Does Aripiprazole (Abilify) Have Antidepressant Effects?
The short answer is: probably yes. A much longer answer has just been posted as an update to my webpage about aripiprazole and the "atypical antipsychotic" family of which it is a member.
If for one reason or another you are interested in the data on aripiprazole in bipolar depression, or Major (unipolar) Depression, I've summarized four studies, the three of them unpublished so far, which have recently been made available by the manufacturer.
JP
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9 Comments:
I can only speak for myself of course. In my case Abilify had a significant antidepressant affect. I am bipolar and also have seasonal depression during the winter. I was given Abilify in January and bounced up (not too far) immediately.
How does aripiprazole work as an
anti depressant?
I am interested to know since our
daughter is on this med for last
14 months as an anti psychotic. On
long term use certainly improved
her negative symptoms. It took long time for the psychiatrist to
finally diagnose her as sz though
initially they thought "looks just
unhappy". She was getting more
and more withdrawn......
Risperidone and later Quetiapine
though helped her positive symptoms, did not do anything for
her mood or negative symptoms.
Aripiprazole after 14 months enabled her to start a post graduate course with self motivation.
Jena
Aripiprazole does something like what antidepressants do. How it does that remains unclear (perhaps especially to me; although I think it is unclear generally).
You mention that there was an affect on your daughter's motivation, as well as mood. I have definitely seen that affect from aripiprazole. And that affect is probably associated with the way that this medication works on the neurotransmitter called dopamine, which has been very clearly associated with motivation levels.
As you may have learned, aripiprazole does something very different to dopamine levels compared to older medications like risperidone and quetiapine. Instead of jest blocking dopamine entirely, it partially stimulates that system as well.
However, and as for effects on depression generally, I don't think we quite know the mechanism of that, not in this way.
We just see that for some people it works quite well where other things did not. I'm glad it had that effect for your daughter.
Dr. Phelps
I am a family physician and have a question about using Abilify to treat depression in patients who have not responded fully to antidepressants, particulary to those who are still very anxious. Would Abilify work differently for these patients than stimulant medication such as Ritalin or Adderall? I have been reading your website at psycheducation.org and am so fascinated about the depression/bipolar spectrum. Thank you for the wonderful job you are doing.
To Dr. Margaret --
Thanks for your interest in the site. I'm glad to hear that some of it has been useful.
Would aripiprazole work differently than a stimulant? I think there is little doubt that it will indeed work differently. However, to my knowledge, we don't yet have secondary analyses from the big clinical trials in which the investigators might look at the impact of aripiprazole on ADHD-like symptoms (in the context of treating depression that did not respond fully to an antidepressant).
Otherwise, I have not seen data addressing this question, and I have not used aripiprazole in this antidepressant-adjunct role (I am a serious foot dragger). Frankly, I think the entire question about the role of aripiprazole and the treatment of depression is still wide open. Initially, you may be in a better position to arrive at some conclusions about this than I!
Good luck with the process --
Jim Phelps
Hello again Dr. Phelps,
Abilify is sooooo expensive. If it helped someone's depression, would there be something cheaper (perhaps a generic) that might have a similar effect? Again, thank you for what you do. I have learned more from this website than any lecture or journal article concerning mood disorders. Again, I am a family physician.
Dr. Margaret
Dr. Margaret --
Good on ya' for learning enough to be asking something like this. Your patients must love you.
Is there something similar that's cheaper? I've wondered if combining an old-generation antipsychotic, like perphenazine, with a stimulant (what an odd idea). That at least presents both an agonist and an antagonist, like aripiprazole.
But in the one fellow in whom I tried it, who had a good response to aripiprazole it seemed, but was getting glucose increases and weight gain -- the substituted pair of med's above did not help at all. Not that I really thought it would be equivalent, but we'd tried so many other things, I though it might be worth trying.
As for something similar that's cheap, whoa, now you're asking for the moon (just kidding; it's certainly worth asking for, but the point is, it's really out of reach because even the first half of the request -- something similar -- brings up about zero options. There are other atypical antipsychotics, of course, but as you're probably discovering, they really aren't "similar". And from the mechanism of action, we wouldn't have expected so either.
Drat. I guess the good news is that some people can get enough samples or patient assistance to be able to take aripiprazole, and for some it really helps. I'm still waiting to see if it's really helping a year from now. But for now, there are some responders, that's sure.
Good luck out there --
Jim Phelps
hi doc,
i just found your site, and just bookmarked it.
my pcp rxd me abilify for unipolar depression.i have sleep disorders and realize i do not replenish dopamine stores due to not enuf deep,restorative sleep.when i read one site about abilify inhibiting dopamine uptake in one area of the brain and increasing dopamine uptakein another area of the brain...what areas of the brain are these and what are these areas responsible for? i need all the dopamine i can get, i am close to vegetative.thanks!
I am bipolar and had treatment for a number of years with no obvious relief. Abilify is a miricle. I could immediatly tell a difference. I actually feel like smiling and getting out and doing activities. I would recommend that patients ask their doctor about this medication.
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