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Abilify (aripiprazole) withdrawal can confound physicians and patients alike, with few professionals able to confidently guide this process. Sometimes, you might ask if the drug itself might be the problem.
We look at these potential misdiagnoses or overmedicating cases with a discerning eye, and in 75% of the cases, we found that the drugs could be sustainably eliminated … and that in many of the others that the medications could be reduced to vastly increase the quality of life
Do Your Symptoms
Alternative to Meds has led the world on antipsychotic withdrawal now for 15 years. We have published evidence regarding our success. We have found that addressing underlying issues results in much less toxic treatments. Overlooked medical conditions including poor diet, drug use, toxic accumulations, were probably not addressed. Misdiagnoses or premature diagnoses are not at all uncommon in the absence of vigilant observation.
15 Years Experience by Professionals Who Understand Your Journey.
This video is the stunning account of an individual named Gordie who would have been otherwise hopeless if it were not for the intervention for ATMC. Any mother, father, or concerned loved one of an individual suffering from psychosis should certainly see this video as it will redefine hope for your situation. And Gordie is one of many testimonials and videos that we have documenting our success.
Many of us at ATMC were misfits at one point, in fact, our founder at one time was diagnosed schizoaffective. The video attached here is our founder talking about Abilify withdrawal in a way that helps normalize the process.
Antipsychotic withdrawal is characterized by upregulated dopamine receptors getting overstimulated when the drug is reduced. This is why Abilify withdrawal is liable to mimic mania.
Abilify Withdrawal Symptoms
Abilify withdrawal can induce harsh symptoms and, like any antipsychotic medication, it should generally not be abruptly discontinued. There are important exceptions to this. For example, where NMS (or other life-threatening reaction) appears, the drug should be immediately stopped.7 The drug label lists no specific guidelines for discontinuing treatment, except for mentioning abrupt discontinuation is not recommended. We have found studies uniformly confirm the safest procedure is a slow reduction of the dosage over an adequate time frame.2,8,9,10,11,12,13
Abilify withdrawal symptoms include:
Tardive dyskinesia* and other involuntary movement disorders.2,10,12,13
Psychosis, delusional thought, paranoia.10
Diaphoresis (excessive sweating involving the entire body.)2,18
A constellation of symptoms including decreased concentration, irritability, agitation, sleep disturbances, and depression.18,19,20
*Tranter and Healy’s 1998 study reminded physicians of the very real movement disorders associated with withdrawal from dopamine-blocking agents, a subject that they felt had been neglected since the 1960s.
These withdrawal symptoms may range from mild to severe, and a person may experience one or multiple concurrent symptoms when tapering Abilify. Withdrawals can also develop after the drug is discontinued, especially when done abruptly or too fast, and where withdrawal management has not gradually compensated for the neurochemical changes that transpire. Abilify has a relatively long half-life, which is suggested by Tranter and Healy as a possible explanation for the lag time of emerging withdrawals.2
Antidepressant drugs that are prescribed to treat depression can cause headaches when they are withdrawn.15 While Abilify is not classified as an anti-depressant, some similarities may overlap where it has been prescribed in the treatment of depression. Abilify withdrawals have not been as extensively studied as other drug withdrawals. However, some zebrafish studies, as well as Abilify studies on monkeys, have concluded that withdrawals from sedative-type drugs such as Abilify are observed after the drug is discontinued.19,7,20
Notes on Proper Abilify Withdrawal
Discontinuing or quitting Abilify (aripiprazole) can be best done by gradually tapering off the drug, with medical oversight and step-by-step guidance. Despite taking a gradual approach, symptoms may yet develop to a severe and intolerable level. In this case, the preferred approach if possible would be to taper while in residential care.
