Treating Bipolar Disorder

Abilify- 2nd Generation Antipsychotics in a Geriatric Patient in Treating Bipolar Disorder

Abilify (or aripiprazole) is a second generation antipsychotic drug. It is one of the medicines that the Food and Drug Administration (FDA) has approved for treatment of bipolar I disorder (NAMI, 2021). Other conditions that the drug is commonly used to treat include major depressive disorder, schizophrenia, Tourette’s syndrome, and irritability due to autism (Anderson, 2017; NAMI, 2021). Abilify exists in form of both tablets and oral solutions. For patients with bipolar I disorder, this medicine is recommended for those aged ten years and older (Williamson, 2020). Thus the drug can be administered to a geriatric patient with the condition.

Bipolar I disorder is characterized by mixed and manic episodes, depression, and mood swings (Cuomo et al., 2019; Strakowski et al., 2020). Abilify is used to stabilize and treat such symptoms. The drug helps to regulate the balance of serotonin, dopamine, and other neurotransmitters in the affected person’s brain (NAMI, 2021). By doing so, it plays an important role in improving his or her level of concentration, thinking capacity, and behavior. This enables the patient to feel less anxious, think positively about life, and participate actively in various life activities.

Abilify can be prescribed either alone or along with other types of drugs. When used on a geriatric patient with bipolar I disorder, it can be used with mood stabilizer medicines such as valproate and lithium (NAMI, 2021; Cuomo et al., 2019). The recommended initial dose of Abilify is 15 mg administered once in a day. Depending on the severity of the condition and clinical indications, the dose may increase to 30 mg once a day (Cuomo et al., 2019). There is need to continue administering the stabilization dose to the patient for up to a period of six weeks. This can help to ensure that the drug works effectively in the achievement of positive health outcomes.

Just like other antipsychotic medications, Abilify is associated with a number of mild and serious side effects. Some of the mild side effects that can be experienced by a geriatric bipolar I disorder patient include vomiting, nausea, constipation, chills, tremors, sweating, headache, dizziness, memory loss, anxiety, insomnia, restlessness, breathing difficulties, sexual problems, and hair loss (Cunha, 2020; Williamson, 2020). On the other hand, the serious side effects of the drug that the patient is likely to experience include impaired thinking, suicidal feelings, changes in metabolism, troubles in swallowing, extrapyramidal disorder, stroke, neuroleptic malignant syndrome, low blood pressure, decreased number of white blood cells, and allergic reactions (Williamson, 2020; Gettu & Saadabadi, 2021).

There is need to closely monitor the various side effects associated with the use of Abilify. It is important to take baseline measurements of a patient’s blood pressure, body weight, height, waist circumference, lipid panel, fasting plasma glucose concentration, liver function, electrolytes, and changes in libido (Gettu & Saadabadi, 2021). Any of such changes after the administration of the medicine may suggest that the patient is experiencing side effects. Under such circumstances, it is vital to determine whether the dosage given is appropriate. If not, it is necessary to consider reducing it or using other alternatives of the drug.

If a geriatric patient who has bipolar I disorder is experiencing serious complications due to usage of Abilify, there are other alternatives that he or she can use. Some of the alternative antipsychotic drugs that can be taken include olanzapine (Zyprexa), nortriptyline (Pamelor), and duloxetine (Cymbalta) (Ferrara, 2021). Such drugs can work for patients whose intolerance of Abilify is high. Natural alternatives include dietary changes and increased involvement in physical activities (Ridaeus, 2021). The patient should take more of green vegetables and avoid foods containing a lot of sugars. He or she can also engage in lighter exercises, including jogging and walking.

References:

Anderson, J. L. (2017). Abilify, Aripiprazole: Treatments of Bipolar Disorder, Depression, Schizophrenia, and Irritability Associated With Autism. CreateSpace Independent Publishing Platform.

Cunha, J. P. (2020). Abilify. Retrieved from https://www.rxlist.com/abilify-drug.htm#description

Cuomo, A., Crescenzi, B. B., Goracci, A., Bolognesi, S., Giordano, N., Rossi, R., Facchi, E., Neal, S. M., & Fagiolini, A. (2019). Drug safety evaluation of aripiprazole in bipolar disorder. Expert Opinion on Drug Safety, 18 (6): 455-463.

Ferrara, D. (2021). Abilify Alternatives – What Are Your Options? Retrieved from https://druggenius.com/alternatives/abilify/

Gettu, N., & Saadabadi, A. (2021). Aripiprazole. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK547739/

National Alliance on Mental Illness (NAMI). (2021). Aripiprazole (Abilify). Retrieved from https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Aripiprazole-(Abilify)

Ridaeus, D. (2021). Abilify Alternatives. Retrieved from https://www.alternativetomeds.com/blog/abilify-alternatives/

Strakowski, S. M., Fleck, D. E., Adler, C. M., & DelBello, M. P. (2020). Bipolar Disorder. New York : Oxford University Press.

Williamson, J. M. (2020). Abilify (aripiprazole). Retrieved from https://www.medicalnewstoday.com/articles/abilify#_noHeaderPrefixedContent