Abilify to treat anxiety and/or depression?

In my new job, I work with developmentally disabled adults. I am a behavior specialist, so I develop plans to manage and decrease challenging behaviors. I noticed from when I first started that some of the staff really seem to love Abilify. When a client has a particularly difficult behavior, someone will often ask how we could get that client on Abilify. They are reporting that when a client starts taking Abilify, the behaviors improve by a lot.

Yesterday I met the nurse-practitioner who prescribes the Abilify, and I asked her why we have so many people on an antipsychotic when they do not have a diagnosis of psychosis or bipolar. She explained about Abilify working on the dopamine receptors (as I understand many antipsychotics do), and said that at low doses (these clients are on 2-5 mg), Abilify is used for depression and anxiety too, so she is attempting to treat mood and anxiety disorders. This sounded okay to me, as I could see some of the behaviors as symptoms of depression or anxiety. Some of the clients are nearly nonverbal, so they can't exactly express their feelings very effectively.

So I have just been looking up the uses and side-effects of Abilify, and nowhere can I find that it is used other than (1) treatment of schizophrenia, (2) acute manic and mixed phases of bipolar I, and (3) maintenance after a manic or mixed episode of bipolar I. In fact, one of the side effects of Abilify is anxiety. This concerns me. I asked whether the clients with anxiety disorders had been tried on anti-anxiety meds, and she said that was what Abilify was at 2-5 mg.

Has anyone heard of this use of Abilify or have you anything to back it up (either direction)?

She also mentioned her focus on getting people off o Mellaril, which I feel is admirable, but I am uncertain that we should have people on antipsychotics at all if they don't need to be.

Thanks,

Rap

I thought abilify was only used for bipolar disorder and as an antipsychotic, although I think they call it an atypical antipsychotic.

I recently quit taking it because it was making me incredibly anxious and causing so much anxiety i couldn't even sit still. I have a diagnosis of bipolar disorder so that is why I was prescribed it. It seems like many doctors prescribe based on symptoms than diagnosis these days...

To use it for anxiety or depression make no sense at all. There are several alternatives to get people off of mellaril. You really have an NP who does all the prescribing?? That is scary.

Thanks. The NP is not on staff, but does prescribe for several of our clients. She really seems to love Abilify.

I just talked to a psychiatrist I know, who told me that Abilify is not really approved for this purpose, but speculated that it is probably being used to treat aggitation, since it is similar to Risperdal but has less bad side effects, and Risperdal is approved for treating aggitation associated with autism and other disorders (most of these clients are mentally retarded but not autistic). I would prefer to see anti-anxiety meds used for anxiety symptoms, myself, but I guess this makes some sense. So I'll watch for indications of side effects and monitor what happens with these prescriptions, as well as behavior plans. Does this explanation make sense to you? What alternatives might you consider?

I'll have my psychopharmacology class in three months - wish that one were coming up next but unfortunately I'll have to wait that long. I can get a head start on it though.

Rap

Abilify is sorta similar to risperdal, but I would choose risperdal in these cases because it is approved for this use and unlike abilify it rarely causes anxiety and agitation.

Valcat, thanks for sharing your experience. It is something that I will keep in mind. May I ask what dosage you were on?

It does seem like most prescribing now is based on symptoms rather than dx. I guess when it comes down to it, the symptoms are more important to address because the dx is supposed to serve as a brief sketch of what the symptoms are, but it doesn't always work that way. Symptoms are real, while dx is just really an abstract concept.

Rap

Hi Rapunzel!
I was taking 15 mg when I had to quit taking abilify. I started out at 5 mg and slowly went up, but once I hit 15 mg something just got out of whack and I was a nervous wreck.

I'm on a few different meds right now and it scares me to think about how they affect everyone differently. What can help one person tremendously can send someone else into a downward spiral.

You hit the nail on the head though, I agree the dx is somewhat of an abstract concept. I think it is important to treat the symptoms. I just hope everyone who is prescribing meds knows what they are doing...a scary thought if they don't.

I have actually read somewhere that Abilify helps with depression. I found this information when I researched it after finding out on my own that it does, in fact, help depression. I stopped taking it (10mg) and became extremely depressed. After suffering a few weeks, I went back on it and returned to normal.

Tracy, that is good to know. Thanks. I am glad that it helps you. What were you originally or primarily taking it for?

I have been on abilify for depression since it has come on the market, it helps with depression /anxiety symptoms and keeps my mood stable--I am not bipolar but had severe mood swings at times and aggitation. My only complaint is weight gain! I have gained 30# since going on it and prior to starting it I was always trim and never had to watch my weight!

Rapunzel, It was prescribed as an antipsychotic to treat severe irritability and rage. It helps. I was prescribed it after I assaulted a woman in the Walmart parking lot because she irritated me. (I'm normally not a violent person). It also helps with paranoid thoughts that I had.

They added abilify to my cymbalta and that made me suicidal

I've been prescribed Abilify to help with depression. I've tried it twice at 5mg and both times it caused me to feel very anxious.

Really? An RN told me that Abilify shouldn't be given to people who suffer from anxiety...do you have anxiety?

Yes, I have severe anxiety that is made worse by certain meds.

Abilify (at both 5mg and 2.5mg) made me agitated, aggressive, and even physically violent. I wanted to hit first and ask questions later. I wasn't in my right mind at all.

I was prescribed it for its supposed antidepressant effects, under the theory that with it not being a true antidepressant that it wouldn't trigger a manic episode.

My pdoc added 5 mg Abilify to my mix of antidepressants saying that it can "boost' the antidepressants. Seems like I saw somewhere online that Abilify has been approved as an add on for depression. It helped some, but for me it was basically a tranquilizer. I stayed on it because I was desperate and didn't want to be hospitalized so I did everything pdoc said to do. Eventually my treatment resistant depression improved, and I was gaining weight so I told pdoc I wanted off the Abilify. I am now off it. The main thing I noticed when I tapered is that I feel happy once in a while. While on it, I never felt much of anything.

I take abilify with antidepressants for depression. It has helped me a lot

I'm giving Abilify one more try. I'm hoping it decreases depression and anxiety and helps stabilize my thoughts and moods. If it makes me anxious again, I will not take it anymore.

I was prescribed Abilify for the boost it can give to antidepressants. It has work well for me but I am on 15 mg. Sometimes true anti anxiety meds can be truly addictive and are better not used. I say if abilify works for the person, and you would be able to tell, then good for them.