RedRobin123 Weaning off Abilify

[RedRobin123]

I was put on abilify 2 years ago. I had suffered several losses within a six month period. I started having anxiety attacks. The drug did work for me initially.  I did not realize it was going to be a life contract. I want my life back and have tried to get off this terrible drug. Has anyone been successful in weaning off?

[Gridley]

Hello, RedRobin123, and welcome to SA.  I congratulate you on wanting to get off Abilify.  It does not have to be a life contract.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.

• Any drugs prior to 24 months ago can just be listed with start and stop years. 
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
• Please leave out symptoms and diagnoses. 
• A list is easier to understand than one or multiple paragraphs. 
• Link to Account Settings – Create or Edit a signature.

At Surviving Antidepressants, it is recommended that a person taper by no more than 10% of their current dose with at least a four week hold in-between decreases.  The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.  Some people may have to taper at a more conservative rate as they are sensitive to even the smallest drops.
To get you started, and familiarized with the protocols followed by SA, I am linking a few topics so that you have a better understanding of what is recommended here. 

 

Before you begin tapering what you need to know

Why taper by 10% of my dosage?

Brain Remodelling

What is Withdrawal Syndrome?

Glenmullen’s withdrawal symptom list.
Tips for tapering off aripiprazole (Abilify)

 

Here are two examples of members successfully weaning off Abilify.  

wiresoma: What's going on here with Abilify withdrawal ...

Silverkid's Success Story - Surviving Antidepressants

This is your introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community. I hope you'll find the information in the SA forums helpful for your situation. I'm sorry that you are in the position that you need the information, but I am glad that you found us.

 

Best,

Gridley

 

Edited February 20, 2018 by ChessieCat
removed excess white space

[RedRobin123]

I am on Lexapro abilify and ambien cr. Just starting to taper off abilify. Went from 2m to 1 for 35 days. Now on 1m. every other day for 6 weeks. So far I am ok. Does anyone have any advice for me

I am so scared. This is my 2nd try.

 

[ChessieCat]

Please complete your drug signature as Gridley requested above.  This is the preferred format.

 

A request: Would you summarize your history in a signature - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly?

• Please leave out symptoms and diagnoses.
• A list is easier to understand than one or multiple paragraphs. 

• Any drugs prior to 24 months ago can just be listed with start and stop years.
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.
• Link to Account Settings – Create or Edit a signature.

[ChessieCat]

41 minutes ago, RedRobin123 said:

I am on Lexapro abilify and ambien cr. Just starting to taper off abilify. Went from 2m to 1 for 35 days. Now on 1m. every other day for 6 weeks. So far I am ok. Does anyone have any advice for me

I am so scared. This is my 2nd try.

 

 

I moved your post from "Taking multiple psych drugs".  Please ask questions about your own situation here in your Intro topic.  This keeps your history in one place as well as helps other members who will see your questions and the responses.

 

Just starting to taper off abilify. Went from 2m to 1 for 35 days. Now on 1m. every other day for 6 weeks.

 

Taking a drug every other day/skipping days is NOT recommended.  The brain likes consistency.  Skipping Days vs Every Day Dosing Graph

 

It would be better to take 0.5m EVERY DAY.

 

Please see this topic:  Tips for tapering off aripiprazole (Abilify)

 

Please put all your drugs in the Drug Interactions Checker and copy and paste the results in a post here in your Intro topic.

 

Taking multiple psych drugs? Which drug to taper first?
If you're not having an adverse reaction from the other medications, taper the most activating drug first. This is usually an antidepressant or stimulant (ADHD drug).

 

Tips for tapering off Lexapro (escitalopram)

 

Tips for tapering off Z drugs for sleep (Ambien, Imovane, Sonata, Lunesta, Intermezzo, etc.) 

[savinggrace]

The usual protocol here is reducing by no more than 10% of current dose for 2-4 weeks unless your w/d symptoms are severe, in which case a lower reduction with a longer hold would be wise. 

