hi. i was put on risperidone (related to invega, chemically) in a hospital. inpatient...there seems to be a preference for sedating meds, sometimes higher doses, etc. anyway...

once i got outpatient, i was switched to abilify. not the solution for everyone, but...for me, good times, as neuroleptics/antipsychotics go. not terribly sedating, chases the crazy away, no prolactin elevation, no massive weight gain...

in animal models, Abilify doesn't mess up the D2 receptors as much as other drugs. D2 receptors are targeted by -all- neuroleptics/antipsychotics. thing is...there's a 'sweet spot'; under the sweet spot, why bother? above the 'sweet spot,' tics and depression, even straight up Parkinson's-type symptoms emerge. long term, by blocking the D2 receptor, the antipsychotics/neuroleptics cause the brain to adapt...

problem there is, over the long haul, the way the brain adapts can cause people to need higher dose antipsychotics, more psych drugs, or...sometimes, possibly...have more psychotic relapses even -on- the prescriptions. eek.

so, in animals, it looks like abilify doesn't cause the same level of brain changes. it also seems to be associated with less 'tardive dyskinesia,' which...again, happens with -all- antipsychotics, some antidepressants, even (rarely...) antiseizure drugs, anti-nausea drugs, and very rarely stimulants and opioids. its what we get for messin' with dopamine, I guess. :-(

the thing about it is, though...the animal data looks awesome, people who treat the severely mentally ill (severe end of bipolar I, Schizoaffective, Schizophrenia, psychotic depression...) report good results -but- lots of people are being put on Abilify with other psych drugs, for less severe problems, and...

as a result, more reports are popping up about tardive dyskinesia, especially in the mood disorder crowd. to be fair, -some- psych data indicates that the bipolar i people have a higher rate of TD, in general, than people who have Schizophrenia, no major mood issues. :-( oh well.

but yeah...there's new D2 partial agonists, too. rexulti and..vraylar, I think. seroquel isn't 'better,' in terms of response and such, but it does have lower EPS (tics and such) and lower TD than risperidone. i think it also goes easier on prolactin. it is densely sedating, though.

oh, and...a prescriber person once recommended that i ditch the abilify and go for amoxapine. its an old, generic, tricyclic antidepressant that also partly metabolizes to an antipsychotic. this doctor told me that -when it is effective- , it can clear up psychotic depression in 2, 3 weeks. i declined, because...wow...tricyclics can be rough.

hope this helps a bit. :-)