I have been on Abilify for 5 years and I am afraid of the risk of TD. Supposedly the longer you are on it the higher the risk. I only take 7.5MG but I feel it’s time to change meds even though they work perfectly. I don’t want to take Seroquel or Zyprexa due to risk of increased sugar in blood. And respirdone just does not work. We don’t have lurasidone here or at least my pdocs have never heard of it the last time I asked.
The thing is, every time I have tried to come off the med with the consent of my GP, it’s ended horribly. Not because of the psychosis (I have not had an issue with that for five years) but because my moods get a bit chaotic.
Now I would much prefer they treat the mood with an anticonvulsant med but obviously I’m not the pro and my GP said antipsychotics are a must for this condition because I had a psyhosis… I wish we patients had more of a say in our treatments…
Arg I was told by one of my earlier pdocs I’d be off these things in two years. Nope. I’ve been on them for 5!
You’re quite lucky in a way, you’ve found a med that works and you’re able to tolerate it. TD is a risk for any med, so I’m not sure changing meds is going to solve that problem.
I dont know why you would want to switch meds, especially if Abilify is working for you.
Out of all of the meds you mentioned, Abilify is probably going to be safer -
You are on a low dose and Abilify has strong mood stabilizing properties, so it acts like a mood stabilizer, especially at the low dose that you are on.
I dont even know that at the dose you are on, its going to act as an antipsychotic.
All of the antipsychotics have side effects, switching to another antipsychotic may not work as well as Abilify.
Abilify and Latuda are pretty safe as far as antipsychotics go - I would discuss all concerns that you may have with your doctor
There is always a significant risk of relapse and problems when you change medicines. Thats why doctors generally want you to stay on something if its working.
The saying here is “if its not broke, don’t fix it”.
If things are going well - perhaps talk with your doctor about lowering the dosage a bit.
Of course - the doctor may not want to due to risk of relapse. (the studies below show that you have about a 50% lower risk of relapse if you’re on antipsychotics.
Ah - right. Don’t lower your medications any more. Sounds like you would be best off just to keep taking them. Abilify is one of the best medications, and it just got very cheap this week because its off-patent and is now available in generic form.
I have been trying to get off lithium since December; but, I have been unable to convince the pdocs and prescribers. It is has been rendered useless to me as I have been on it for over twenty years. I was taking invega but it caused me to have wicked, scary noises in my throat and I was afraid my throat would constrict and I couldn’t breathe. I was on Buspar; but, that put in a an awful fog. So, I am only taking vitamin b12 in the morning and vitamin b6 at bedtime. I am seeing the pdoc on Monday afternoon; but, I will tell her I am tired of the medications. I will take the least amount needed to keep out of the hospital and away from scary thoughts. I think I like the vitamins, though, and I have bought some books on cbt. I discussed this with my therapist and he seems to think the cbt book thing is a good thing and wants me to bring what I read and learn to my sessions. I am not sure about the meds thing, though. I understand they might be necessary; but, too much or the wrong ones can also be very scary and dangerous. As scary and dangerous as the illnesses themselves.
I have been on a low dose of Seroquel quetiapine for over ten years now. No TD at all; no liver problems; no weight gain; no low blood pressure; no nuthin. But it sure helps trim the bipolar mania, not to mention the screwy ideas I get when I’m flyin’.
Risperdal risperidone and Geodon ziprasidone TD’d the bejesus outta me, tho.
Believe me, I am sympathetic relative to lithium. (I am bipolar.) But when Depakote valproix came in years ago, I switched… and the stuff worked pretty well… except it tore my stomach to shreds. (Very acidic; ya gotta take it with food, but even then…)
So we went to Trileptal oxcarbazepine for a while, and it worked okay for about nine months. Then I freaked out (manically) again. So, once my new doc said, “You gotta lotta PTSD going here,” and flipped me to Seroquel quetiapine, everything came up roses (well, relatively).
The trouble with lithium carbonate is that it takes “this” much to get anything useful to happen, and about five percent more than that to make a real mess.
Have you been on Tegretol carbemazepine, Trileptal, Lamictal lamotrigine, Topamax topamirate, or Depakote?
Have you tried any of the anti-Ps like Seroquel, Abilify arapiprasole, Latuda lurasidone, Fanapt iloperidone, etc.? There are a lot of options for bipolar nowadays.