 

I think you you should read the “slow and steady” tapering advice on the home page. Reducing by dosing every other day causes huge fluctuations in your blood levels. 

 

If you are scared to death of going this fast, then you likely need to slow down. Many of us have learned this the hard way!

 

If if you read more here at SA, you will learn this a common mistake people make while tapering. This is a great place to learn about a safe taper

 

Faster is not better. Listen to your gut. It is telling you to slow down. 

 

Good luck

Grace

 

[RedRobin123]

Thank you for the advice

 I am new to this site. It has been so helpful.

[mammaP]

Hi RedRobin, have you been skipping days for 6 weeks?  Doctors often recommend this way of tapering but it causes interdose withdrawal and is not recommended by us here at SA.   If you have been skipping doses for 6 weeks at 1mg  it would be best to take 0.5 every day and holding a few weeks to avoid withdrawal.Then restart the taper.    You can get abilify solution that is easier to get the tiny doses. Here is the topic for tapering abilify. 

 

http://survivingantidepressants.org/topic/1896-tips-for-tapering-off-abilify-aripiprazole/

 

 

[Altostrata]

Welcome, RedRobin. How do you feel now that you've reduced Abilify?

[RedRobin123]

I am not having any symptoms of withdrawal at this point. I have had some sleep problems but that is pretty normal for me. I am working with a dr. and I hope his schedule of weaning will workout well. He will prescribe liquid if I have problems and need to go lower than 1ml before stopping. We are working on 1ml every other day for at least 4 weeks. When I feel I am in a place to move forward we will go every 3 days etc. until I am completely off Abilify. Has anyone tried this type of schedule before. We are going to go very slow. Please pray for my success in getting off this terrible drug. It is my second try.

[Gridley]

 

Skipping doses is equivalent to reducing your dose by 50%.  As ChessieCat and MammaP said earlier, skipping days is NOT recommended by SA.  SA recommends tapering by 10% of the previous dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.

 

Skipping Days vs Every Day Dosing Graph

 

The half-lives of almost all psychiatric drugs are too short for this to make any sense. It causes the amount of the medication in your bloodstream to go up and down, battering your nervous system, and makes withdrawal worse.  It is like playing ping-pong with your brain.

Your brain likes stability, to be treated gently.  It is ideal if you can accommodate it to lower and lower dosages. Move it slowly down a ramp by gradually decreasing dosage by an amount it may hardly notice. The 10% taper method is a harm reduction approach to going off psychiatric drugs. This is explained in the attached link:

 

Why taper by 10% of my dosage?

 

[ChessieCat]

It may be because of the long half life of Abilify that taking your drug by skipping 1 day you have not experienced any issues.  However, once you start skipping 2 days you may start experiencing interdose withdrawal.

 

You may be experiencing mild withdrawal symptoms which you haven't attributed to your tapering method.  Please see Dr Joseph Glenmullen's WD Symptoms Checklist

 

I also suggest that you read these topics:

 

How do you talk to a doctor about tapering and withdrawal?

What should I expect from my doctor about withdrawal symptoms?

[ChessieCat]

I suggest you Keep Notes on Paper so that you can you are able to recognise if withdrawal symptoms are starting.

[Altostrata]

Please do not skip doses, even of a long-acting drug like Abilify. Skipping doses causes the amount of the drug to vary in your body. This may cause confusing symptoms.

 

Taking the drug consistently helps us determine if the taper is working. If you do not take the drug consistently, we won't be able to figure out where symptoms are coming from.

[RedRobin123]

Where can I get Abilify in liquid form? I am at 1ml and can’t cut any smaller. My Dr decided to do every other day because of this problem. How have others solved this.

[ChessieCat]

From Post #1 tips-for-tapering-off-abilify-aripiprazole

 

Abilify solution, oral 1 mg/mL 150-mL bottle NDC 59148-013-15

 

and

 

Have a compounding pharmacy make a liquid for tapering
Compounding pharmacies can make a liquid from the tablets. You will need a prescription written for the custom compound. The only drawback is this can be quite expensive.

