Why I am fucking enraged that I saw a commercial for ABILIFY in a doctor's office last week

1. The commercial urged consumers who were already on antidepressants to ask their doctor about Abilify. Basically: “Is your antidepressant not working fast or well enough? Ask your doctor about ABILIFY!!!!!”

***EDIT*** Here is the actual commercial I saw on the waiting room TV.

2. Abilify is a dangerous and serious antipsychotic mostly used to treat schizophrenia, bipolar disorder, and psychotic depression. They also like to use it “to control irritability and violent behavior in Autistic children who are at least 6 years old.” As an Autistic adult, I find this fucking disturbing.

3. The side effects of Abilify include: heart failure, sudden death, pneumonia, hyperglycemia (high blood sugar), dehydration and heat exhaustion, significant weight gain (50 or more pounds), and tardive dyskinesia (uncontrollable muscle movements) that can become PERMANENT. That’s not all of them, those are just the worst ones.

4. The reason they’re trying to promote Abilfy so hard and SPECIFICALLY for conditions that PROBABLY DO NOT WARRANT IT, is because their patent is ABOUT TO EXPIRE and despite the fact that they have been able to keep extending it since it was first patented in 2002, Otsuka holdings/Bristol Meyers Squibb co. stands to lose 13% of their total revenue, a.k.a. 2.76 BILLION DOLLARS if generic Abilify becomes available. So they are promoting the shit out of it as a “antidepressant enhancer”.

5. My ex (who I was with for 11 years) was schizophrenic, and Abilify was one of the medications they tried. The tardive dyskinesia and weight gain started right away and the medication was changed. A lot of the time, psychiatrists will NOT tell you about side effects. I have been put on medications that caused disassociation, vertigo so bad I ended up in the ER and on meds to control the vertigo, ones that made my teeth fall out, erratic behavior and lack of impulse control, and an endless host of other problems. I wasn’t warned about most of them. A lot of them were for conditions I didn’t even HAVE.

I’m not saying that Abilify is bad.

Is it better than Haldol and/or Thorazine? Almost certainly. Should it be an option for people who need those options? OF COURSE. YES. DEFINITELY.

DO YOU KNOW WOULD WOULD BE HELPFUL TO THOSE PEOPLE? HAVE A GENERIC ALTERNATIVE TO A DRUG THAT COSTS ABOUT 700 DOLLARS FOR A MONTH’S SUPPLY.

700 FUCKING DOLLARS

700

FUCKING

DOLLARS

A

MONTH.

And the people who most need Abilify are the least likely to BE ABLE TO PAY FOR IT.

America.

In what could be considered the craziest/most creative drug experiment ever, artist Bryan Lewis Saunders pushed himself to the limit when he decided to take a different drug everyday for a few weeks.

Nicotine Gum

Klonopin

Dilaudid

Risperdal

Abilify

Trazodone

Hydrocodone/Oxycodone/Xanax

Abilify/ Xanax/ Ativan

Absinthe

Adderall

Ambien

Ativan/ Haloperidol

Buspar

Butalbitals

Butane Honey Oil

Cephalexin

And Many More…

US spends the most money on this drug… and no one knows how it works

Americans spent over $7.5 billion on one drug over a one-year period ‒ more than any other medication. And yet no one knows how the powerful pill works. But that doesn’t keep Big Pharma from marketing it for a multitude of disorders.

“Quick: what’s the top-selling drug in the United States?” the Daily Beast asked. “Prozac? Viagra? Maybe something for heart disease?”

The answer is actually Abilify (aripiprazole), a powerful antipsychotic used to treat schizophrenia and bipolar disorder, among other major psychiatric conditions.

clearance

I hate for this to become a medication journal, but I’m sure it’s just temporary. I’m hoping what I’m experiencing becomes my “normal” and I’ll stop being amazed by what I’m feeling. Or not feeling.

I’ve been through other medications. It was obvious they were not working or, in some cases, making things worse. That’s why I was just happy to pop a Xanax and not take anything else. Because I could handle this, right? This is who I am and I can deal with it.

No. No I could not deal with being bipolar. I could not deal with the manic phases. I could not deal with the low phases. I could not deal with hating myself for the way I was and the way I was making people around me feel. So I had to put aside my fear of bipolar/depression meds and tell myself that while past meds made me crazier, I had to give something else a chance or run the risk of getting worse, mentally.

It still amazes me when I look at this tiny pill I take every day that something so small can contain the ingredients needed to give someone like me a clear head and a strong mind. I don’t understand chemistry. Not chemistry of the brain, not chemistry of modern medicine. Then again if I could, back in the 70s, grasp the concept that a tiny microdot of mescaline could change my brain chemistry I should be able to undertand this. And yes, I have wondered if the drugs did something permanent to my brain. But then I remember most of my childhood was spent in a state of mild depression. I think my drug use was a reaction to my depression and anxiety rather than a cause of it.

