Abilify discontinuation syndrome

Abilify Side Effects | Compulsive Behavior & Withdrawal Symptoms

Common Abilify (aripiprazole) side effects include nausea, vomiting, headache, insomnia and weight gain. Serious Abilify side effects include tardive dyskinesia and neuroleptic malignant syndrome. Stopping Abilify may cause withdrawal. Abilify withdrawal symptoms include anxiety, panic attacks and sweating.

Common Abilify Side Effects

Common side effects of Abilify include nausea, vomiting, dizziness, anxiety, insomnia, constipation, movement disorders and restlessness. The most common side effect is headaches.

Abilify, also known as aripiprazole, is an atypical antipsychotic medication that doctors prescribe for major depressive disorder, bipolar I disorder and schizophrenia, and to manage irritability from autism spectrum disorder or Tourette’s syndrome in children.

Other common side effects of Abilify include:

Blurred vision
Drooling
Drops in blood pressure when standing up
Constipation
Choking or trouble swallowing

Sleepiness is a common Abilify side effect for children ages 6 to 18. Other side effects for children include headache, nausea, vomiting, insomnia, movement disorders, increased appetite and weight gain.

If the drug does not reduce psychiatric symptoms, consider asking your doctor to switch you to a different antipsychotic medication.

Serious Side Effects of Abilify

Abilify can cause serious side effects, many of which can be dangerous to long-term physical and mental health. These include seizures, involuntary muscle movements and neuroleptic malignant syndrome. The drug is also associated with harmful metabolic changes, including weight gain, increased cholesterol, low white blood cell counts, insulin resistance and nonalcoholic fatty liver disease.

Abilify can cause new and worsening suicidal thoughts and impulse control disorders. People experiencing impulse control while taking Abilify might engage in behaviors such as compulsive gambling, hypersexuality, compulsive shopping and spontaneous wandering. Recent reports suggest Abilify might also cause obsessive-compulsive thoughts and behaviors.

Black Box Warning for Elderly Dementia Patients

Abilify’s drug label includes a black box warning stating that elderly people with dementia who take the drug are at an increased risk of death. In clinical trials, elderly people with dementia taking atypical antipsychotics such as Abilify were 1.7 times more likely to die than those in the control group.

Clinical data does not spell out the reason for this increased mortality risk, but suggests the problem is caused by multiple factors. Elderly people who take antipsychotics such as Abilify are more likely to suffer strokes, which are often fatal within this population. They may also be more vulnerable to cardiovascular events such as heart attacks and serious infections such as pneumonia.

Doctors normally prescribe Abilify for elderly patients with dementia when there is a serious risk the person will harm themselves or others. In some cases, the risks are necessary to prevent greater harm. If you or a loved one with dementia have a prescription for Abilify, take it exactly as directed by your doctor.

Neuroleptic Malignant Syndrome

Neuroleptic malignant syndrome is a rare, life-threatening reaction to antipsychotic drugs such as Abilify. It is a potential side effect of almost all antipsychotic drugs.

Characteristics of NMS include fever, altered mental status, muscle rigidity and instability of the autonomic nervous system. This system controls unconscious functions such as breathing, heart rate, digestion, urination and sexual arousal.

Tardive Dyskinesia (Uncontrolled Body Movements)

Tardive dyskinesia, another serious side effect of Abilify, is characterized by involuntary muscle movements throughout the body, but mostly in the lower face.

TD is most common among people who take Abilify for months or years, but it can manifest as soon as six weeks after beginning the drug. TD can go away after you stop taking Abilify, but sometimes it becomes a permanent condition.

Abilify and Weight Gain

Studies also link Abilify to weight gain, particularly in children. A 2022 review in Australasian Psychiatry examined 11 studies and found that young people (mean age 18) gained an average of 2.7 kg (6 pounds) while on aripiprazole. Youths who took the drug for longer periods (more than 12 weeks) gained more weight than those who took it for shorter periods. Dosage sizes had no impact on weight gain.

Abilify sometimes causes weight gain in adults. This happens less often than it does in children, and the total weight gain is usually less significant. Studies suggest that aripiprazole is less likely to cause weight gain in adults than most other antipsychotics in use today.

Abilify Withdrawal

Because Abilify affects how your brain works, stopping the drug all at once may lead to withdrawal symptoms. This is more likely when you quit the drug after long-term use or if you are used to taking high doses of the medication.