[RubyJ]

I can't cut my pills any smaller either (Don't they just crumble so easily?  I hate cutting them.) and I called my doctor and had her call in a prescription for aripiprazole (Abilify) oral solution to my pharmacist.  (She also wanted me to do every other day with the cut pills but after advice from everyone here and some critical thinking I decided that was not what I wanted to do.  It's true that abilify has a long half-life, and so it might appear to work at first, but I doubt playing on and off again with your brain chemistry is a good idea.)  The name brand liquid solution is no longer made but there are generics available.  I haven't started using the liquid yet so I can't share my results.  I'll be reporting how it goes in my own intro thread, though.  Good luck!

[RedRobin123]

I cannot find a pharmacy that can fill a prescription for the liquid.

[RubyJ]

Really?  Hmmmm.  You know, I'm picking up my prescription later today and then I'll have the exact details of the script the doctor wrote, and we can compare notes.  What are they telling you, that they can't order it -- or is it that they won't?  Or is it a prescription insurance issue?  I've had trouble over the years with other meds with pharmacies refusing to order drugs -- if it wasn't in stock, they wouldn't order it and tell me I was just out of luck.  Ugh. 

 

I'm assuming you're in the US?  I'm currently in a small town and it's a small local pharmacy.  They are actually BETTER than Walgreen's in the speed of deliveries and what they can get delivered.  You could check with some smaller pharmacies if you haven't already. 

 

If this might help you obtain it, here are the generic companies' information pages on the oral solution: https://app.catsy.com/amneal-catalog/#/details/2023/4052109800 & http://www.lannett.com/docs/Lannett_Catalog_2015_2.pdf (page 12).

[RedRobin123]

Thanks for the info. I did find a pharmacy that will do compounding . I am going to try that. I found pharmacies outside the U.S. that sell the liquid but nervous about that. They have different standards.

[RubyJ]

Great!  I hope that works for you. 

 

Yeah, I'd be nervous about that too, although I admit I'm not terribly enamoured with the FDA right now.  I don't think they should have allowed the company to sell Abilify without doing a dependence study in humans after the monkey study showed dependence in monkeys. 

 

[mammaP]

Taken from the tapering abilify topic. 

 

You may be able to make a solution with the Abilify DISCMELT® Orally Disintegrating Tablets (available in 10mg and 15mg dosages); I don't know what the stability would be -- how long the liquid would be good.
 
For general instructions about making your own liquid http://survivingantidepressants.org/index.php?/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/   

 

Could you get the discmelt tablets?  I always ask at the pharmacy if certain drugs are available, then ask them to write it down and take it to the doctor. Doctors are not always aware of what is available.  My GP was adamant that effexor was not available in liquid here, so I went and asked the pharmacist who looked it up and wrote down the details which I took to the doctor, he was shocked to see that is was available and was not too happy about it but i got the liquid! 

[RubyJ]

mammaP's suggestion is a good one, too -- cheaper than compounding, I'd imagine, if available. 

 

Just in case it'll be helpful to you, here's the info on the liquid my pharmacy here in Montana was able to get:

 

Aripiprazole Oral Solution 1 mg/mL (150 mL bottle)

Manufactured by Apotex Corp

NDC 60505-0404-5

 

The NDC number is probably the most pertinent piece of info.

This is just info in case you need it -- if the compounding works for you, then you may be all set.

[RedRobin123]

My dr has me on every other day method of weaning. I stay on every other day for 35 days then I will go to every 3 days for 35 days. I will continue on a schedule of reducing every 35 days until I am at once a week . Does anyone think this will work? I mentioned liquid but he just kind of blew it off. He is the only dr. In my area that has even listened to be about coming off of this drug.

