Talk:Aripiprazole

EPS

Why isn't there any mention of it's potential for extrapyramidal side effects

The reason there's no mention is because there's not any. The studies haven't found significant evidence of them. It's a dopamine receptor AGONIST. Technically, if it did what they think, it could be used to treat parkinsons. 69.205.97.220 (talk) 03:23, 1 May 2009 (UTC)

hogwash. —Preceding unsigned comment added by 76.108.242.37 (talk) 15:14, 15 May 2011 (UTC)

this is a misunderstanding of partial agonism. Partial agonists usually function as a competitive antagonist at the receptor site. A full agonist will exhibit 100% effect, while a partial agonist has <100% effect leading to a relative reduction in function despite being an agonist. Therefore, the partial effect exhibited by aripiprazole at the dopamine receptor sites(2-4 primarily) decrease the effect of dopamine and can cause parkinsonian types of side effects.

sure it can cause EPS. it's dose-related from 5%-16%

                            Pharm D at psych hospital

Effects

Surely weight gain is a side effect as with other atyp anti psy.??? 220.237.158.214 10:22, 26 September 2007 (UTC)

Can anyone find specific information about what this medication does?

ADHD instead of due to the calming effect it has although it is not licensed for ADHD treatment What specific kind of information are you looking for?

Search Google for aripiprazole and you will find more information than you may wish to digest.

This is just medical justifiation of many cases of mind control

Yes, I need this class of drug. Thanks for the info - I am going on a drug trial of this.

The statement that there are case reports of abilify inducing mania needs citations. Medline does not show any such case reports in my search, and I have never heard this. Abilify is used to treat mania. It can cause akathesia and states of agitation, which are not the same as mania, although may be confused with mania. It does not cause weight gain, unlike most of the other atypical agents. —Preceding unsigned comment added by Lizdoc (talk • contribs) 17:31, 14 February 2008 (UTC)

Anecdotal evidence

I know Wikipedia prohibits original research, but I know that I experienced tardive dyskinesia and insomnia after only about a week on this drug (prescribed for manic break). I was also taking an antibiotic that is metabolized by the liver, so I think that was blocking the pathway and may have strengthened the effect some. Is there any data to be had as to how common such reactions are among users of the drug, or is still too early? I was rather upset, to say the least, once I had recovered to find that I had been put on such an untried medication. Now I'm on Depakote, which seems to stabilize me without any significant side effects Evan Donovan 03:10, 25 March 2006 (UTC)

Anti-biotics commonly interact with many drugs.J. M. 02:25, 22 May 2006 (UTC)

What you was experiencig after a week of aripiprazole medication almost certainly was not tardive dyskinesia, unless you've been taking other antipsychotics before at least for some weeks (rather months or years); what it well could have been would be early extrapyramidal syndrome; in this cases, dystonia, dyskinesia, akathisia and the like are not uncommon. Insomnia could have been a side-effect of aripiprazole medication; and some antibiotics are certainly inhibiting microsomal metabolism of other drugs, aripiprazole included. Wish you all best with current therapy.--Spiperon 09:21, 4 May 2007 (UTC)

I would not consider this "original research" anymore maybe it is time some doc wrote an article on this so we can make it a fact. Oh i know this is not a "request page" but can someone clarify that MAJOR WARNING!!! message at the bottom of this page? its making me nervous.

I would just like to add that within one month of my starting Abilify, I started having severe restless leg syndrome. Just another side effect to look out for with this drug. —Preceding unsigned comment added by 66.140.82.161 (talk) 16:31, 28 March 2008 (UTC)

I thought I would add that I had been on Abilify for a short while, but started having linguistic hallucinations (basically, auditory hallucinations, however as a polyglot I couldn't attach a specific language to any of the hallucinations, just random spontaneous hallucinations of meaning). I tried to offer my pen to a wall one time. It's probably important to note that this drug shouldn't be used for anyone without mood-stabilization issues in their depression. --Puellanivis (talk) 08:06, 16 December 2008 (UTC)

Abilify is a dopamine receptor AGONIST. What you guys are describing is basically impossible if you were normal. The person who says RLS, it's probably tremors - abilify increases motor activity (though dopamine), you're probably only noticing because when you go to sleep, dopamine levels RISE until you fall asleep. And the other person who says hallucinations - you're probably right. Hallucinations get worse on Abilify, but usually only after pre-treatment with a typical antipsychotic - a typical antipsychotic can upregulate dopamine up to 98% - check haloperidol, but I don't doubt someone will develop hallucinations after taking it normally. Anecdotally, I'm having some language difficulty on Abilify (I say the wrong words e.g. if they sound alike) and my attention is reduced to nothing - like from playing video games for an hour now I quit after five mins, but here's the catch - I have treatment resistant depression, and the medicine isn't working for that anyway.