Aripiprazole has a half-life of 75 hours, and the half-life of its active metabolite “dehydroaripiprazole” is 94 hours. It was at one time thought that due to the drug’s long half-life, that withdrawals would not likely emerge on abrupt cessation, but this was not always found to be the case in more recent trials and research. Sometimes even on abrupt cessation, there is a delayed onset of symptoms, which can nonetheless be quite hard to tolerate unless proper support is in place. Therefore the medical recommendation is to taper gradually from antipsychotic medications.2,7
Abilify Side Effects
Some commonly reported side effects of taking Abilify may fade within a short time. However, if these reactions linger or worsen, they need immediate medical attention. Always seek medical guidance to deal with these adverse reactions, especially if lingering or intense. The below lists of Abilify side effects are not complete lists, and unless indicated otherwise are from the drug manufacturer’s official site,24 or the FDA label information.7
Some commonly reported side effects include:
Impaired driving, increased accident rates.23
Low blood pressure, fainting
Low white blood cell count
Heatstroke, overheating especially after exercise
Increased cholesterol, weight gain
High blood sugar symptoms, such as thirst, hunger, confusion, nausea, fruity breath
Restlessness, need to keep moving
Cold-like symptoms like runny or stuffy nose, sneezing, etc.
For any of the above seek medical attention, especially if lingering or severe.
Possible Severe Abilify Side Effects
Side effects that are more severe may be less common, but consumers and their caregivers should be aware that they may require medical intervention immediately should they occur. Abilify was given at least 3 black box warnings. One was a warning about the increased risk of death for elderly patients with dementia due to the risk of stroke or other cardio events leading to fatality. Another black box warning was given for suicidal thoughts and behavior, in the under 25 age range, and another warning for causing compulsive behaviors such as pathological gambling, binge eating, compulsive shopping, and hypersexuality.21
Additional severe Abilify side effects include:
Thoughts of suicide, suicidal behavior notably in the under 25 age range.
Aspiration (swallowing the tongue or other objects obstructing the airway)
Blood pressure fluctuations, high or low
Difficulty with speech or articulation
Drooling, excess salivation
Swelling of hands, feet, bloating in the limbs, etc.
Tachycardia (pounding or racing heartbeat)
Loss of balance
Tingling or numbness in the extremities
Inability to move
Rash, blistering rash, or ulcers that develop in mucous membranes
Trembling muscles, jerking motions, spasms
Muscle stiffness, rigidity
Uncontrolled facial motions
Twisting body or limb motions (involuntary)
Loss of bladder control, incontinence
Lip-smacking, puffing of the cheek muscles
Sudden loss of consciousness
Akathisia combined with suicidality
Other involuntary muscle movements, repetitive
Tardive dyskinesia (very rare) usually irreversible
Aripiprazole is a third-generation type of antipsychotic medication, thought to be better tolerated than conventional or earlier antipsychotic drugs. Nonetheless, severe or persisting side effects should be monitored carefully and given medical attention if needed, without delay.1
Abilify is known to cause compulsive behaviors such as hypersexuality, change of sexual orientation, pathological gambling, among others. In a case study authored by Mete et al, the patient’s compulsive behaviors ceased within 2 weeks of discontinuing Abilify and he soon after returned to a heterosexual state, and the hypersexuality ceased as did the compulsion to gamble.22
Aside from these compulsive behavior syndromes, no studies were found after an exhaustive search that indicate Abilify addiction or drug-seeking behavior, or drug cravings have been observed, documented, or studied in the available medical literature.
Does Abilify Increase Dopamine?
According to a 2015 NIMH study4 aripiprazole may bind to certain receptors in the brain, and trigger a number of responses that modulate dopamine in various ways, sometimes increasing or even decreasing the transmission of dopamine (and perhaps other neurochemicals) along certain pathways. This “adaptive” mechanism of dopamine modulation relates in particular to the mechanism of aripiprazole and not necessarily to other antipsychotic medications.
One theory relating to schizophrenia is that overactivity of the brain’s “mesolimbic pathway” may contribute to symptoms of schizophrenia such as delusions and hallucinations. Therefore, a suggested corollary seems likely, that decreasing mesolimbic pathway activity (such as suggested by ongoing pharmacology research) can reduce symptomology associated with schizophrenia.3
A 2005 study on mouse brain activity 5 showed that aripiprazole increased dopamine and did not increase other neurotransmitters such as serotonin or norepinephrine. Although more research is greatly needed, the aforementioned 2015 study gives a more expanded and optimistic view of managing and treating schizophrenia.
Research on Dopamine, Abilify Withdrawal, and Bipolar
In genetic studies we have performed clinically at Alternative to Meds Center, we have seen an association with the COMT (catecholamine methyltransferase) genetic polymorphism and certain conditions involving psychosis, mania, and features of high and low moods as described by the term bipolar.
