Abilify- Stanford Clinic Patients

leokitten

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I would recommend if people are interested to read this new ME hypothesis paper and thread discussion

https://forums.phoenixrising.me/thr...elitis-chronic-fatigue-syndrome-me-cfs.82761/

After doing some background reading, I realized there could be a possible mechanism here for how Abilify might improve symptoms in ME.

The hypothalamus is innervated by, and therefore responsive to and regulated by, dopamine, serotonin, and noradrenergic systems in the brain. It is also responsive to and regulated by many hormones and other signals in the endocrine and other systems.

So if this hypothesis is true and there is a central dysfunction in hypothalamic and pituitary gland function that ricochets throughout the entire endocrine system causing deleterious systemic effects and a vicious reinforcing cycle, then maybe Abilify’s actions at the monoamine systems improve hypothalamus function.

I thought a possible mechanism for why Abilify stops working after a while would be related to this vicious reinforcing cycle described in the paper. Maybe the hypothalamus, even with partial improvement in function, is still getting all these other signals reinforcing dysfunction, and these eventually are stronger than the positive effects Abilify has on the hypothalamus via monoamine systems, so the hypothalamus eventually falls back to its dysfunctional state.
 
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Would be interesting to start an Abilify Poll. To see how many patients benefitted, and how many KEPT the benefits for more than a few months. Right now I have the impression that barely anyone besides Whitney has extended use for Abilify.

There is a poll running in the Facebook group, “Abilfy for ME/CFS”. Also someone recently posted that they have been taking abilify since 2018 and are still benefiting from it. From severe to moderate.
 

Martin aka paused||M.E.

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There is a poll running in the Facebook group, “Abilfy for ME/CFS”. Also someone recently posted that they have been taking abilify since 2018 and are still benefiting from it. From severe to moderate.
I read that statistically 10-15% build tolerances against any medication... can’t find the source
 

leokitten

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Does the article mention what happened to this group after discontinuation ? If that resolved the problem then 14% is not a bad percentage. I think this ratio is a lot higher for antidepressants.

In addition, as someone reminded me of on S4ME, pwME can have significantly higher medication sensitivity than other conditions, so this could be a factor that’s it due to the nature of ME causing discontinuation not necessarily due to Abilify itself.
 

andyguitar

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Does the article mention what happened to this group after discontinuation ?
I could'nt see anything about it.
In addition, as someone reminded me of on S4ME, pwME can have significantly higher medication sensitivity than other conditions, so this could be a factor that’s it due to the nature of ME causing discontinuation not necessarily due to Abilify itself.
Yes that's a good point.
 

Reading_Steiner

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14% that got worse could have been non responders that were on a downward trend anyway so abilify made no difference. Side effects looks horrific but so are SSRI and those are very widely taken... need more information.
 

leokitten

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Inhibitory effects of aripiprazole on interferon‐γ‐induced microglial activation via intracellular Ca2+regulation in vitro. Kato et al. J Neurochem (2008)
The activation of the inflammatory/immunological response system is suggested to be related to the pathophysiology of schizophrenia. Aripiprazole is a novel atypical antipsychotic, which is a high‐affinity dopamine D2 receptor partial agonist. Atypical antipsychotics, all of which have dopamine D2 receptor antagonism, have recently reported to have significantly inhibitory effects on interferon (IFN)‐γ‐induced microglial activation in vitro. In the present study, we investigated whether or not aripiprazole also has anti‐inflammatory effect on IFN‐γ‐induced microglial activation. Not quinpirole, dopamine D2 full agonist, but aripiprazole significantly inhibited the generation of nitric oxide (NO) and tumor necrosis factor (TNF)‐α from IFN‐γ‐activated microglia and suppressed the IFN‐γ‐induced elevation of intracellular Ca2+ concentrations ([Ca2+]i) in murine microglial cells. Increased [Ca2+]ihas been reported to be required, but by itself not sufficient, for the release of NO and certain cytokines. As a result, we can speculate that aripiprazole may inhibit IFN‐γ‐induced microglial activation through the suppression of IFN‐γ‐induced elevation of [Ca2+]i in microglia. Our results demonstrated that not only antipsychotics which have dopamine D2 receptor antagonism but also aripiprazole have anti‐inflammatory effects via the inhibition of microglial activation. Antipsychotics may therefore have a potentially useful therapeutic effect on patients with schizophrenia by reducing the microglial inflammatory reactions.
 

leokitten

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@leokitten but then why the "low dose"? Shouldn't this mean there is no reason to take higher doses as well ?

This is a difficult question to answer with any certainty, as for most drugs, including Abilify, we don’t know many of the mechanisms by which they work. Also, this is a single paper with mouse in vitro results, so it’s important to not draw any larger conclusions other than suggesting that Abilify could possibly inhibit IFNg-induced microglial activation in humans.

If I were to hazard a guess it would be because as you go to higher Abilify doses certain mechanistic effects of the drug become much more prominent or change, and these could be counterproductive in ME/CFS. This includes side effects becoming more prominent.

An important change in mechanism that’s known about Abilify and been discussed here is that at higher doses it becomes more a dopamine antagonist instead of a functionally selective dopamine stabilizer.

Anyway, just my guess but that there’s likely a “sweet spot” wrt ME benefits and minimizing unwanted effects.
 

mitoMAN

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leokitten

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Off label use of Aripiprazole shows promise as a treatment for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): a retrospective study of 101 patients treated with a low dose of Aripiprazole


https://translational-medicine.biom...ftlObPMdE__m0CwqPh7w65BYMsQQl3ZuxP8Jg0RTH4U24

Another interesting finding from this study is that, while pwME who’ve taken Abilify generally report increased insomnia, the study participants reported improvements in the ME unrefreshing sleep symptom.

Do people here who’ve taken or are taking Abilify experience the same thing? Did you sleep less but had better quality sleep and/or woke up feeling less shitty?
 

Martin aka paused||M.E.

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Another interesting finding from this study is that, while pwME who’ve taken Abilify generally report increased insomnia, the study participants reported improvements in the ME unrefreshing sleep symptom.

Do people here who’ve taken or are taking Abilify experience the same thing? Did you sleep less but had better quality sleep and/or woke up feeling less shitty?
I slept poorly but felt better
 
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