Here's one link for agonism proof: http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T1J-4CCP0FS-1&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=6f2e8a522bc80b0d62b05df0fa11ba81

Risperidone to Abilify relieves Tardive Dyskinesia: http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6TBR-4VFC82H-2&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=4b829dcb22e31474b8a55b57cd0e11a1 69.205.97.220 (talk) 03:42, 1 May 2009 (UTC)

It is a partial and selective dopamine agonist, your sir are a tard. Anti-psychotics, typical or atypical, should be used with caution in anyone. Also raising dopamine lowers serotonin and raising serotonin lowers dopamine, so perhaps there is something to do with that if it actually was a true dopamine agonist (like cocaine or amphetamine) 71.162.227.170 (talk) 19:36, 4 June 2009 (UTC)

This is a misunderstanding of pharmacology. Abilify is a partial agonist, meaning that is exhibits less effect on the receptors than does a full agonist, in this case dopamine. It is a competitive antagonist since they are both capable of exerting effect at the receptor site, which REDUCES the effects of dopamine. In parkinson's disease, there is a relative lack of dopamine receptors, using abilify would exacerbate the disease state by inhibiting dopamine activity. Hope that helps.

                                                              PharmD at a psychiatric hospital  — Preceding unsigned comment added by 159.238.36.19 (talk) 20:23, 16 August 2013 (UTC) 

Spelling

Please correct "miscle", etc under "Side Effects"

Tardive dysphrenia

I've included a link to the new wiki Tardive dysphrenia (under See Also), which I hope, must be of interest to this one. Cheers, LFrota.

Major Warning!

Waring: This drug (even at low dosages) may cause liver failure/disease, high chlosterol, diabetes, and weight gain, etc.

This guy better be screwing around! ill rather die than to go trough this kinda fucked up stuff... oh and cholesterol is misspelled... can someone clarify this ASAP? (please?)

There's no evidence of those effects. 69.205.97.220 (talk) 05:11, 1 May 2009 (UTC)

69.205.97.220, I swear to fucking god you work for a pharma company, weight gain is common with dopamine changes because less dopamine = more eating (that is why amphetamine for example stops you eating since it is such a potent dopamine agonist), stop spewing shit out of your mouth. 71.162.227.170 (talk) 19:38, 4 June 2009 (UTC)

This is a dopamine agonist too, dork. — Preceding unsigned comment added by 67.169.180.34 (talk) 19:29, 5 November 2011 (UTC)

Not an azole

Who names these drugs? It's not an azole! Bloody pharmacologists.

New Indication for Major Depressive Disorder

On 11/16/2007, US FDA approved aripiprazole for use as adjunctive therapy for Major Depressive Disorder (unipolar depression).

For this purpose, it is usually prescribed at a much lower dose than for bipolar or schizophrenia (schiz= 10-15 mg/day, bipolar=15-30 mg/day, major depress=5-10 mg/day with starting dose of only 2 mg/day).

This is listed on FDA website:

http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.Label_ApprovalHistory#apphist

and new FDA labeling info is here:

http://www.fda.gov/cder/foi/label/2007/021436s018,021713s013,21729s005,021866s005lbl.pdf

Crazymiddle (talk) 03:57, 22 November 2007 (UTC)

I've just been perscribed this drug at 5mg to replace the Seroquel I've been taking for the last 7 months after having gained 30 pounds in 7 months. But this doesn't seem to be any better when I read the side effects. Has anyone actually taken this drug and did you gain weight or not? What about the diabetes issue? —Preceding unsigned comment added by 71.127.131.100 (talk) 20:19, 20 June 2008 (UTC)

I just recently started taking it and my appetite is way up, so I guess it can make you overweight. Not sure about the Diabetes, though. It seems likely that diabetes would be a product of increased appetite, thus making Apiprazole only the indirect cause.

3D structure

It would be nice to get a 3D representation of the aripiprazole molecule. Is their anyone out there that could add one?--Metalhead94 (talk) 18:02, 19 November 2008 (UTC)

Someone added one, but an animated one, which I find next to unusable, and removed the stick-and-balls one. I'm pretty sure I've seen click-for-animation images somewhere on Wikipedia. Is there a better way to have those than a static GIF linked to a spinning one? Pending that, I'll remove the animated GIF and restore the ball-and-stick one. The Crab Who Played With The Sea (talk) 08:32, 22 July 2013 (UTC)

Using Abilify for ADHD?