A potential theory to explain this correlation could be due to the way that the biological pathways for catecholamines function. Catecholamines include dopamine, norepinephrine, and adrenaline, each of which performs an excitatory response to the limbic system, also known as the emotional brain.
Dopamine is associated with the perception of reward. A person with a low sense of reward may be attracted to stimulants, and a person with an overly high sense of reward may present as manic.
The enzyme COMT can degrade dopamine and other neurotransmitters. However COMT impairment inhibits its ability to break down dopamine. Where genetic testing shows the presence of COMT genetic polymorphism, it would stand to reason that the person could be suffering from a dopamine excess. Thus, genetic testing can provide valuable information that can assist in helping someone to normalize or regulate neurotransmitter function as part of Abilify withdrawal.
The methionine variant results in a more sluggish COMT enzyme, which may leave dopamine around the prefrontal cortex for a longer period of time.6
More research studies are encouraged on this particular point, particularly considering that the aforementioned study is referring to the breakdown of dopamine in the prefrontal cortex as opposed to the striatum structures such as the caudate, putamen, and mesocorticolimbic regions.
Abilify is believed to have the capacity to deflect dopamine from the D2 receptor, and therefore, reduce manic symptoms. Unfortunately, most drugs have limitations due to the adaptations of the body. The body, perceiving a dopamine deficiency can then make more receptors for dopamine. This usually makes an antipsychotic withdrawal the most challenging of all drug classes, including the difficulties of withdrawal from heroin and benzodiazepines.
What is Abilify (aripiprazole) Used For?
Abilify is a third-generation atypical antipsychotic medication used in the treatment of adult schizophrenia, bipolar 1 disorder, Tourette syndrome, and in young children (age restrictions apply) presenting symptoms associated with Autistic Disorder, such as temper tantrums, mood swings and aggression. Abilify (aripiprazole) research has accumulated a significant body of data from clinical trials on various age groups and populations over the time the drug was first developed in the late 1990s and released in the US in 2002. Some side effects of aripiprazole led to the FDA placing a black box warning that restricted prescribing the drug within certain populations or age groups.6
The drug is used primarily in the treatment of schizophrenia, bipolar disorder, and major depressive disorder in adults. The FDA expanded approved uses to include acute mania and mixed episodes (a combination of manic and depressive symptoms), in adults as well as in children who are at least 10 years of age. Elderly patients with signs of dementia should not take Abilify, as stated in the FDA black box warning regarding an increased risk of death in that population.6
Abilify was also approved in 2009 for use in children aged 6 and up with autism. Studies show a reduction in irritability, hyperactivity, inappropriate speech, and aggression associated with autism, but an increase in weight gain, tremors, sleepiness, and drooling. There are no long-term studies to show safety over long-term use of Abilify in young children.
In the treatment of acute manic/psychotic episodes, Abilify is considered a maintenance medicine and is usually minimally prescribed for a period of 1-2 years. The below list is taken from the drug manufacturer’s official site.24
Abilify is prescribed for these conditions:
Schizophrenia (impaired perceptions of reality vs unreality, paranoia, difficulty in relating to others, delusions, hallucinations, etc.)
Borderline personality disorder (an emotionally distressed state characterized by intentions to self-harm, fear of abandonment, intense mood swings, explosive anger, etc.)
Tourette syndrome (characterized by vocal or muscle tics, repeating phrases, movements, etc.)
Autism (a condition in children characterized by emotional outbursts, lack of speaking or ability to articulate, social withdrawal, etc.)
Schizoaffective disorder (mood swings and disconnection from reality)
MDD, or major depressive disorder (severe depression that lasts over a long period of time)
OCD, obsessive-compulsive disorder (characterized by repeatedly checking or counting objects or other compulsive motions/actions, etc.)
Mania/ manic episodes/ psychotic episodes (delusions, extreme euphoric state, impulsive behaviors that could involve harm to self or sometimes others)
PTSD, or post-traumatic stress disorder (flashbacks or re-experiencing effects from past traumatic events triggered by present environment)
Agitated State (unpleasant state of aroused negative emotions, confusion, etc.)
