antipsychotics as a first line treatment?

I'm currently on Abilify and I'm kind of freaking out about the movement disorder risk. I'm thinking about trying a MS instead. Is it more common to start with a MS first, or are AAP's in common usage as a first line treatment?

[ILADVOCATE]

All atypical antipsychotics are FDA approved as first line medications for bipolar. For psychosis, they are of course neccessary. For bipolar mood stabilizers could be used instead depending on what your psychiatrist thinks is going on. Speak to them about your concerns.

[wj74]

Oh, of course I will. :) I like to get others' opinions on the matter before I do something about it. Thanks!

[JennyDots]

My understanding is that all antipsychotics, both typical and atypical, carry some risk of movement disorders. Your risk increases with the time you're on them.

When I was first diagnosed, lithium was the first-line treatment. Then anticonvulsants started to be used more and more as mood stabilizers. Now it seems atypical antipsychotics are being prescribed,not only for psychosis, but as first-line treatment for bipolar disorder AND as adjunctive treatment for depression and anxiety. Right now I think they may be overprescribed. But - I do think they have a place in the treatment of bipolar disorder, and many people get significant relief.

I think it's a matter of weighing risks and benefits. The last research I saw put the movement disorder risk at around 5 percent. If bipolar causes major problems in your life, a 5 percent risk might be, comparatively, very minor.

Jenny