I know a woman who has gotten Abilify for her ADHD. Does anybody know if this is a known usage of Abilify? --Algotr (talk) 22:41, 29 April 2009 (UTC)

Abilify has been researched for ADHD, and while there's nothing really definitive, at least one pilot study in children with no comorbidities and two studies in children and adolescents with comorbid bipolar disorder have been done, with mixed results (two favorable, one unfavorable wrt reduction in ADHD symptoms). --Aurochs (Talk | Block)

I think that information should be in the article as well! --Algotr (talk) 18:32, 14 May 2009 (UTC)

So do I. I just need to get up off my lazy ass and finish writing the therapeutic uses section. --Aurochs (Talk | Block)

"Aripiprazole is at least as effective as haloperidol at reducing manic symptoms"

I find this statement pretty dubious. I can understand how it would be better tolerated, but, I highly doubt it is AT LEAST as effective as haloperidol. This isn't just my original research or POV either, I think most psychiatrists would agree, I don't see aripiprazole being very effective in cases that would require Haloperidol. Any feedback is welcome.--Metalhead94 (talk) 13:57, 10 July 2009 (UTC)

I was only following the abstract of the article I cited. I don't have access to the article itself, nor the training to determine whether or not it's reliable. If you're able to review the study and debunk it, be my guest. However, my understanding is that anecdata is not a reliable source as far as Wikipedia is concerned. --Aurochs (Talk | Block)

Okay, I just reviewed what I could of the article, and it appears that most of the authors were employed by either Brisol-Myers Squibb or Otsuka. That alone makes the abstract suspect, but it doesn't necessarily disprove the findings. If anybody can get me a copy of the article, I would be pleased to review the data to the best of my ability. In the meantime, I'm tagging it as a possibly unreliable source. --Aurochs (Talk | Block)

I agree. I generally am careful around studies funded by pharmacuetical companies themselves, as they often seem slightly biased, especially when it is the very company[ies] that market the drug. Thanks for the feedback.--Metalhead94 (talk) 19:29, 11 July 2009 (UTC)

Side effects: citation needed for sudden death claim under side effects section

I've marked that tidbit of info with a citation needed tag. If anyone can find a source that says Aripiprazole causes sudden death, go ahead and add it in because I can't seem to find one. --69.109.159.232 (talk) 15:13, 11 February 2010 (UTC)

Location

Where do they make and produce abilify? —Preceding unsigned comment added by Eupeyd (talk • contribs) 21:05, 24 March 2010 (UTC)

Chemistry

Why does the posted synthesis use a chemical weapon (mustard gas, in this case)? I mean it's great to find new applications for chemical weapons but I am somewhat skeptical that this is the correct synthetic pathway. That and it doesn't come up in any patent/research article related to synthesis of this drug. —Preceding unsigned comment added by 18.60.11.132 (talk) 19:51, 19 May 2010 (UTC)

Use of Ki values

Is it really necessary to have a long list of numbers that are completely meaningless to the average reader, and easily found by anyone who does know what they mean? What's especially problematic is that there's only one source given for these numbers, even though different labs can come up with completely different values. There's no real assurance given in the text that these numbers closely approximate other published data. I just feel like aripiprazole's affinity for various receptors can be easily explained without getting so technical, and that anyone who wants more precise information (i.e. numbers) can follow the citations. --Aurochs (Talk | Block)

It's been over a month since I posted this, and nobody has responded. I'm going to go ahead and remove the list of values from the page. --Aurochs (Talk | Block) 00:31, 26 September 2011 (UTC)

It's an encyclopedia. Please put the table back. — Preceding unsigned comment added by 67.169.180.34 (talk) 19:31, 5 November 2011 (UTC)

Exactly. It's an encyclopedia, not a technical reference. I do not expect to see long lists of data in any encyclopedia article. --Aurochs (Talk | Block)

Litigation

It would be helpful to have a section entitled "Litigation" on this drug and many others. The best way to gauge the seriousness and pervasiveness of the side-effects for drugs like Abilify is to look at the lawsuits. Who is suing? Why? Have class actions been initiated? What are the characteristics of the Plaintiffs? What are the claims? Wrongful death? Loss of consortium? Serious bodily harm? Have doctors been sued as well as the drug companies? Have settlements been reached? If so, how much? Has a verdict been rendered? If so, where and for how much? Has the research that lead to the approval of this drug been subjected to scrutiny through the deposition process? If so, what were the results? Were admissions made? Etc. — Preceding unsigned comment added by 70.173.238.127 (talk) 04:46, 29 May 2012 (UTC)

Binding Profile

There is an error there: aripiprazole is 5HT2A partial agonist, not parcial antagonist. Correcting it. Thank you. — Preceding unsigned comment added by 163.247.80.14 (talk) 13:36, 13 May 2013 (UTC)

Ongoing Phase 3 trial

Is the currently ongoing phase 3 trial (efficacy and tolerability of aripiprazole depot IM injection for treatment of bipolar disorder I) worth mentioning in the wiki? Here's the link: http://clinicaltrials.gov/ct2/show/NCT01567527 I'd make that nicer... but I don't know how to do a link in wiki markup! Sorry... Havensfire (talk) 18:20, 22 June 2013 (UTC)

We do not typically mention ongoing trials unless they have been discussed in a secondary source (thus putting them into context). Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:30, 22 June 2013 (UTC)

Chemical structure diagrams with no description

If I draft a description, can someone check for me that it's accurate? The Crab Who Played With The Sea (talk) 08:39, 22 July 2013 (UTC)

Autism

Some portions of the article say irritability associated with autism, and some just say autism. The drug is approved by the FDA for the former. It's misleading to only say autism, and I believe this should be changed. Thoughts? Archdiamond (talk) 17:09, 3 October 2013 (UTC)

Is this the same as saying that it treats symptoms? MaynardClark (talk) 14:46, 26 April 2014 (UTC)

...Society and Culture...?

