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Dynamic Chiropractic – January 1, 2010, Vol. 28, Issue 01

Abilify (Aripiprazole)

By Daniel Hough, DC

These days, we are bombarded with advertisements for prescription drugs. Many of our patients are taking these drugs. As chiropractors, we need to be informed about prescription drugs so we can educate our patients about their effects, side effects and dangers, as well as suggest safer alternatives when appropriate. (Don't count on their medical doctor or pharmacist to fully inform them.)

Abilify is currently being marketed heavily as a drug to add to antidepressants already being taken. The advertisements claim that antidepressants don't work two-thirds of the time and that adding Abilfy to those medications will help relieve the symptoms of depression. Abilify is manufactured by Bristol-Myers-Squibb, whose 2008 sales of Abilify alone totaled $2.2 billion.1 In Bozeman, Mont., where I practice, CVS Pharmacy charges a whopping $484.99 for a 30-day supply of 15 mg tablets of Abilify.

Abilify was originally approved by the FDA for the treatment of schizophrenia and bipolar disorder. Once a drug is approved by the FDA, it can be prescribed for any illness an MD thinks appropriate. Approval is based on risk/benefit analysis. Certainly schizophrenia and bipolar disorder are much more serious conditions than depression, and a higher risk to the patient might be acceptable for treatment of those disorders.

My PDR lists the following side effects from Abilify: tardive dyskinesia (which may be permanent), abnormal dreams, anxiety, blurred vision, chest pain, constipation, flu-like symptoms, headache, insomnia, lightheadness, nausea, neck pain, rash, restlessness, runny nose, sinus infection, sleepiness, tremors, vomiting, weakness, weight gain, neuroleptic malignant syndrome (which includes high fever), rigid muscles, irregular pulse or blood pressure, rapid heartbeat, increased perspiration, altered mental status, changes in heart rhythm and increases in blood glucose levels high enough to cause coma and death.2

A study in the August 2009 Archives of General Psychiatry states that more than 10 percent of Americans are now taking antidepressants, double the rate since 1996.3 More than half of those prescriptions are for problems other than depression, including back pain, nerve pain, fatigue, sleep difficulties or other problems. Spending for direct marketing to the consumer for antidepressants went from $32 million to $122 million during that time period.

Before prescribing dangerous, expensive medications, physicians should first rule out diseases that might cause depression, including but not limited to low blood sugar and hypothyroidism.4 Additionally, a study at Duke University demonstrated that 30 minutes of brisk exercise three times a week is as effective as medication for the relief of depression - and continuing to exercise keeps depression from returning.5

References

  1. Bristol-Myers-Squibb 2008 sales of Abilify. www.bms.com
  2. Sisken D, Ed. The PDR Pocket Guide to Prescription Drugs. New York: Simon and Schuster Inc., 2008.
  3. Olfson M, Marcus SC.  National patterns in antidepressant medication treatment. Arch Gen Psychiatry, 2009 Aug;66(8):848-56.
  4. Hough D. What Every Chiropractor (and MD) Should Know About the Thyroid. Dynamic Chiropractic, April 7, 2003;21(8).
  5. "Study: Exercise Has Long-Lasting Effects on Depression." www.dukenews.duke.edu/2000/09/exercise922

Dr. Daniel Hough is a 1991 graduate of Western States Chiropractic College. A former member of the Montana Chiropractic Association Ethics Committee, he practices in Bozeman, Mont.


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