Abilify (aripiprazole) Alternative Names and Slang
Abilify is a trade name for the generic drug aripiprazole or aripiprazole systemic. Other brand names for the drug include:
Abilify has not developed a significant demand or presence as a street drug, with the exception in possible cases of diversion, a potential outcome that is shared by all pharmaceutical products in general. For natural alternatives to Abilify please visit our Abilify Alternatives page.
Abilify (aripiprazole) FAQs
Here are some of the most frequently asked questions about Abilify and aripiprazole. For more information please contact us and we will freely offer any other available information on these or other topics of interest on request.
What does Abilify (aripiprazole) do to the brain?
The exact mechanisms of action on the brain of aripiprazole are not completely known or understood.
Aripiprazole acts in different ways than other types of antipsychotic medications; it can produce a modulating effect on certain neurotransmitters and their action along various pathways. 4
Should you get pregnant on Abilify (aripiprazole)?
Pregnancy is a very personal health matter and an important one to discuss with your primary caregiver, especially when your pregnancy may overlap starting or stopping the medication. As with all medications, the gold standard medical advice is that to stop a drug like Abilify, gradual cessation is the safest procedure.
Always speak with your medical advisor so that an informed decision can be made regarding your and your child’s optimum health.
Is Abilify withdrawal (aripiprazole) dangerous?
Abilify is a third-generation antipsychotic medication. Though rare side effects are associated with any medication, Abilify is considered one of the least likely to produce severe reactions or withdrawal phenomena even after dependence on the drug has developed over the long term.4
Treatment for Abilify (aripiprazole) Abuse and Addiction?
When the antipsychotic medication is reduced, based on existing theories concerning potential restriction of dopamine, dopamine expression will begin to return. Dopamine now flooding into up-regulated receptors often clinically presents as a rapid expression of manic symptomology. In many cases, the patient may become enchanted with the newfound sense of reward which could result in resistance to either slowing down the medication taper or increasing the dose to regain stability. This unwillingness to take pragmatic guidance makes this situation very labile and requires expert and precise management.
Working closely with a doctor or center that has hospital admission privileges is highly advised as regaining control in a humanistic way may prove necessary. It is much better in extreme cases to have the individual safe and hospitalized under a trusted doctor’s admission, so that later, slower tapering efforts may be investigated. An involuntary commitment or incarceration erupting from a situation where the Abilify withdrawal was either too rapid or otherwise unstructured or unsupported is certainly not a good outcome.
Recovery after long-term antipsychotic medication.
These considerations are especially relevant in cases where the medication has been relied upon for many years. Done well, certain dispositions can transition to being medication free or to the lowest possible dose that provides the highest quality of life successfully, which is our goal concerning Abilify withdrawal at Alternative to Meds Center.
When Abilify (aripiprazole) medication is taken over a long period of time, as is usually the case with such prescription drugs, dependence will likely have developed, resulting in many possible discomforts associated with cessation. It may be prudent to select an inpatient program that is well equipped both in understanding the unique problems with antipsychotic drug withdrawal and also can provide comfortable, personalized assistance while withdrawing from the drug.
We use integrative therapies during Abilify withdrawal.
Antipsychotic withdrawal at Alternative to Meds Center is done meticulously, with gentle, careful, medical oversight. Our program involves multiple methods and therapies that can significantly reduce the stress that may otherwise make the process seem and feel more difficult and time-consuming than it has to be.
Using nutritional testing and support, toxic load removal, counseling, Qigong, physical exercise, colon hydrotherapy, equine therapy, and many other therapeutic approaches to support the gradual tapering process in a beautiful and restful setting, we can help the body to ease back to a healthier state, and move toward the goal of normalizing the neurochemistry for better natural mental health. Contact us for more information on this important area of healthcare, and you may find you are closer than ever to be able to take the next step to full recovery. Abilify withdrawal can free you from dependence on antipsychotic medications in a safe, nurturing, and comfortable setting at Alternative to Meds Center.
Diane is an avid supporter and researcher of natural mental health strategies. Diane received her medical writing and science communication certification through Stanford University and has published over 3 million words on the topics of holistic health, addiction, recovery, and alternative medicine. She has proudly worked with the Alternative to Meds Center since its inception and is grateful for the opportunity to help the founding members develop this world-class center that has helped so many thousands regain natural mental health.
Medical Disclaimer: Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.