Schizophrenia Medications: Managing Abilify and Its Side Effects

Schizophrenia Medication Consultation

I have been taking Abilify since middle school.
At that time, peer verbal and physical bullying led to insomnia, hallucinations, and disorganized thinking.
Initially, I was prescribed 15 mg, taking half a tablet of 7.5 mg, and later it was increased to 30 mg.
Taking 30 mg has been very painful for me; I experienced severe drooling, my speech would become rapid, and I had to constantly swallow saliva, especially while sleeping.
For some reason, my appetite was also very strong; the more I ate, the more I wanted to eat, and I couldn't stop until I felt unwell, only then would I refrain from eating.
I have always experienced drooling while on Abilify, so although I increased to 30 mg twice, I consulted my doctor to reduce the dosage both times due to the unbearable drooling and appetite issues.
Currently, I take 15 mg, which is 1.5 tablets, totaling 22.5 mg.
The side effects still make me uncomfortable; even when I reduced to one 15 mg tablet, I became very depressed, and the disorganized thinking issues resurfaced, so I am hesitant to reduce my dosage further.
I would like to ask: 1) Is it true that schizophrenia will not improve on its own one day, and I will never be able to stop taking medication? 2) For patients with schizophrenia, what dosage of Abilify can effectively manage symptoms without causing uncomfortable side effects? 3) Since I currently have no symptoms of schizophrenia, is taking medication for preventive purposes? If it only manages symptoms and cannot cure the condition, what is the significance of preventive medication? 4) Is there really no room for me to reduce my medication? 5) What exactly is non-specific schizophrenia?

Nìmíng zhě, 20~29 year old female. Ask Date: 2019/11/10

Dr. Huang Xiaoxian reply Psychiatry

DEAR Yuki, thank you for your questions.
Here are the responses to your inquiries:
1) Will schizophrenia ever get better on its own, allowing one to stop taking medication? Generally speaking, schizophrenia is a chronic illness, and the vast majority of patients need to maintain stable medication to prevent deterioration.
However, many individuals can remain stable on a low dose of medication without experiencing significant symptoms.
2) For patients with schizophrenia, can Abilify effectively manage symptoms, and what dosage is appropriate to minimize discomfort from side effects? I'm not sure about your weight, but typically, a dosage of 10-20 mg may be more suitable.
3) Since I currently have no symptoms of schizophrenia, is taking medication for preventive purposes? Given that it manages symptoms but does not cure the condition, is there a point to preventive medication? In the absence of symptoms, taking medication is more about preventing symptom exacerbation.
You might consider discussing with your doctor about possibly lowering the dosage based on your situation.
4) Is there really no room for reducing my medication? If symptoms are stable, there is generally room for adjustment.
5) What exactly is non-specific schizophrenia? It generally refers to schizophrenia patients who do not exhibit obvious delusions, hallucinations, or catatonic symptoms.
It sounds like you are relatively stable at the moment, and it may be worthwhile to discuss with your doctor about adjusting your medication to achieve a dosage that minimizes side effects while still providing preventive benefits.
Best wishes!

Reply Date: 2019/11/10

More Info

Understanding schizophrenia and its treatment can be complex, especially when it comes to medications like Abilify (aripiprazole). Your experience with this medication highlights some common concerns and side effects that many patients face. Let's address your questions one by one.

1. Will schizophrenia ever get better on its own?
Schizophrenia is a chronic mental health condition that typically requires ongoing treatment. While some individuals may experience periods of remission where symptoms lessen or disappear, the underlying condition often remains. This means that, for many, medication is necessary to manage symptoms effectively and prevent relapses. It's essential to work closely with your healthcare provider to monitor your condition and adjust treatment as needed.

2. What is the optimal dose of Abilify to manage symptoms without severe side effects?
The effective dose of Abilify can vary significantly from person to person. While some may find relief at lower doses, others may require higher doses to manage their symptoms effectively. The typical range for treating schizophrenia is between 10 mg to 30 mg per day, but the goal is to find the lowest effective dose that minimizes side effects. Since you have experienced significant side effects at higher doses, it is crucial to communicate these issues with your doctor. They may consider adjusting your dose or exploring alternative medications that might be better tolerated.

3. Is taking medication when symptoms are absent still meaningful?
Yes, taking medication even when you feel well can be essential for preventing relapse. This is often referred to as "maintenance therapy." The goal is to keep the symptoms at bay and reduce the risk of a return of psychotic symptoms. While it may feel frustrating to take medication when you don't have symptoms, it can help maintain stability and prevent future episodes. Your healthcare provider can help you weigh the risks and benefits of continuing medication versus the potential for relapse.

4. Is there room for reducing my medication?
Reducing medication is a decision that should be made collaboratively with your healthcare provider. If you are stable and symptom-free, your doctor may consider a gradual reduction in your medication. However, this process should be approached cautiously, as abrupt changes can lead to a return of symptoms. Regular follow-ups and open communication about your feelings and experiences with the medication are vital in this process.

5. What does non-specific schizophrenia mean?
Non-specific schizophrenia is not a widely recognized term in clinical practice. It may refer to cases where the symptoms do not fit neatly into the typical categories of schizophrenia, such as paranoid or disorganized types. This can include a mix of symptoms or atypical presentations. It's essential to discuss any concerns about your diagnosis with your healthcare provider, as they can provide clarity and ensure that your treatment plan is appropriate for your specific situation.

In summary, managing schizophrenia with medications like Abilify involves a careful balance of efficacy and tolerability. Regular communication with your healthcare provider is crucial to finding the right treatment plan for you. Remember, mental health is a journey, and it's okay to seek support and ask questions along the way. Your well-being is the priority, and adjustments can be made to help you feel more comfortable while managing your condition effectively.

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