Wednesday, March 30, 2011

Abilify's chameleon-like behavior

Here's a scenario concerning the ever expanding market for neuroleptic medication. Perhaps some of you have ideas to contribute to this scenario.

Abilify originally was approved by the U.S. Food and Drug Administration as an antipsychotic, and rather quickly gained approval as a treatment for depression and autism. I am now thinking of Chris, if I have to use a label for him at all, as "depressed," and no longer "schizophrenic" thanks to Bristo-Myers-Squibb's (BMS) amazing Abilify trick, aided and abetted by its good friend, the FDA.

BMS has now freed us to pick and choose our label based on the many diagnoses its product is treating. Technically, since Chris is on Abilify only, he is not clinically depressed, because to meet this standard he would have to be also on an antidepressant, as Abilify is only approved for unipolar depression if used in conjunction in conjunction with an antidepressant. I could begin thinking of Chris as bipolar, since bipolar doesn't seem to carry the same stigma as "schizophrenia." I sincerely doubt Chris is autistic, so autism is a non-starter. I like the idea of "depressed" because anyone can start off on both Abilify and an antidepressant and then drop the antidepressant. Can Chris now go to his doctor and get his original diagnosis changed, given that he was once on an antidepressant and weaned himself off it? I think, judging from the Abilify, that this is a valid conclusion to draw. On what basis could a doctor refuse to change his original diagnosis?

But what does this mean for the BMS pipeline? The company is going to have to reposition schizophrenia, once again, as horrible, devastating, and, most importantly, "unique." Will it begin to trash Abilify as no longer useful for schizophrenia while simultaneously introducing a new improved drug, e.g. "Rehabilify" marketed only for schizophrenia?  What new "diseases" will replace schizophrenia market for Abilify?

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Aripiprazole (pronounced /ˌɛərɨˈpɪprəzoʊl/ AIR-i-PIP-rə-zohl; brand names: Abilify, Aripiprex) is an atypical antipsychotic and antidepressant used in the treatment of schizophrenia, bipolar disorder, and clinical depression. It was approved by the US Food and Drug Administration (FDA) for schizophrenia on November 15, 2002, for acute manic and mixed episodes associated with bipolar disorder on October 1, 2004, as an adjunct for major depressive disorder on November 20, 2007 and to treat irritability in children with autism on 20 November 2009.[1][2] Aripiprazole was developed by Otsuka in Japan, and in the United States, Otsuka America markets it jointly with Bristol-Myers Squibb. (Wikipedia)


  1. Rossa,

    I can't get my head around this!

    At least Pharma can argue that the SSRIs and SNRIs were a good try... They can always say that they thought by holding (preventing re-uptake) of serotonin, or serotonin/norepenephrine they gave things a good try. (In spite of the fact they never have worked, were fraudenltly marketed... we all know the story... not to bore your readers.

    But Abilify?

    Let me get this straight.... adding a drug that inhibits the reception of dopamine (considered one of the king of feel-good brain chemicals)... inhibiting its absorption will help with depression?

    So, a person who is on a worthless (clincally no better than placebo) drug to hold a feel-good brain chemical (or two in the case of the SNRIs) is suppose to add a drug to keep another feel-good chemical (dopamine) OUT of the brain?

    That void of any common sense, any logic.

    What's next?

    Add a bottle of Jack Daniels, a six-pack of Budweiser, and a pack of Marlboro lights to the mix, as adjuncts, to help the antidepressant and Abilify do their job?

    Is that next?

    Wait a mijute.
    I almost forgot.
    There's not nearly as much money in alcohol and cigarettes.

    As an adjunct to an antidepressant to treat depression?

    What do I think?
    I think it's CRAZY!
    That's what I think.

    Duane Sherry

  2. Whoever the reader was who mentioned having hope, and reclaiming his/her life (name not visible on this computer for some reason)...

    Keep getting the support you need.
    Never lose hope!
    Reclaim it!

    Duane Sherry

  3. Duane - I know, it's crazy to add Abilify as an adjunct treatment for depression, but here's the good news. According to Wiki,two large, double-blind, placebo-controlled studies for bipolar disorder found no difference between aripiprazole (Abilify) and a placebo. One study reported depression as a side effect of the drug!

  4. Duane - "Whoever the reader was . . ." That was my mistake. I started out doing on post on NAMI, scrapped the idea, but forgot to take out quote that set me off in the first place. (What set me off is how "thanks to my medication" is found just about in every second line of NAMI testimonials.

    I have removed the quote. Thanks for alerting me to the problem.

  5. Rossa,

    Not surprising that Abilify would cause increased depression...

    That's what happens when the brain isn't getting dopamine!

    As far as the comment from a NAMI testimonial, I thought it was from a reader, and wanted to give him/her some encouragement.

    I think it's fair to say that those of us who are down on psychiatric drugs have anger toward the drugmakers and the front-groups, not people who are taking the drugs, which is why I wanted to send a message of encouragement to (who I thought was a reader of your blog).

    Belated congratulations on your book... I hope you do well with it!

    My best,

    Duane Sherry

  6. Duane,You are absolutely right.

    "I think it's fair to say that those of us who are down on psychiatric drugs have anger toward the drugmakers and the front-groups, not people who are taking the drugs."


I am no longer approving comments. All I ask is that you be respectful of others and refrain from using profanity.