[ChessieCat]

I suggest you refer him to The Icarus Project.  They have a guide which you can download:  http://willhall.net/comingoffmeds/

 

From Page 28:

 

"If your prescriber doesn’t support your goals, ask them to explain their reasons in detail. Consider what they say carefully – if they are making sense, you may want to reevaluate your plan. You may also want to get a friend or ally to help you express yourself, especially someone in a position of authority like a family member, therapist, or health practitioner. Present your perspective clearly. Explain that you understand the risks, and describe how you are preparing to make changes carefully with a good plan. Give them a copy of this Guide, and educate them about the research behind your decision and the many people who succeed in reducing and going off their drugs. Remind the prescriber their job is to help you help yourself, not run your life for you, and that the risks are yours to take."

[RedRobin123]

On 8/4/2013 at 8:54 PM, wiresoma said:

Good point. I chose ten days because I based that on the half-life of Abilify which is three days. It takes three days for the amount of Abilify in your blood to drop by half. Also, I knew from past experience that after three days (like what happened to you) the w/d symptoms can start. So, I waited ten days to see if any w/d symptoms occurred before continuing on with the taper.

I have been tapering for a month and just reduced my taper  so I am at .25. I am not able to drag myself out of bed most mornings, can't drive, aND have trouble leaving the house. I have never had any of these problems before taking abilify.  I am so scared that it has done permanent damage to my brain . Has anone had problems while still tapering 

I wasn't expecting to have problems until after I took my last pill. Please if anyone has had similar problems let me know how you did.

 

 

[RedRobin123]

I am weaning off abilify . Just started 2nd taper after 30 days.  I am down to 

.25. I will stay there for another 30 days. I am tried all the time, can barely get out of bed. I stopped driving as my head is very fuzzy. I have to force myself to go outside. I have been getting stomach aches. Are these symptoms normal at this stage of the weaning process. I am very scared. I feel like my depression is coming back . Has anyone else had this experience? 

 

[ChessieCat]

I have merged the new Intro topic you created with your original Intro topic.  Each member has only 1 Intro topic where they can ask questions about their own situation and journal their progress.  This keeps your history in one place.

 

Please do not create any more Intro topics.  Thank you.

[ChessieCat]

8 minutes ago, RedRobin123 said:

I am tried all the time, can barely get out of bed. I stopped driving as my head is very fuzzy. I have to force myself to go outside. I have been getting stomach aches. Are these symptoms normal at this stage of the weaning process. I am very scared. I feel like my depression is coming back . Has anyone else had this experience? 

 

If these symptoms have started since you commenced tapering then it is a sign that you are reducing too quickly.  I suggest you read back through your Intro topic.  The 10% taper method has already been mentioned.

[RedRobin123]

I have to force myself to get out of bed. Some days I don’t even get dressed. Going out of the house is almost impossible for me. I leave only on the days I have a doctor appointment. I do not drive at all as I feel unsure of my ability behind the wheel. I have to depend on my sister to get my groceries. I am in the process of weaning off Abilify. It has been 2 months as I am proceeding very slowly this time. Any advice on getting through this phase is appreciated.

[Manny78]

On 7/3/2018 at 10:01 PM, mammaP said:

Taken from the tapering abilify topic. 

 

You may be able to make a solution with the Abilify DISCMELT® Orally Disintegrating Tablets (available in 10mg and 15mg dosages); I don't know what the stability would be -- how long the liquid would be good.
 
For general instructions about making your own liquid http://survivingantidepressants.org/index.php?/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/   

 

Could you get the discmelt tablets?  I always ask at the pharmacy if certain drugs are available, then ask them to write it down and take it to the doctor. Doctors are not always aware of what is available.  My GP was adamant that effexor was not available in liquid here, so I went and asked the pharmacist who looked it up and wrote down the details which I took to the doctor, he was shocked to see that is was available and was not too happy about it but i got the liquid! 

I am taking disintegrating tablets mammaP,too.

[manymoretodays]

Hi RedRobin,

 

I saw your post on Migotka's introduction regarding the fatigue and hot flashes.  So......I did a quick review of your posts.

