Posted by med_empowered on September 7, 2008, at 12:10:29
In reply to Re: Is Abilify pretty safe concerning tardive dys? » theo, posted by yxibow on September 7, 2008, at 3:51:11
hey. OK, I did some reading...no one really knows how likely Abilify is to cause TD. On the one hand, it doesnt' seem to cause nearly as much dopamine upregulation as, say, Haldol...and dopamine upregulation may be part of what causes TD. (Dopamine upregulation happens when your brain creates new dopamine receptors in response to the hardcore dopamine blocking induced by antipsychotics).
Its good that Abilify doesn't cause much dopamine upregulation but...apparently, Zyprexa causes about as much Dopamine upregulation as Haldol, but causes considerably less TD.
In the few caes described online, it seemed like Abilify was more likely to cause TD in people with affective disorders and also in people who were on multiple meds (in one case, the docs thought the addition of Cymbalta may have messed with Abilify's partial dopamine agonism).
Also...in many of these cases, it seems like the TD reverses itself upon discontinuation, often quickly. This is bizarre b/c although TD often goes away, it usually takes a while...some of these patients had TD disappearing over the course of a couple weeks. This is odd 1) because it often takes months to years for TD to go away and 2) because TD usually gets *worse* for a while upon discontinuation, not better.
Abilify is sometimes used to treat TD. This makes sense: Abilify is hardcore potent; 30mgs gives you over 90% d2 occupancy. If it weren't for the partial agonism @ dopamine receptors, Abilify would be like a modern-day Prolixin. My guess is that the Abilify is able to suppress the TD w/o causing much in the way of EPS.
What scares me more than TD with Abilify is the possibility of Tardive Akathisia. Akathisia is apparently **really** common Abilify, so it stands to reason that long-term treatment could make the akathisia permanent. Tardive akathisia is pretty difficult to diagnose and there aren't any reliable treatments, except for tranquilizers.Good luck!
poster:med_empowered
thread:850398
URL: http://www.dr-bob.org/babble/20080903/msgs/850781.html