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 FDA3:
- 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.