On 3/16/2018 at 10:11 PM, RedRobin123 said:

I am weaning off abilify . Just started 2nd taper after 30 days.  I am down to 

.25. I will stay there for another 30 days. I am tried all the time, can barely get out of bed. I stopped driving as my head is very fuzzy. I have to force myself to go outside. I have been getting stomach aches. Are these symptoms normal at this stage of the weaning process. I am very scared. I feel like my depression is coming back . Has anyone else had this experience? 

 

 

Have you decreased all the way down to .25mg of your Abilify?  If so.......I think you are tapering way too fast.  Many of the symptoms you describe can certainly be attributed to W/D.  And certainly might be minimized if you can slow down with the taper.  You are tapering way too fast.

 

I did a few severe, almost CT tapers myself and really don't think I have suffered permanent brain damage..... such as you are worried about.   But it's still just so hard to read how fast you are going down on the Abilify.  Is there a reason you can't negotiate with your Dr.?

 

Were you able to read some of the links given to you about tapering Abilify in more cautious manner?   Can you talk to your Dr. and just tell him/her you would like to go more slowly and get your Abilify prescribed in perhaps an alternate form?

 

The fatigue and hot flashes may be with you off and on for awhile now.  Good that you have some help and are taking some safety precautions with your activities.  I took a fair amount of time myself........ after I arrived here at surviving antidepressants.......to just rest and recover.  That might be to your benefit as well.

 

Love, peace, healing/inrecovery, and growth,

manymoretodays

 

 

[RedRobin123]

Thank you I am back up to 1 ml and doing a slower taper but still have symptoms previously discussed. Going to stay at this dose until under control again

[manymoretodays]

Oh excellent.  Yah.......get to feeling a little better before further changes.  Thank you for the reply. 

This might help you understand a bit more too.  Windows and waves.

 

http://survivingantidepressants.org/topic/82-the-windows-and-waves-pattern-of-stabilization/

 

Have the best day possible.

mmt

 

Edited April 19, 2018 by manymoretodays
added a link

[Altostrata]

Yes, stay at this dose for a good while to let your nervous system settle down.

 

Never, ever skip doses to taper.

 

You can get generic Abilify liquid at Walmart and other pharmacy chains, see https://www.goodrx.com/aripiprazole?form=bottle-of-oral-solution&dosage=150ml-of-1mg-ml&quantity=&days_supply=&label_override=aripiprazole

 

Your insurance may or may not cover it. Any doctor can write the prescription, it doesn't have to be a psychiatrist.

 

On 3/7/2018 at 10:33 PM, RubyJ said:

Aripiprazole Oral Solution 1 mg/mL (150 mL bottle)

Manufactured by Apotex Corp

NDC 60505-0404-5

 

The NDC number is the pharmacy ordering number. Thank you, RubyJ.

[manymoretodays]

On 4/19/2018 at 8:40 AM, RedRobin123 said:

Thank you I am back up to 1 ml and doing a slower taper but still have symptoms previously discussed. Going to stay at this dose until under control again

 

Hi again RedRobin,

I just noticed you stated that you are back up to 1 ml of Abilify.  I had assumed it was  mg. 

What was the dose in mg that you started your taper from?  And do you know how many mg's(milligrams) of Abilify are in 1 ml(millileters)?

Did you go to the pharmacy liquid listed above?  Or homemade?  If it is the pharmacy liquid then 1 mL does equal = 1 mg.  That's nice...... it would make it easier as we continue down.......mathwise.

When slowly tapering we are most concerned with the mg reduction.  Our 10% harm reduction recommends are all based on the milligrams of the active ingredient.  The active ingredient......... in your case....... is Abilify........generic name is aripiprazole.

 

If/when you get a chance could you update your signature with your medication doses in milligrams(mg).   That will really help us help you with a bit more clarity.  

 

Love, peace, healing in recovery, and growth at any age,

mmt

Edited April 21, 2018 by manymoretodays