Jump to content

Stacyduck: Want to taper Abilify


Stacyduck

Recommended Posts

I started Abilify 3 months ago and it has done very little depression wise, but has definitely given me akathisia, muscle twitching, and increased anxiety. I am currently taking 2mg and wish to taper off as safely as possible. I’d like to use liquid if possible. Any advice, dosing schedules, success stories would be greatly appreciated.

Link to post
  • ChessieCat changed the title to Stacyduck: Want to taper Abilify
  • Moderator
manymoretodays

Hi Stacyduck and welcome,

 

I'm sorry you've experienced such nasty side effects from your Abilify. 

When did the akathisia, muscle twitching, and increased anxiety begin in relation to your taking the Abilify?  Has your dose changed since you started the Abilify, up or down?

 

This current page, in the Introduction section, will act as your own main page......a place for you to introduce yourself to the community, ask questions specific to your situation, and provide updates, as well as keep a record of your withdrawal experience.

 

We need you to create a signature for us.  This is explained in the link below. 
Please put your medications and withdrawal history into a signature

Before you begin tapering- what you need to know

Just some basics in this ^ one.

 

The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs. While it is not a guarantee you will have trouble-free withdrawal, we believe this conservative tapering method will cause harm to the fewest number of people.

Why taper by 10% of my dosage

What is withdrawal syndrome

 

Tips for tapering off Abilify/aripiprazole

There is a generic liquid now available, that could be used for tapering purposes.  Please update and let us know IF you decide to taper this way, BEFORE you do the crossover to liquid.

 

Love, peace, healing, and growth,

mmt

 

 

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016. 

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

Link to post
  • Moderator
manymoretodays

Hi Stacyduck,

And I hope you'll get back around soon.  We generally recommend a cross over for the switch from tablets to liquid and treat it as a dose change event.

This is our usual cross over formula.

Stay at your present dose while doing this.

Days 1-3:  3/4 of your dose in tablet form and 1/4 in liquid

Days 3-6:  1/2 tablet and 1/2 liquid

Days 6-9:  1/4 tablet and 3/4 liquid

Day 10:  take your entire dose in liquid

 

I just thought I would share with you the following information on liquid aripiprazole(Abilify is the brand name) as well.  It is one of the drugs that has a long half life, which results in any changes to the dose taking longer to register physiologically.  Something to keep in mind.

 

We usually deal with drugs that have half-lives of around 24 hours or less. For a psychiatric drug, aripiprazole has an unusually long half-life, plus it has an active metabolite with a long half-life. According to https://en.wikipedia.org/wiki/Aripiprazole
 

Quote

 

Aripiprazole displays linear kinetics and has an elimination half-life of approximately 75 hours. Steady-state plasma concentrations are achieved in about 14 days. Cmax (maximum plasma concentration) is achieved 3–5 hours after oral dosing. Bioavailability of the oral tablets is about 90% and the drug undergoes extensive hepatic metabolization (dehydrogenation, hydroxylation, and N-dealkylation), principally by the enzymes CYP2D6 and CYP3A4. Its only known active metabolite is dehydro-aripiprazole, which typically accumulates to approximately 40% of the aripiprazole concentration. The parenteral drug is excreted only in traces, and its metabolites, active or not, are excreted via feces and urine.[50] When dosed daily, brain concentrations of aripiprazole will increase for a period of 10–14 days, before reaching stable constant levels.[citation needed]

 

 

 

 

 

When changing from tablet to liquid form, you may begin to feel a difference beginning as early as 4 days, however research shows for certain drugs (unless your symptoms ramp up right away, then you will want to back off,  the full effect takes 7-10 days for the Blood Serum Concentration to become Steady State in the blood.  You may not wish to change or increase your dose for at least 2 weeks, to allow your CNS to fully recognize the change for drugs like this one with a long half life, (the time it takes you body to metabolize half of the dose)."

 

The drug concentration peaks in just a few hours after you take it then starts to drop off as it moves toward the half life.  Because of the long half life and the overlap between doses the  concentration rises until it reaches a plateau which is Steady State.

Any dose change needs to reach Steady State.

 

The liquid form of aripiprazole has a Blood Serum Concentration approximately 20% higher than the tablets.  " The single-dose pharmacokinetics of aripiprazole were linear and dose proportional between the doses of 5-30 mg"

(source: https://www.accessdata.fda.gov/drugsatfda_docs/label/2006/021729lbl.pdf )

So when crossing over and changing your formulation from tablet to liquid, you might consider a decrease in dosage to reflect this.   I would suggest asking the pharmacist about this as well.

 

That may be more information than you wanted or needed, and I'm not a doctor or pharmacist........yet it may be helpful in your harm reduction approach to tapering off Abilify.  I was just looking for some other information and came across this.

 

Love, peace, healing, and growth,

mmt

 

 

 

 

Edited by manymoretodays
checking sources, clarity

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016. 

