight gain.

Another medical review compared the risk of weight gain and metabolic disorder from Abilify use with that from other antipsychotic medications, and found that while Abilify was associated with weight gain, it caused less weight gain than other drugs in the same class.

It appears that the risk of weight gain is not unique to Abilify but to atypical antipsychotic use generally, and that Abilify may be the best option in regard to minimizing risk of weight gain when selecting a drug for this type of treatment.

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Abilify is effective for treating various forms of psychosis based on medical research. It has been proven to treat schizophrenia, acute mania, and bipolar disorder.

The drug comes with some serious side effects to consider, but unfortunately there don’t appear to be many natural options for psychosis which are research-backed. We typically reference a natural alternative in our pharmaceutical review articles to provide consumers with a treatment option to discuss with their doctors that may be less risky, but we couldn’t locate any medical research proving a supplement or lifestyle change was effective for treating psychosis.

Abilify is associated with weight gain, and may increase impulsive behaviors and suicidality. 

We recommend that patients speak with their doctor about the benefits of Abilify oral versus Abilify Maintena, because the added risk of intramuscular injection doesn't appear worth it to us without clear benefits.

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