Abilify withdrawal symptoms include:

Anxiety
Appetite changes
Concentration problems
Confusion
Depression

Diarrhea
Dizziness
Hallucinations
Headache
Joint pain
Panic attacks
Sweating
Vomiting

Experts recommend tapering off Abilify if you want to stop taking it. Always consult your doctor for correct dosages when weaning yourself off of the drug.

Impulse Control Issues from Abilify

In 2014, a study published in JAMA Internal Medicine found that dopamine receptor agonist drugs such as Abilify were associated with new and worsening impulse control disorders. This research led to a new warning on the drug’s label, mandated by the U.S. Food and Drug Administration. This warning cautions that the drug may cause serious impulse control problems such as problem gambling, compulsive shopping and binge eating.

A 2022 review of impulse control disorder reports uploaded to the FDA Adverse Event Reporting System since December 2020 confirms that this association is still ongoing. About 94% of the impulse control disorder reports examined during the study involved people taking aripiprazole.

Many people who feel their lives were irreparably altered from gambling or uncontrolled impulse spending after taking the drug filed Abilify lawsuits to seek compensation.

Impulse control problems related to Abilify often go away when you stop taking the drug or reduce your dose. If you struggle with impulse control, talk to your doctor about reducing the dose or switching medications. Don’t lower your dosage or stop taking your medication without informing your doctor.

Compulsive Gambling

Problem gambling is the most common impulse control-related side effect of Abilify. The medication may be more likely to cause gambling problems than other related drugs with similar impulse control effects. A 2021 study of Swedish health records found that people taking Abilify were significantly more likely to develop problem gambling behaviors than people taking other dopamine agonists.

Most of those who develop gambling issues while taking Abilify have no prior history of problem gambling. Contact your doctor immediately if you have the urge to gamble more frequently than usual.

Sexual Side Effects of Abilify

Hypersexuality is another manifestation of Abilify’s effects on impulse control. This includes having unprotected sex, compulsive masturbation, having sex with multiple partners, or having sex outside of a committed relationship. Some people engage in sexting or share explicit images of themselves.

FDA data shows that 34% of people affected by antipsychotic-related impulse control disorders display uncharacteristic hypersexual thoughts or behaviors. Like Abilify’s other impulse control side effects, hypersexual behavior usually stops when you stop taking the drug or lower your dose.

Suicidal Thoughts

People who take Abilify have an increased risk of developing suicidal thoughts and behaviors. For those who already experience these issues, Abilify may worsen them. The drugmaker now notes this side effect in the black box warning on the drug’s label.

Monitor yourself for new or worsening suicidal thoughts while taking Abilify. Contact your doctor immediately if you notice them. Don’t stop taking your medication without your doctor’s knowledge.

Aripiprazole Side Effects

Please seek the advice of a medical professional before making health care decisions.

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Abilify Discontinuation Syndrome | Risks, Symptoms, Side Effects

Alternative to Meds News & Blog Articles

What Are the Risks of Taking Abilify?

Although Abilify does produce fewer side effects than earlier forms of antipsychotics, it does still involve a lengthy list of potential side effects that lead many patients to discontinue taking the drug.² These symptoms range from mild symptoms that last only a few days or weeks, to severe symptoms that can linger or worsen and require immediate medical attention.

The most common side effects consist of:

Agitation or irritability
Anxiety
Fatigue, insomnia, or restlessness
Headaches
Dizziness or feeling light-headed
Hyperventilation
Drooling
Blurred vision
Low or high blood pressure or fainting
Heatstroke after exercise

Digestive issues, including heartburn, indigestion, nausea, vomiting, constipation, and stomach pain
Shakiness or tremors
Cold-like symptoms, including runny or stuffy nose, sneezing, and sore throat
Rash
Decreased white blood cell count
Increased cholesterol and weight gain
Impaired driving with a higher likelihood of automobile accidents

More severe side effects tend to be less common, but Abilify does feature the following black box warnings from the FDA

³:

Increased risk of suicidal thoughts and behavior among patients under the age of 25 years old.
Increased risk of stroke and other cardiovascular issues in elderly patients with dementia that could result in death.
Increased risk of engaging in compulsive behaviors, such as binge eating, pathological gambling, hypersexuality, and compulsive shopping.