So here I am today, trying to explain to you what my little dose of Abilify does for me.

Think of a tv that has no connection to cable, no antenna. You turn it on. It’s just static. Just all those shades of black and white and gray, little specks of information colliding with each other, making nothing more than visual noise. There’s something back there waiting to come into focus. It just needs something. A connection. A wire. All that static, all that fuzz and noise are thoughts and ideas, dreams and memories, fears and hopes, equations and shopping lists and song lyrics and important reminders and words waiting to be written. But the get in each other’s way and each one shouts to be heard above the other and you stop trying to make sense of any of it. There are days the static show takes over your brain and everything is a jumbled mess of noise and there are days you just can’t deal with the noise and turn the tv off so there’s just nothingness.

That has been my brain.

And suddenly, a picture forms. A wire gets uncrossed. A plug gets a connection. The static clears up and you can see the separate pieces of information pulling away from the mass, becoming their own, whole thoughts. There is color. There is defined movement. There is life. 

My brain keeps smiling and saying, “We have clearance, Clarence.”

It’s my little inside joke with myself.

Now I’m able to compartmentalize. I’m able to prioritize. I can, for the most part, control my emotions because my emotions are no longer coming in manic waves. I can have a sustained thought process without it meandering off into seven thousand other thoughts, branching out to something unrecognizable from the original thing I was thinking about. I can concentrate on what’s important. I can do. I can be

And there are other things. The desire to do. The desire to be. Where before they were half hearted and all my attempts to make something of my world and do something with my life were attempts I felt were destined to fail, thus keeping me from really putting my all into them, now I see everything as a possible triumph. It makes me want to do more. Be more. 

Yes, there have been side effects. But I’m working my way through the insomnia (thank you, melatonin). And yes, I am still taking Xanax for now (I’ve worked my way down from 2 .5 doses a day to one .25, which I hope to be off of by the end of the month). But unlike the side effects of my previous medications, these are bearable. They are worth getting through considering the benefits I am getting out of the good effects.

I still marvel at how one little pill can change my life like this. How a bunch of chemicals put together by human beings can replicate the chemicals my brain has been missing. Science, right? Amazing stuff.

I feel like I’m on the verge of something big here. The Abilify has allowed me to take this giant leap I’ve been holding back on for so many years out of fear of where that leap would land me.

And that’s the big thing.

The fear is gone.

The fear of the future, the fear of the past, the fear of the unknown, the fear of everything from getting up in the morning to driving to work to going into a crowded subway to doing anything alone, those fears are gone, replaced by a strength that I have to believe was inside me all along, just waiting to be let loose from the noise and fuzz of the static that was keeping it from being seen. 

This is a new life for me. A new way of being. And suddenly, instead of pretending I’m looking forward and excited about things, instead of going through the motions while waiting for the fear, anxiety, terror and depression to kick in, I’m really excited about what I can accomplish now.

Oh, yes. It’s all still there. I know there will still be days when it hits me. I know the anxiety is so acute it will always be lurking, waiting for the right moment to leap out out me. That’s why I’ll keep the Xanax prescription. That’s when the people I love will be there for me. That’s when I’ll feel the difference between letting it overtake me and taking charge of it. Because I feel like I can do that now.

There’s a specific kind of personal heartbreak that comes with the knowledge that you need a pill (or two or four) to help you become a better person, a mentally healthier person. It’s jarring. It makes you feel weak for a moment or two. And there are people who will try to make you feel even worse about it, whether they mean to or not, who will use words like “crutch” or “get over it” or “just stop being sad.” 

I’ll just smile at them. They don’t know. They can’t know. And they don’t know how lucky they are to not know. 

All I do know is that I’m better. I’m not cured. I’ve not banished the demons of mental illness. It’s all still there. But I’m able to now focus on being a functioning human being instead of focusing on being unwell. 

That’s a victory.

We have clearance, Clarence.

[Realizing you've been on every single med mentioned in Silver Linings Playbook]
  • Tiffany:"What meds are you on?"
  • Pat:"Me? None. I used to be on Lithium and Seroquel and Abilify but I don't take them anymore, no. They make me foggy and they also make me bloated."
  • Tiffany:"Yeah, I was on Xanax and Effexor but I agree, I wasn't as sharp so I stopped."
  • Pat:"You ever take Klonopin?"
  • Tiffany:"Klonopin, yeah!"
  • Pat:"Right?!"
  • Tiffany:"Jesus!"
  • Pat:"What day is it?"
  • Tiffany:"Ha ha"
  • Pat:"What about Trazodone?"
  • Tiffany:"Trazodone?"
  • Pat:"What, it flattens you out. I mean, you are done. It takes the light right out of your eyes."
  • Tiffany:"Yeah it does."
A warning to those who take Abilify ~

Your doctor/psychiatrist probably has not told you that Abilify can fuck up your vision. It causes sometimes permanent damage (blurriness and inability to focus eyes) by causing a spasm in the muscle in the eye. This happened to me and I was not impressed that my psychiatrist did not inform me of the severe side effects. Be careful with this drug.

my night with abilify

Feel drowsy after taking medication. Struggle to stay awake until it’s an appropriate time to go to bed. Think to yourself, well if it makes me this drowsy, at least I’ll get some sleep. Finally go to bed. Then:

Lay awake for a while, staring into space
Fall asleep.
Have nightmare.
Wake up, stare into abyss for 45 minutes.
Fall asleep.
Have nightmare.
Wake up, stare into abyss for 45 minutes.
Fall asleep.
Have nightmare.

