Abilify: way oversold

You probably have seen a TV ad recently for Abilify. I do all the time. It’s terrible.

Each time I’m amazed at the audacity of its makers, Bristol-myers Squibb.  They’re making a killing off those ads; they sold 30% more in 2009 than in 08 of the stuff.

But what don’t they tell you?

The ads position Abilify as an option if your antidepressant doesn’t provide complete symptom relief.

(That includes pretty much everyone. Antidepressants flat out don’t work in at least 33% of people, and completely eliminate symptoms in almost no one.)

But the ads don’t mention that Abilify is a very powerful drug mainly used for schizophrenia and mania.

That it has hardly any scientific backing for its ability to treat depression. And that there are many, many other options that should be considered first when depression doesn’t fully respond to an antidepressant.

Abilify is an antipsychotic

Abilify is primarily used for schizophrenia and mania, not depression. Like most antipsychotics, it has serious side effects. Use for just 1 year can potentially cause irreversible movements like facial tics or leg twitching. It can potentially cause diabetes. And an astonishing 25% of people who use it experience akathisia, an intense feeling of being unsettled.

People who have akathisia can experience severe anxiety that prevents them from working, sleeping and daily activities. Again, there’s a 25% chance of getting some form of it from Abilify.

Other common side effects from Abilify include headaches, insomnia, and vomiting. Weight gain is pretty common too.

This is in a medication being sold to people who’re somewhat depressed.

Abilify hasn’t been tested nearly as much as it should

Based off the heavy advertising, you’d think it was scientifically established that Abilify works.  Hardly.

Two major studies commonly cited for showing its efficacy showed about 25% improvement as opposed to 15% placebo. That’s only 10% difference. So if you are taking this medication, you’re just as likely to feel better as you are to feel extreme anxiety and being unsettled. That isn’t even the worst part.

The worst part is that 25% efficacy rate was from studies that were manipulated to make the drug seem better!

To achieve this, the study makers tested for depression in several different ways. They then analyzed the results and threw out the ones that showed their drug didn’t work. If you’re curious, the ones that didn’t show they worked were the ones where people reported how they felt in self-reports.

So you could be saying “I feel horrible,” and they’d count you as a success story if some other measurement showed some improvement.

That’s not all. Even taking the 25% efficacy rate as legit, it’s almost meaningless. The measurement of mood took place on a 60 point scale, and Abilify had only a 3 point difference. Hardly impressive.

So you get a pretty small chance of getting slightly better on this drug.  Is it worth the side effects?

Other treatments are better

Other treatments for treatment resistant depression work better with less side effects. If you’re really that depressed that you are considering heavy medication (as if SSRIs weren’t that strong), you’d probably be better off considering lithium or other options first.  See this article for a discussion of those methods.

Sources:

Aripiprazole in Refractory Depression?