Other severe side effects of Abilify include:

Seizures
Catatonia
Stroke
Tachycardia, or racing heartbeat
Unusual urges, meaning the desire to do something you would not normally do or to do something in excess, such as gambling or binge eating
Inability to move
Loss of balance
Muscle stiffness, trembling muscles, or spasms
Involuntary, repetitive movement
Extreme fatigue

Sudden loss of consciousness
Sleepwalking
Aspiration, or swallowing the tongue or other items obstructing the airway
Speech difficulties
Swelling, tingling, or numbness in extremities
Joint pain
High fever
Rash, blistering rash, or ulcers in mucous membranes
Incontinence
Suicidality combined with akathisia, a movement disorder that makes it difficult to stay still and compels constant movement, particularly in the legs

In rare situations, patients can develop tardive dyskinesia, a rare but typically irreversible condition caused by long-term use of neuroleptic medications. ⁴ This condition is characterized by involuntary, repetitive movement of face, body, limbs, or other muscles, such as grimacing, protruding tongue, pursing, puckering, or smacking lips, puffing cheeks, and rapid blinking. In some cases, these symptoms persist indefinitely even after discontinuation of the drug.

Abilify can also lead to serious interaction issues when taken with other medications. Hundreds of drugs have been found to interact with Abilify, including antidepressants, antihistamines, antifungals, HIV protease inhibitors, sedatives, tranquilizers, sleeping pills, and medications for anxiety, motion sickness, high blood pressure, Parkinson’s disease, irritable bowel syndrome, ulcers, urinary problems, or other mental health conditions.

Does Abilify Need to Be Tapered Off?

Due to the multitude of serious, debilitating side effects Abilify can cause, many patients who are prescribed this antipsychotic eventually choose to stop taking it. However, like any antipsychotic medication, discontinuation should not happen abruptly and must occur with the oversight and guidance of a physician. The safest method for reducing potential withdrawal symptoms is through tapering off of the drug, or gradually reducing the dosage over a specific time frame. The timing and dosage your physician will recommend depends on your unique circumstances, including the severity of your mental health disorder and the length of time you spent taking Abilify.

Does Abilify Have Withdrawal Symptoms?

According to a meta-analysis published in Frontiers of Psychiatry in 2020, 53% of patients demonstrated withdrawal symptoms after abruptly discontinuing antipsychotic medication. Even when patients carefully followed their physician’s instructions and discontinued Abilify by tapering off the medication, they developed severe withdrawal symptoms that became intolerable.⁵ This is referred to as Abilify discontinuation syndrome.

Abilify withdrawal must be carefully managed so the gradually tapering dosage can appropriately compensate for the neurochemical changes that result from this changed dosage. If withdrawal is not properly managed, or if the patient abruptly discontinues taking the drug without medical supervision, they can quickly develop withdrawal symptoms ranging in severity from short-term and mild, to severe enough to require hospitalization.

Symptoms of Abilify discontinuation syndrome include:

Akathisia
Tardive dyskinesia or other involuntarily movement disorders
Psychosis, including hallucinations, delusions, and paranoia
Decreased concentration
Anxiety, depression
Irritability, agitation
Insomnia or other sleep disturbances

Nausea and vomiting
Headaches
Tremors, shakiness
Vertigo or feeling lightheaded
Diaphoresis, or excessive sweating of the entire body
Flu-like symptoms

In cases involving severe Abilify withdrawal symptoms, the best approach is to seek treatment from a residential care facility that offers constant medical attention.

What Happens When You Stop Taking Abilify?

Tapering must be completed in a cautious, precise, and incremental manner. Typically, your physician will begin the process of Abilify discontinuation by tapering your dose with a 10% reduction. Before the dosage can be further reduced, you must experience a stability period of a full two weeks in which you are no longer symptomatic, meaning you eat and sleep properly, maintain a regular routine, and do not demonstrate anger or mania.

After this stabilizing period, your physician will continue to taper the dosage by making another “cut,” after which you must spend another full two weeks without withdrawal symptoms. This process continues until the cut equals a small enough dose that your physician can cut the drug in half or break it down into smaller pieces. The taper must be gradual and carefully monitored to ensure no additional cuts are attempted before symptoms subside.

