![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Christ_empowered on October 11, 2015, at 22:00:11
vryalar or something...is it worth considering? I'm doing well on 30mgs Abilify per day, but I've gained weight, and its now hard to lose the weight.
I don't do well on D2 antagonists. I got akathisia from 5mgs zyprexa but, weirdly enough, haven't gotten it from Abilify (although I did have a tremor that went away w/ Orthomolecular. Could be placebo, could be that the OM people are right...).
Anyway, I read somewhere that this new Abilify has more EPS, which I find frightening. I thought the whole point of the atypicals was less EPS? Or is it just novelty and $$$?
Thanks in advance.
Posted by Tomatheus on October 12, 2015, at 12:52:37
In reply to the new abillify, posted by Christ_empowered on October 11, 2015, at 22:00:11
Christ_empowered,
My understanding is that there are two D2 receptor partial agonists that the FDA has recently approved: the first one being Rexulti (brexpiprazole), and the second one being Vraylar (cariprazine). The FDA approved Rexulti on July 10, and the agency approved Vraylar on Sept. 17. I think that Rexulti, and not Vraylar, is technically considered to be Abilify's successor, as it was developed by the makers of Abilify. According to an article that I read (http://www.hcplive.com/conference-coverage/2014-apa/Brexpiprazole-Shown-to-Be-Effective-for-Major-Depressive-Disorder-with-Fewer-Side-Effects-Than-Aripiprazole), patients in a phase-III placebo-controlled clinical trial taking Rexulti (brexpiprazole) had a "two-thirds reduction in the chance of having restlessness." So, it may be the case that Rexulti is less likely to cause akathisia than Abilify, although I don't know how Vraylar compares to Abilify as far as akathisia and other extrapyramidal symptoms are concerned.
One thing that you might want to do is compare the incidence of various side effects of Rexulti and Vraylar with the incidence of side effects from Abilify. I will, however, express some skepticism toward doing what I just suggested, as it sometimes seems that the side effects reported in clinical trials don't always match up with what's reported in real-world reports. For example, my understanding is that Abilify was touted as a weight neutral drug based on clinical trial data, but it seems based on everything that I've read about Abilify and weight gain that weight gain is pretty common on the medication. Perhaps the weight gain comes on more slowly with Abilify and is thus less likely to be noticed by patients in short-term clinical trials? I don't know, but I tend to think that the side effect data from clinical trials may not always seem to match up with what patients actually experience.
I will say that at this point, I'm not personally planning on giving Rexulti or Vraylar a try (I still take Abilify), although I will watch for anecdotal reports from patients taking both new medications. I've just had so many bad experiences with medications up to this point, with Abilify being one of the few medications that I've tried since the onset of my psychosis that hasn't worsened one symptom or another, that I think that sticking with the safe choice (staying with Abilify) would be best for me. But as I said, I will be watching for anecdotal reports from those taking Rexulti and Vraylar, and I might change my mind about trying one of those medications depending on what I read about them.
So, to answer your question as to whether Rexulti and Vraylar are worth considering, I'd say that they're worth looking into and possibly trying, depending on what your situation is with medications. As far as weight gain is concerned, I think that it would probably be hard to determine in advance whether Rexulti and Vraylar would be less likely, more likely, or just as likely to lead to weight gain as Abilify. So, if you're looking to determine whether you should try Rexulti or Vraylar based on the likelihood that the medications will lead to weight gain, I think it would be hard to make such a determination at this point. Still, I'd encourage you to look into the two new medications to see if you might find something about one of them that you might find to be desirable.
Tomatheus
Posted by Christ_empowered on October 13, 2015, at 10:47:27
In reply to Re: the new abillify » Christ_empowered, posted by Tomatheus on October 12, 2015, at 12:52:37
thanks, Tomatheus. I"m thinking now I'll stick w/ Abilify and hope the Wellbutrin helps weight loss. Maybe a dosage reduction would help? Ugh. 30mgs/Abilify works well, but...yeah. Its a fatty pill, lol.
Thanks again.
Posted by Lamdage22 on October 31, 2015, at 15:42:24
In reply to the new abillify, posted by Christ_empowered on October 11, 2015, at 22:00:11
> I don't do well on D2 antagonists. I got akathisia from 5mgs zyprexa but, weirdly enough, haven't gotten it from Abilify
Thats weird. I experienced the exact opposite. Makes me think if i should try brexpiprazole or cariprazine.
First things first though: My Notrtiptyline trial!
Posted by Lamdage22 on October 31, 2015, at 15:44:28
In reply to Re: the new abillify, posted by Lamdage22 on October 31, 2015, at 15:42:24
Interesting how we all have similarities but we are all wired differently!!
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.