Society and Culture seems like a weird heading for the information it contains, but I'm having trouble coming up with a better one.Archdiamond (talk) 17:17, 3 October 2013 (UTC)

I agree, I was expecting more about how commercials advertising the drug have become the target of jokes. Seriously the list of side effects is comical.

Diabetes etc.

The article mentions diabetic ketoacidosis as a side effect, but it doesn't say anywhere that Abilify can cause blood sugar problems that lead to diabetes. To me, saying diabetic ketoacidosis does not imply that. Thoughts? Archdiamond (talk) 17:19, 3 October 2013 (UTC)

Removed large tract of uncited text added by good faith edit by IP, I've placed it below if anyone wants to restore it with citations

Misuse of Aripiprazole (Abilify)

Receptors are activated by agonists and blocked by antagonists. Upon binding to its receptors, an agonist will trigger a cascade of biochemical and/or physiological reactions. Each agonist has two characteristics: affinity and efficacy. Affinity is the reciprocal of dissociation constant. It indicates how tightly an agonist binds to its receptors. Efficacy was measured by the effectiveness of the response elicited by an agonist. A full agonist produces 100% response while an antagonist produces no response and blocks the activation of receptors by its agonists. A partial agonist, also called a partial antagonist, produces less than 100% but more than 0% response. It blocks a full agonist but can still produce partial response. It also can replace an antagonist and unblock the blockage by the antagonist. As a result, it will produce a partial response. Using a simple analogy, we may say a full agonist opens a door fully; a full antagonist keeps the door closed. A partial agonist will keep the door ajar.

Abilify is a partial agonist on the Dopamine D2 receptor site. It has been misused with full D2 antagonists, such as Risperdal, Zyprexa, Geodon, Haldol. It will attenuate the effects of a full D2 antagonist. It has been observed that Abilify worsened TD, similar to withdrawal TD, and exacerbation of psychosis in patients who were on a full antagonist and then started Abilify.

Partial agonists have used for various reasons. Subutex, a partial agonist on opioid mu receptors, is used for opioid withdrawal and addiction. If a patient has been on a full opioid agonist, the patient has to wait until moderate withdrawal symptoms occur before starting Subutex. If it is used too early, it can precipitate opioid withdrawal symptoms. Suboxone, a combination of Subutex and Naloxone, a full opioid antagonist, is used to prevent perenteral use of Subutex. When administered sublingually, due to its low bioavailability, Naloxone has minimal effects on Subutex activity, whereas when administered intramuscularly, Naloxone is able to block the partial agonist activity of Subutex. Chantix, a nicotinic acetylcholine receptor partial agonist, has been used for nicotine cessation. It produces partial activation of the nicotinic acetylcholine receptors so that a smoker will not have severe nicotine withdrawal symptoms and at the same time, the smoker will not be able to feel the full effects of nicotine as Chantix occupies the receptor and prevent nicotine from binding to the receptor. Acebutolol, a partial agonist on beta adrenergic receptor site, produces a lesser reduction in heart rate and cardiac output than does a full antagonist (propranolol or atenolol). It has been used on hypertensive patients with slow heart rate.

Abilify is also a 5-HT-2A receptor antagonist and can alleviate depressive symptoms. But it should not used when a patient is on a D2 antagonist or a D2 agonist.

In summary, Abilify interferes with full D2 antagonists or agonists. It should not be used with those medications. Economically, it is a waste of money. Pharmacologically, it does not make sense. Clinically, it is not a good practice.Wzrd1 (talk) 16:13, 16 October 2013 (UTC)

Off-Label Uses

Can the edit (inserted sentence) "Abilify is sometimes used to treat ADHD instead of due to the calming effect it has although it is not licensed for ADHD treatment" be rewritten as "Abilify is sometimes used of-label for ADHD because of its calming effect."? MaynardClark (talk) 14:46, 26 April 2014 (UTC)

That would be an off-label use. It'd require a citation, but we should first get some consensus here on including it. Anyone, is it a common off-label use for ADHD that would make it notable enough to include in the article?Wzrd1 (talk) 14:57, 26 April 2014 (UTC)