My husband is bipolar with psychotic features or schizoaffective. He started abilify 10mgs and seems fine now after many monyhs of non-treatment and pychosis. How good is abilify only as he does not want to see a pychiatrist for further managment nor does he want to go onto a mood stabiliser
Yes Ability is FDA approved for use as a mood stabilizer but each person responds differently to each medication. If it is helping him thats whats important but regardless of which medication is used a psychiatrist needs to monitor it as to a person's response and how it is helping them and any other concerns.
The mood stabilizer I take Lovaza is an anti--cholesterol medication that is used off label for bipolar. The use of it is still experimental but some psychiatrists (especially psychopharmocologists who specialize in how medications work) will prescribe it. As its not specifically approved for this purpose they are just learning how it works. Generally the more common mood stablizers (lithium, Depakoate, Lamictal) are used first. However I have been tried on all other available mood stabilizers but either wasn't able to tolerate them or over time they stopped working over time. It has helped me with mood swings but as I have schizoaffective disorder I need an antipsychotic as well.
The antipsychotic agent I am authorized to take under clinical supervision glycine (google "Dr. Javitt, glycine") has in Phase 2 FDA studies being given as an adjunct (additional) antipsychotic agent shown to be of help on the negative (difficulty relating to people) and cognitive (difficulty processing and understanding things) symptoms of schizophrenia. I am the first person noted to respond to it for positive (not as in good but things that shouldn't be there that are such as auditory hallucinations and delusions) symptoms of schizoaffective disorder and be able to take it as a primary (stand alone) antipsychotic. The reason I was authorized to take this treatment is because I have advanced tardive dyskinesia,a side effect that occurs with all current antipsychotics (for more information google "patient education tardive dyskinesia" as the site itself says "some of these medications may be medically neccessary") and could not tolerate Clozaril which is the one currently available antipsychotic that won't cause it and would be used more if it weren't for the side effect profile it has that requires regulary blood work.
It will take some time for this class of antipsychotic to complete the studies and potentially be FDA approved. Mood stabilizers used off label are generally prescribed when first line ones that are did not work. These decisions, along with all other decisions as regards medications need to be made by a psychiatrist so that's why they are the ones that should be following up.
Please be aware that antipsychotics don't ALWAYS cause tardive dyskinesia. It is a possible side effect for antipsychotics but at a very low rate. Older antipsychotics - 1st generation - were more likely to cause it. The antipsychotics called atypical antipsychotics are 2nd generation and have a very low incidence of TD.
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