“An advertising budget of $2.4 billion per year spent on Abilify and Seroquel has catapulted these two very so-so and not-so-safe drugs to fifth and sixth place as revenue producers among all of the many medicines sold in America.”
–Dr. Allen Frances, Saving Normal1
Ferid had always been a calm, thoughtful young man. After his second hospitalization, he’d realized he needed help. Instead of circling back to denial or turning inward, he’d decided to take the medication prescribed and expressed a desire to actively participate in the recovery process before even leaving the hospital in April 2013. At that point, he was not exhibiting delusions. His last episode had made a few things clear, and had even brought us closer together.
I can still hear him asking us to find him a private institution. He believed there would be more personalized, higher quality services if we were paying for them. “I have money,” he told us. He’d managed to put savings aside even on his meager disability income—since that is what his illness was considered, a “disability.” I can picture him after he was released from the hospital, his peaceful expression, shining with hope for the future.
Yet his episode on April 14, 2013 had struck without warning: pain and a burning sensation throughout his entire body, a feeling of emptiness, suicidal thoughts. What could have triggered the break? At the time I never even considered that he was likely suffering from side effects of his new medication.
On Wikipedia I learn that aripiprazole, marketed under the brand name Abilify, is the sixth atypical antipsychotic to be introduced. It is used to treat schizophrenia, acute mania and mixed bipolar episodes. At first glance, the list of side effects beats all records! In December 2011, Heath Canada approved its use for children 15 and over in the treatment of schizophrenia. And the Société Québécoise de la Schizophrénie rejoiced at the news!
Side effects are possible with any medication, drug, alcohol or chemical substance. When a psychiatrist or general practitioner prescribes a drug, they must inform the patient of all the risks, even minor ones. Let us not forget: it is our right.
When it comes to Abilify, the first of the “precautions” is monitoring hematological parameters to survey changes in blood sugar and cholesterol levels to prevent type 2 diabetes. It can also cause tardive dyskinesia, which involves abnormal, involuntary movement of the tongue, jaw, torso or extremities; this side effect gives rise to other debilitating consequences like social exclusion, isolation and diminished self-esteem and self-worth of the patient. Numerous cases of neuroleptic malignant syndrome, characterized by intense muscular rigidity and fever, have also been reported. Abilify may cause other side effects related to the nervous system including agitation, anxiety, insomnia, dizziness, akathisia (restlessness), extrapyramidal syndrome (types of involuntary movement with neurological basis), trembling, an increase in saliva production, confusion and gait disturbance, difficulty concentrating, dystonia, motor impairment and vasodilatation. In terms of psychiatric side effects, the drug can cause depression as well as manic, schizophrenic or paranoid reactions, hallucinations, hostility, suicidal thoughts, delusions and strange dreams.
In short, Abilify causes side effects worse than those associated with my son’s disorder, for which the drug was prescribed! Important note: alongside Zyprexa, Risperdal, Paxil, Trileptal, Seroquel and many other neuroleptics, Abilify is on the long list of drugs that have been subject to lawsuits; it’s creator, Bristol-Myers Squibb, was fined US$515 million for off-label promotion in 20072 and agreed to pay a $19.5 million settlement in December 2016.3
Ferid had been taking Abilify for a month. He felt depressed and suffered from physical burning sensations and thoughts of suicide. He’d explicitly told the psychiatrist this when he was seen at Emergency on April 14, 2013. All she had been concerned with finding out was whether he was taking his medication, without even considering that the drug itself might be the culprit. She simply evaluated whether he was dangerous to himself or others, based on whether he had a plan to kill himself, but didn’t assess any other risk factors. She imposed her decision on Ferid, who didn’t contest it out of respect for her authority. Few of us feel comfortable contesting medical authority. In the end, my son just gave up.