Posted by med_empowered on March 28, 2005, at 13:31:11
In reply to Abilify and TD, posted by scribble'ntweak on March 28, 2005, at 11:23:27
Hey! I took abilify for a while (dose range: 10-30mgs, for Bipolar Disorder+Psychotic Depression) and didn't have develop TD, although the high-end dose did make me shake some (treated with propranolol+the dose was lowered). I'm off Abilify and all anti-psychotics now, and I still don't have any problems, although during Abilify withdrawal I started shaking some...it went away after a few weeks. Anyway, its hard to tell you just how risky any antipsychotic, especially the new ones, are in terms of TD development. The 1980 American Psychiatric Association taskforce on TD reported a 3%/year rate for the old ones, with 20% eventually developing it after a period of 5 years. Other researchers say that the APA data was low, and put the old antipsychotic TD rate at around 30-40% for 5 year continuous exposure and as high as 60-70% for lifetime (20-25 year), chronic exposure seen in chronic schizophrenia. As for the new ones...Risperdal seems to be worse than all the other new meds in terms of TD development, but I haven't seen any solid data on that. Cases of TD and neuroleptic malignancy syndrome have been reported for all known neuroleptics. The best estimate I could find for the new antipsychotics puts the rate at anywhere from .5-1%/year...the risk from long-term exposure is going to take a while to gather. My personal advice would be to stop taking ANY anti-psychotic, if possible, and find a less risky form of treatment. If you're using Abilify as a mood-stabilizer, you can probably get comparable results with less risk from "conventional" mood-stabilizers such as Depakote, Lithium, and Tegretol. If you're using Abilify for severe and/or psychotic depression, replacement meds may be hard to find...then again, even psychotic depression has been shown to respond to anti-depressants alone, or ECT w/ anti-depressant(s). Some people take Abilify for anxiety...I personally think this is way too risky, unless there's some major reason you're unable to tolerate benzos, anti-depressants, or other treatment for anxiety (talk-therapy helps alot, too). If you have Schizophrenia/schizoaffective disorder, your options are decidedly limited. You do, of course, have the option of going anti-psychotic free; the risk of relapse is high, but some people manage, and there are some mental health professionals engaged in treating chronic psychotic disorders without neuroleptics, or with minimal anti-psychotic use. Basically, I quit Abilify in part b/c of the "zombie" side-effects (not specific to Abilify, at least in my experience; I had bad side-effects from all atypicals I tried) and in part b/c of the long-term risk of developing TD. As I said, data on TD is kind of sketchy, even for the old drugs, and is even more scarce for the "new" drugs, in large part b/c a HUGE part of their success in the marketplace is dependant upon having fewer side-effects than, say, Haldol...shrinks seem reluctant sometimes to admit that these drugs even HAVE risks, since they're so sold on their safety, efficacy, etc. My personal decision was to stop the Abilify and never take any anti-psychotic again, atypical or otherwise, unless very good, very solid research came out that showed that TD would *not* be a problem. Good luck!
poster:med_empowered
thread:476728
URL: http://www.dr-bob.org/babble/20050326/msgs/476755.html