I have been on Depakote; but, it’s kind of useless to me. I have been on Tegretol and it really worked the best for me. However, it lowered my white blood count so low; I got sick and almost wound up in the hospital; but, the pdoc showed mercy on me because it was Christmas and told me to lay low and stay away from crowds. That’s when I got switched to Lithium; over twenty years ago. I was on abilify in addition to taking lithium; but. stopped taking abilify when I had trouble swallowing food and drink. I was fanapt for about a month along with the lithium; but, it is too expensive for my Medicare Part D plan. I was on Seroquel for about a month; but it put me in a fog and brought back my psychotic thoughts. I have also been on risperidal in addition to the lithium for many years. (I think risperidal made me have to buy a bigger sized bra!) I don’t like lithium; because you have to be so wary about the heat and I live in the SE USA! I have been diagnosed schizoaffective; although I really believe I am both bipolar and have schizophrenia. Pdocs and the mental health industry prefer shorthand. I got my disability with a schizoaffective diagnosis. My last intake diagnosed me bipolar; but, my therapist questions this and he is trying to obtain my records from my previous mental health clinic. After all these years, I am really getting all “drugged” out! I think I wrote I see the pdoc on Monday afternoon. It’s hard to explain to them what really goes on in the brain and body. Even the best get some sort of mind/prescribing/diagnosing block. Thank you for the information, though. For some reason, I feel hot this early morning and I am coming down with a headache and I am not taking any of those drugs right now. Sometimes, I don’t understand my mind/brain or body; but, I am resolute to be as healthy as I can and live to 100 years old despite it all! One more thing, I have also been on trileptal/ oxcarbazepine at one time. For me, I would have done better with a sugar pill!Thanks again, notmoses. Your thoughts and caring are helpful and appreciative!
I believe you are at risk of TD on any anti-psychotic, not just Abilify. Stop one to go on another one wouldn’t make any sense to me. You are right back where you started. Some patients are at higher risk for TD than others. I have a relative who suffers from TD and she is**emphasized text suffering from it. I’ve been on one anti-psychotic after another for 52 years and TD hasn’t bothered me. If Abilify is working for you, I would stay on it.
Encephale. 1993 Nov-Dec;19(6):645-50.
[Short-term sequelae of lithium discontinuation].
[Article in French]
Verdoux H1, Bourgeois M.
Author information
Abstract
It has long been considered that lithium therapy could be abruptly stopped because it was guessed that lithium salts did not induce withdrawal symptoms. However, several open and controlled studies have shown that lithium discontinuation was associated with a possible withdrawal syndrome and with an incontestable rebound effect. Lithium withdrawal symptoms have been described in some patients, but it is not easy to distinguish them from depressive or manic symptoms, because no specific somatic withdrawal symptoms have been observed. The most important risk related to lithium discontinuation is the early recurrence of bipolar illness. Especially, it has been shown that the risk of manic recurrences is increased in the first weeks after discontinuation of lithium therapy, and that this risk is higher than the one predicted by the natural history of the manic-depressive illness. Relapses can occur even when lithium is stopped only for a few days. Abrupt discontinuation of lithium seems to be associated with an increased risk of recurrence. The pathophysiology of this rebound effect is still unknown. In clinical practice, lithium discontinuation has to be gradual when possible. Further studies are needed to precise at what time the risk of lithium withdrawal syndromee develops after starting lithium therapy. It is also necessary to establish more precise clinical guidelines for lithium discontinuation.
Br J Psychiatry. 1993 Oct;163:514-8.
Is there a lithium withdrawal syndrome? An examination of the evidence.
Schou M1.
Author information
Abstract
The evidence for abstinence phenomena after discontinuation of lithium is weak and ambiguous. Early manic and depressive recurrences after lithium discontinuation may suggest rebound, but studies carried out with appropriate methodology have failed to confirm its reality. Discontinuation of prophylactic lithium treatment of recurrent manic-depressive illness, whether abrupt or gradual, involves risk of relapse, but the existence of a special lithium withdrawal syndrome remains unproven.
J Clin Psychiatry. 1999;60 Suppl 2:77-84; discussion 111-6.
Effects of lithium treatment and its discontinuation on suicidal behavior in bipolar manic-depressive disorders.
Baldessarini RJ1, Tondo L, Hennen J.
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Abstract
BACKGROUND:
Whether mood-altering treatments reduce risk of suicidal behavior remains largely unproved.
METHOD:
We compared suicidal rates in published studies of patients treated with lithium with those who were not, and in a mood disorders clinic before, during, and after discontinuing lithium.
RESULTS:
Published reports indicate a 7.0-fold lower rate of suicidal acts with lithium treatment of manic-depressive patients. In new findings in over 300 bipolar patients, latency from illness onset to lithium maintenance averaged 8.3 years (from 11.0 years in women with bipolar II disorder to 6.9 years in men with bipolar I disorder), but half of all suicidal acts occurred in the first 7.5 of 18.3 years at risk. Most acts (89%) occurred during depressive (73%) or dysphoric-mixed (16%) mood states and were associated with previous severe depression, prior attempts, and lower age at onset. Morbidity was reduced 2.7-fold and suicidal acts per year 6.5-fold during lithium treatment, with 8.3-fold cumulative sparing of risk by 15 years on lithium. In the first year off lithium, affective illness recurred in 67% of patients, and suicidal rates rose 20-fold but were much lower thereafter; fatalities were 14 times more frequent after discontinuation of lithium. Early morbidity was 2.5-fold lower, and suicidal risk was 2.0-fold lower after slow versus rapid discontinuation.
CONCLUSION:
Lithium maintenance is associated with sustained reduction of suicidal acts in manic-depressive disorders. Treatment discontinuation, particularly abruptly, led to early affective morbidity [depression, anxiety, mania] and suicidal behavior. Improved diagnosis and treatment as well as earlier intervention for potentially lethal bipolar depression are urgently needed, as are studies of all mood-altering agents for effects on suicidal behavior.
