Metabolic syndrome and drug discontinuation in schizophrenia: a randomized trial comparing aripiprazole (Abilify) olanzapine and haloperidol


The prescription of aripiprazole (Brand name Abilify) did not significantly reduce the rates of Metabolic Syndrome (e.g. diabetes), but its treatment retention was worse.

Aripiprazole cannot be considered the safest and most effective drug for maintenance treatment of schizophrenia in routine care, although it may have a place in antipsychotic therapy.


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“The psych med that doesn’t produce nasty side effects if you have to use it for a long time hasn’t been invented yet.” – Andy Janik, MD, psychopharmacologist extraordinaire, Rancho Mirage, CA.

I guess I have been relatively lucky when it comes to physical side effects. Biggest one for me has been weight gain.
In terms of symptoms as a side effect I do think antipsychotics may dampen positive symptoms while increasing negative ones.
It’s hard to get the balance right.

I no longer think that. I know that (now). And why. Which I have laid into a couple of times on other threads the last couple of days. Anti-Ps being the diametric opposite of anti-Parkinson’s meds and all that.

One little sliver of Seroquel usually gets it done for me now. But I will take two little slivers – or a whole 25 whopping mgs – if I get wrenched up into the hypomanic stimulus chasing – and then feel like they dropped the bed on me the next morning. (Med-sensitive? Noooooooo.)

I am more cautious. I had a drive, goal directed(the only goal I can think of is to lose weight) and motivation problem before I was taking meds regularly .
It’s therefore hard to tell whether the med has been just ineffective with dealing with that ,but the problem stayed at the same level, or whether the med exacerbated the problem .
It’s very hard to assess which is true.

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My psychiatrist explained me why my current medication (aripiprazole) is effective against voices yet also more activating than my previous one (risperidone). He said while there may be too much dopamine uptake in one area, there may be too little of it in another. Suggesting that the former is responsible for hallucinations, and the latter for lack of drive and motivation. Accordingly, a drug that would just block the dopamine receptors across the board would be expected to be effective versus the hallucinations, but would exacerbate the drive/motivation issue. Because my current medication is supposed to have more of a balancing rather than a blocking effect, in theory it can work on both areas.

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Yes- that makes sense to me and is what I have read and said in forums(though put in simpler terms ie too much dopamine in one part of the brain too little in another).
Certainly things that might be called “positive” symptoms are less pronounced but those that would be called negative have at best remained at the same level.
I think in terms of functioning this is problematic. As it is the cognitive/negative symptoms that have the most negative impact on occupational and social functioning.

cc: @firemonkey

Lordy, yes. Which accounts for mixed symptoms in many sz pts. And we shouldn’t think that those up-regulations or down-regulations will remain stable or “permanent,” either. Stress, diet, illness, positive experiences (e.g. a new romance, even a new pet) & Lord only knows what all else can open and close Da receptors. (Sigh.)