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

Link to post
  • 2 weeks later...

Thanks manymoretodays. I plan on having the discussion about weaning off of Abilify at my next appointment on the 18th. I started Lamictal 2 weeks ago and it seems to be helping with my depression, so that has given me some hope. I just need to gather the strength to start a taper that will take so long. I’ll work on a signature, but I’m currently on 30mg Lexapro, 2mg Abilify, 12.5 Lamictal (dosing up to 25mg), 1.5 Ativan.

Link to post
  • Administrator

Welcome, Stacyduck.

 

It could very well be that your interesting combination of drugs is causing your severe adverse reaction: Drug-induced akathisia and movement disorder are very serious. If I were you, I would not ask my doctor if you can go off Abilify, I would inform my doctor that I am going off Abilify, and I expect his or her assistance in prescribing the liquid for you to taper.

 

Please put ALL your drugs in the Drug Interactions Checker https://www.drugs.com/drug_interactions.php and copy and paste the results or a link to them in this topic.

 

How long have you been taking Ativan? What symptom is that supposed to treat?

 

A common side effect of Lexapro is sleeplessness and a common side effect of Ativan is depression; please consider whether your doctor is pilling on drugs to treat side effects of other drugs and has gone overboard with cocktail-mixing.

 

He or she has you on one drug from almost every food group. The only one missing is an amphetamine analog. This is a sign to me your doctor does not know what he or she is doing. As soon as you developed akathisia from Abilify, you should have been instructed to stop it.

 

If I were you, I would not increase Lamictal dosing. More is not necessarily better with any of these psychiatric drugs, you are already having serious adverse reactions, and increasing any of them might make this worse.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to post

I won’t be asking to wean off the Abilify, I’ll be telling and asking for a prescription for liquid. Given my circumstances, do you still think the 10% per month reduction will be necessary? It seems being on this for 2 more years would risk things getting worse?  The Ativan was prescribed for anxiety and sleep. The interaction checker showed moderate interactions between all the medications.

Link to post
  • Administrator

I would try a 10% reduction, see how it goes. It could be you'll be able to decrease more often than every month.

 

Please be sure to keep daily notes on paper about your symptoms, when you take your drugs, and their dosages. Use a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

 

To help us out, follow these instructions Please put your drug and withdrawal history in your signature

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to post
  • 4 months later...

Hi Stacyduck:  

 

I am also working on titrating Abilify (Aripiprazole) and though I would check in to see how you are doing...?  

 

Best wishes, 

Cleerity

 

4/2001 - Clonazepam, .5mg (at bed); 5/2010: 1 mg; 9/2018: .5 mg; 10/20/2018: .47 mg; 10/24/2018: back up to .5 mg.  Began daily micro taper by liquid prep on 3/12/2021 (avg. 10% redux of last dose every 28 days).  At .25 mg/ml as of 9/12/2021.

4/2002 - Alprazolam, .25 mg (PRN), up to 2x/day.  DISCONTINUED 10/21/2018
5/2010 - Mirtazapine - 15 mg (at bed)
3/2012 - Aripiprazole - 2 mg (in A.M.) - Began reducing Dec. 30, 2018.  Daily micro-taper by liquid preparation.  DISCONTINUED 1/14/2021.

6/2012 - 500 mg  Metformin ER, 2 tabs, 2x/day.  DISCONTINUED April 2020.

Supplements: Multi Vit Calcium-600 mg x2 / D3-5000 IU / C-1000 mg x2 Fish Oil-1000 IU Magnesium-200 mg x2 / Zinc-50 mg / Biotin-10,000 mcg / Glutathione-500 mg / Quercetin-1000 mg

Link to post
  • 2 months later...
  • Moderator Emeritus

Hi Stacyduck, How are you doing?💚

Been on antipsychotics, benzos, antidepressants and painkillers for chronic pain. 

Been cold turkeyed and put on and off all sorts of things. Was suicidal n ended up in a psych ward because I had akathisia from withdrawals. Can’t remember what I was put on but when I was released was in the same predicament with severe akathisia n was suicidal again.

Back to the ward and was given different meds. Tapered off one and have been trying to taper off Seroquel since. It’s been many, many years of tapering so far.

I’ve  tapered from 300mg of Seroquel to 7.5mg./ March 10 2019=7.25mg / 17th of April=7 mg / June 5th=6.75mg/ July 14th=6.50mg/ August 28=6.25mg/ 10th of Oct= 6.20mg/ October 21=6mg/ December 16=5.80mg/.   January 21 2020=5.60mg/April 2=5.40g/ May 29=5.20mg/ August 14= 5mg/ September 29=4.80mg/ Jan 31, 2021=4.60 mg/ April 24=4.40mg/ July 17=4.30mg

 

I AM NOT A MEDICAL PROFESSIONAL. These are my own views based on what I’ve experienced myself.

 

 

Link to post

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...

Important Information

Terms of Use Privacy Policy