Repeat until 5am.

This is going to be a fun couple of weeks until the side effects wear off. 

In older adults, antipsychotic drugs are commonly prescribed off-label for a number of disorders outside of their Food and Drug Administration (FDA)-approved indications – schizophrenia and bipolar disorder. The largest number of antipsychotic prescriptions in older adults is for behavioral disturbances associated with dementia, some of which carry FDA warnings on prescription information for these drugs.

In a new study – led by researchers at the University of California, San Diego School of Medicine, Stanford University and the University of Iowa, and funded by the National Institute of Mental Health – four of the antipsychotics most commonly prescribed off label for use in patients over 40 were found to lack both safety and effectiveness. The results will be published November 27 in The Journal of Clinical Psychiatry.

The study looked at four atypical antipsychotics (AAPs) – aripiprazole (Abilify), olanzapine (Zyprexa), quetiapine (Seroquel), and risperidone (Risperdal) – in 332 patients over the age of 40 diagnosed with psychosis associated with schizophrenia, mood disorders, PTSD, or dementia.

“Our study suggests that off-label use of these drugs in older people should be short-term, and undertaken with caution,” said Dilip V. Jeste, MD, Estelle and Edgar Levi Chair in Aging, Distinguished Professor of Psychiatry and Neurosciences, and director of the Stein Institute for Research on Aging at UC San Diego.

Results of the five-year study led by Jeste, who is also current president of the American Psychiatric Association (which was not involved in this research), showed that within one year of treatment, one-third of the patients enrolled in the study developed metabolic syndrome (medical disorders that can increase the risk of cardiovascular disease or diabetes). Within two years, nearly a quarter of the patients developed serious adverse effects and just over half developed non-serious adverse effects.

Because the patients enrolled in the study were all diagnosed with conditions with psychotic symptoms that required antipsychotic drug treatment according to their treating physicians, no placebo was used in the trial.  Instead, the researchers used a technique called “equipoise stratified randomization” which is a hybrid of complete randomization and a clinician’s choice method. 

“Our goal was to ensure clinical relevance,” said Jeste.  Patients had to agree to be randomized to 2, 3 or 4 of the study drugs, as they or their physicians were allowed to exclude one or two of the study AAPs, due to past experience or anticipated risk of the particular drug.   Treating clinicians could determine the optimal dosage.  “We attempted to make the study as ‘user-friendly’ as possible, to allow the drugs the best chance of success, while seeking to minimize the amount of bias,” he explained.

While the researchers’ intent was to continue the patients on the randomized medications for two years, the average length turned out to be only six months, after which the medications were halted or switched because they didn’t work and/or had side effects. 

Because of a notably high incidence of serious adverse events, quetiapine had to be discontinued midway through the trial.  The researchers  found that there were significant differences among patients willing to be randomized to different AAPs – thus, treating clinicians tended to exclude olanzapine and prefer aripiprazole as one of the possible choices in patients with existing metabolic problems. Yet, the different AAP groups did not appreciably differ in most outcome measures.

Using a common scale called the Brief Psychiatric Rating Scale (BPRS), to measure symptoms such as delusions, hallucinations, unusual behavior, depression, and anxiety, assessments were made at 6 weeks, 12 weeks, and then every 12 weeks.   Results using “blind” raters showed no significant improvement in BPRS over a six-month period.

“While there were a few significant differences among the four drugs, the overall risk-benefit ratio for the AAPs in patients over age 40 was not favorable, irrespective of diagnosis and drug,” said Jeste.

Jeste points out that clinicians, patients, and caregivers are often left with difficult and unclear choices for treatment for older persons with psychosis, such as that associated with dementia.   Not only are psychosis and agitation common in persons with dementia but they also frequently cause considerable caregiver distress and hasten institutionalization of patients. At the same time, there are no FDA-approved alternatives to antipsychotics for this population, and the high cost of newer AAPs also makes their use problematic.

While the researchers say their findings do not suggest that these AAPs should be banned in older patients with psychiatric disorders, they do indicate that considerable caution is warranted in off-label, long-term use of the drugs in older persons.

“When these medications are used off-label, they should be given in low dosages and for short durations, and their side effects monitored closely,” said Jeste. “Clearly, there is also a critical need to develop and test new interventions that are safe and effective in older people with psychotic disorders.”