Abilify caused my ds to shake from head to foot, so we had to stop it.  2 mg. is a very low dose.  If needed Abilify can be rx'd up to 22.5 -30 mg.

The standard treatment for bipolar includes at least one first line mood stabilizer and the use of an atypical antipsychotic if needed.  While antipsychotics like Abilify have mood stabilizing qualities to them, they are not usually enough.  Some hard to treat kiddos require even two mood stabilizers and two atypicals.  Antipsychotics are usually great at treating mania, rage and aggression, and of course any psychotic symptoms that maybe present.

FWIW, Lamictal, one of the first line mood stabilizers, is great at treating depression.  The downside is that Lamictal must be titrated very slowly to avoid the risk of Steven's Johnson Syndrome - a very serious skin rash.  For this reason it can take a long time for it to get to a therapeutic level.

Here is a link to the current expert treatment guidelines.  Many parents have found it helpful to take these along when meeting with their doctor to use a reference point when discussing medicine options.

Hope this helps!

--

Jackie aka mom2one
General & Med board moderator, FRT
Mom to Mr. 17 (dx'd at age 4), Bipolar, Psychotic Disorder, Anxiety Disorder, PDD, Cognitive Disorder
Meds: Seroquel 900 mg., Risperdal 4.5 mg., Saphris 20 mg., Lamictal 600 mg., Lithium 1250 mg., DDAVP, and Synthroid .150 mcg
Fish Oil and Vitamin D
IEP, Therapeutic School
Married to my best friend and rock for 21 years!

If CABF has helped you, please consider a donation! https://www.bpkids.org/donate?campaign=forums2010

We tried Abilify a few years ago.   It did seem to help, although it gave my ds akathesia, which is a feeling of general restlessness.  Vitamin E helped this SE somewhat.  He also seemed to be prone to HA's while on Abilify.   I notice a lot of pdocs are prescribing Abilify as the first med lately.  Keep in mind that there are quite a few atypical AP's available, and some of the older AP's can also work well.  Most often our kids end up needing at least 2 meds, so a MS would be the next med to try on top of the Abilify. 

--

Brenda,50, CABF Parent to Parent Volunteer
Mom to A, 15 1/2, BP, Tourette's, OCD, ADHD: Eskalith CR, Trilafon, Lamictal, Seroquel, Cytomel
E, 14, BP,AS, hypothyroidism: Seroquel, Eskalith CR, levothyroxin, inositol
B, 13 & H, 10
Married 17 years to DH, 49

If CABF has helped you, please help CABF. Donate today. http://www.bpkids.org/donate?campaign=forums2010

FROM CABF: Do not start, stop, or change medications or other treatments for yourself or your child based on what you read on this Website or elsewhere on the Internet. Information presented here should not replace the considered judgement of a doctor who knows you or your child.

My son was on Abilify a year ago. Initially we saw great improvement with his rages and anger. The first week he was on it he was like a different kid. He was completely compliant and reasonable. After a few weeks (and increasing the dose) his mood tapered off and we were pretty much back to where we had been prior to starting the drug.  The downside of Abilify for us was fatigue and his appetite. Although Abilify is supposedly weight neutral, we did not find that to be the case. He was eating all of the time. However, my son was not on a mood stabilizer with the Abilify but on an antidepressant (Celexa). I think the combo was all wrong. We are considering trying Abilify again as the Invega is not working and we having already tried alot of the MS (Lamictal, Tegretol  - he broke out in hives from both), Seroquel and most recently Tenex, which we have just taken him off of because it made his mood decline. Such a difficult and long road to finding stability.

--

7 year old son dx in 2008 with BP and PDD-NOS, taking 6.0 mg Invega and 2 mg Tenex

My daughter has been on abilify for over 2 years. The p-doc just tiratd her up to 30 on Sat. It helps with her mania and rages. So far, it has been very positive for her.