Understanding Withdrawal vs. Symptoms

Unfortunately, it can be difficult to distinguish which symptoms are occurring due to withdrawal and which symptoms were original to your condition and are now returning due to the decreased dosage of Abilify. When you take this medication, you undergo a process called upregulation, meaning your body adapts to the effects of the drug, specifically the change in dopamine levels. Blocking dopamine over an extended period of time causes the dopamine receptors to become supersensitive.

When the drug is reduced, these supersensitive receptors can cause a sudden flood of excess dopamine that overloads your system. This can lead to an overwhelming reaction and produce volatile emotions, thoughts, and behavior that were previously absent or cause them to present more intensely. This phenomenon will eventually even out, or downregulate, but your physician should be monitoring your condition carefully throughout the entire process.

How Long Does Antipsychotic Discontinuation Syndrome Last?

The length of time you experience symptoms of Abilify discontinuation syndrome depends on individual factors, and some people have a more difficult time ceasing the medication than others. The longer you take Abilify, the more severe your withdrawal symptoms may be and the longer it may take to reach full discontinuation of the drug. For example, a patient who takes Abilify for five years may expect their tapering to take five months or more, while someone who takes Abilify for ten years would likely require a taper that lasts ten months or more.

In the meta-analysis mentioned above, researchers found that withdrawal symptoms begin approximately one week after an abrupt discontinuation of the medication, then subside gradually for one to four weeks.⁵ However, some severe symptoms, such as hyperkinesia, may persist for months.

Along with the physician guiding the tapering process, experts suggest making a safety contract with a trusted friend or family member, who will assess your behavior and help you navigate any potential feelings of mania that may arise in the future and make you resistant to taking your medication. Signing a contract establishes expectations and gives your contracted person the authority to contact the police or a healthcare provider if you suddenly stop taking your medication or experience increasingly severe withdrawal symptoms.

How Can Alternative to Meds Help Me?

If you or a loved one is currently taking Abilify and want to initiate the tapering process, contact Alternative to Meds today to speak with our team. After years of experience helping patients with Abilify discontinuation syndrome, our experts at Alternative to Meds have discovered that antipsychotic medications are the most difficult to taper. However, an Abilify prescription is not a life sentence. Even if the antipsychotics you were prescribed did originally help you to manage your symptoms, you do not need to take these medications for the rest of your life.

Alternative to Meds offers Abilify tapering to patients in stable condition, meaning they are eating, sleeping, and exercising regularly, consuming no stimulants or recreational drugs, and have a strong support system of family members or friends to help them through this process. We employ gentle, strategic methods supported by careful observation and medical oversight and create a customized tapering treatment plan for every patient based on their unique history and circumstances. Consult our website to find out the best reasons for tapering Abilify, then contact us today.

Smoking cessation - School of Health - Krasnodar City Polyclinic 25

October 19, 2018

What happens if you quit smoking?
Smoking cessation is known to reduce mortality and increase life expectancy: by 3 years at age 60, by 6 years at age 50, by 9 years at age 40, and by 10 years at age 30.

Treatment
From the point of view of medicine, smoking should be considered and treated as a chronic disease: take into account periods of exacerbation and remission, plan therapy for a long time ahead, assume the possibility of sudden exacerbations. The goal of smoking cessation is to achieve cessation.

Non-drug treatments
Non-drug treatments include psychological counseling and psychotherapy. In the process of individual or group work with a psychotherapist, a smoker will better understand his intentions, correctly formulate a goal and a personal strategy for quitting smoking, and learn about those factors that can prevent him from quitting or lead to a relapse. Special psychological techniques help reduce smoking cravings and increase resistance to stress. Their use will allow you to get rid of an addiction extremely comfortably and in a short time. Methods of psychotherapy are very numerous and effective. However, it is more correct to speak not about the effectiveness of the method, but about how much the patient uses the help provided to him.

Drug treatment
It is believed that drug treatment increases the effectiveness of the fight against nicotine addiction. An important role is played by nicotine replacement therapy: various nicotine gums, patches, etc., which reduce the severity of withdrawal symptoms. This is especially important in repeated attempts to quit smoking in those smokers who have already experienced a severe withdrawal syndrome. Replacement therapy is more effective in men. In women, it is preferable to use products containing varenicline. However, decision
about the beginning of treatment, the choice of drugs and their combination can only be taken by a doctor.

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