--

Sallie, mom to Cara, age 17 BP1, BPD traits, recovering substance abuser does not live at home;
Abilify,30, Lactimal, 175, Strateera,60

My son James is 11.  His dx are Asperger's and Bi-Polar (Officially it's PDD-NOS and Mood Disorder NOS, however the psych who did the testing told me that because they overlap so much he can't officially call it what it is, but to consider the dx to be Asperger's and Bi-Polar).  He has been on Abilify for about a year now.  Currently his dose is a 2 mg tab 3 times a day.  He also takes Seroquel, 2 25 mg at night before bed.  Tomorrow morning I see his psych (a different one than did his dx) and I will be asking to modify his meds.  It seems that every 3-6 months we are doing that.  He is going through a lot of growth right now, so I think that is definately part of the need to constantly adjust.  He was on Strattera to help with the jitters and fidgeting and all of that, though I stopped that and it hasn't made that much of a difference, so I think we'll keep him off of it.  When his doses are correct, he does wonderfully well.  He is courteous, thoughtful, stable, engaging, enlightening, entertaining.  You can really see the smart funny boy that he is.  When his doses are not right, it is pure H*** on all of us.  This most recent time he has become more out of control than I've ever seen him.  His rages are scary and he is unsafe to have around his younger siblings.  He has takend to throwing things and will attack anyone who is even close to him, whether it is them he is angry with or not.  I feel like we are at a worse place than we were at 2 years ago when we first tried Abilify.  He is still on a rather low dose, and I'm going to be asking to increase and see how it helps.  I'm going to want to go back in 2 weeks, not any longer than that, to see if it's really making a difference or not.  I am also going to make sure to find out about an emergency appointment, if need be, if it makes no difference.  Abilify seems to help him when it's right, but it seems that as he is growing, even a small amount of growth greatly throws off the medication ratio and affects him adversely.  There is an increase in his appetite, but he was always a small guy (needing growth hormone injections he's so small) so that has been a benefit to him.

It seemed like we were constantly adjusting meds when my boys were younger.  I agree it is due to growing and the rapidly changing brain.  Since puberty we have really only done tweaking of meds, instead of the med-go-round of their younger years.

Abilify statistically speaking apparently causes the least wt. gain of the atypicals.  But still, like you experienced, some people gain wt. on it.

--

Brenda,50, CABF Parent to Parent Volunteer
Mom to A, 15 1/2, BP, Tourette's, OCD, ADHD: Eskalith CR, Trilafon, Lamictal, Seroquel, Cytomel
E, 14, BP,AS, hypothyroidism: Seroquel, Eskalith CR, levothyroxin, inositol
B, 13 & H, 10
Married 17 years to DH, 49

If CABF has helped you, please help CABF. Donate today. http://www.bpkids.org/donate?campaign=forums2010

FROM CABF: Do not start, stop, or change medications or other treatments for yourself or your child based on what you read on this Website or elsewhere on the Internet. Information presented here should not replace the considered judgement of a doctor who knows you or your child.

Interestingly, we started titrating DS down from 10 mg to 5, then 2 -- we did this starting about 2 months ago... now he is off, and only on Trileptal and Keppra -- we kept it up, because the rages were starting to go down, and now, there seem to be less rages (excluding the start of school) and his shaky hand is gone.

Does anyone think or see that taking the antipsychotic away actually helps if your child has not been officially, 100% dxed as bipolar, but more likely temporal lobe seizure/ maybe ODD/ADD mix????

--

Heather (40) Cymbalta; Ambien, Propranyl
DS (9) BP, ADD, IED (TBD?) 1800 mg Trileptal; 2 mg Abilify; therapeutic level of Keppra; Clonidine for sleep, trying Home School in the fall; DH (39); DD (7); DS (3); Dog

If the sx are being caused by temporal lobe seizures, then it would make sense that AP's could make it worse, since AP's lower the seizure threshhold.

--

Brenda,50, CABF Parent to Parent Volunteer
Mom to A, 16, BP, Tourette's, OCD, ADHD: Eskalith CR, Trilafon, Lamictal, Seroquel, Cytomel
E, 14, BP,AS, hypothyroidism: Seroquel, Eskalith CR, levothyroxin, inositol
B, 13 & H, 10
Married 17 years to DH, 49

If CABF has helped you, please help CABF. Donate today. http://www.bpkids.org/donate?campaign=forums2010

FROM CABF: Do not start, stop, or change medications or other treatments for yourself or your child based on what you read on this Website or elsewhere on the Internet. Information presented here should not replace the considered judgement of a doctor who knows you or your child.