Can Abilify Be Used For OCD?
You have tried all of the “gold standard” OCD treatments – i.e., OCD therapies (cognitive-behavioral therapy or CBT, acceptance and commitment therapy or ACT, and exposure and response prevention (ERP) therapy) with and without medications. But it did not work. You are starting to question if you are dealing with a form of treatment-resistant OCD.
Because you are still from unrelenting and reoccurring OCD symptoms (obsessions and compulsions), and because these symptoms appear to be escalating with an SSRI and attending regular OCD therapy sessions and support groups, your doctor has decided to add another medication to the mix to get your OCD symptoms under control – Abilify.
Abilify is a “different” or “atypical” medication sometimes used to reduce OCD symptoms, so you have fewer intrusive thoughts, urges, fears, doubts, mental images, etc., that lead to compulsions. Some people, who take Abilify for their obsessions and compulsions report fewer obsessions and compulsions, while other people report little-to-no improvement in their OCD symptoms. Therefore, the reviews have been mixed.
However, you may be one of the lucky ones, who experiences a moderate-to-significant reduction in his or her OCD symptoms. That is why it is important to talk with your doctor about whether or not Ability will work for your type of OCD. But until you can get in to see your doctor, it is important to educate yourself on Abilify (i.e., definition, possible causes, side effects, dosage amounts, etc., especially if you are interested in trying it.
A combination of Abilify and/or other medications, and combined with OCD therapy, lifestyle changes, natural remedies, vitamin and mineral supplements, CBD, OCD forums and support groups, mindfulness meditation, and OCD self-help programs, like Impulse Therapy, can help may help ease your obsessions and compulsions so you can live a happy, OCD-free life of your own making.
So, it is ok to take Abilify for your OCD symptoms? Yes, it is but only under a doctor’s supervision.
What is Abilify?
Abilify is an antipsychotic that contains the active drug, aripiprazole. Aripiprazole is the generic version of Abilify (the brand name version). Abilify is commonly used to treat mood and anxiety conditions, such as depression, bipolar disorder, anxiety, OCD, etc. Abilify is also sometimes used to treat other health conditions, such as schizophrenia, Tourette’s syndrome, or autism spectrum disorder (ASD). This medication works by altering hormones/neurotransmitters or chemical messengers in the brain (i.e., dopamine and serotonin).
It is believed that low levels of dopamine and serotonin (serotonin deficiency) in the brain can trigger or worsen anxiety, depression, and OCD symptoms. Researchers suggest that Abilify or its generic counterpart is both safe and effective for OCD and other health conditions. It is often combined with antidepressants (SSRIs) when used to treat mood disorders, like depression and bipolar disorder. Both children and adults can use Abilify for their symptoms, however, caution should be used when giving the medication to young children.
Are There Other Forms of Abilify?
Yes, there are!
Abilify comes in the following forms:
- Abilify MyCite –This form of Abilify comes as a tablet that contains a sensor to record when you have swallowed your doses.
- Abilify Maintena – This form of Abilify is injected into your muscle by a healthcare professional.
What Does Abilify Treat?
Abilify is used for both “approved” and “off-label” uses.
Abilify is FDA-approved to treat:
- Schizophrenia (adults and children, ages 13+)
- Bipolar I Disorder (for manic and mixed episodes in adults and children, ages 10+)
- Clinical Depression or Major Depressive Disorder (MDD) (combined with SSRIs like Luvox, Zoloft, Prozac, etc., and used in the adult population)
- Autism Spectrum Disorder (ASD) (adults and children, ages 6+)
- Tourette’s Syndrome (adults and children, ages 6 years+)
Abilify is used “off-label” for the following conditions:
- Alcoholism or Alcohol Abuse
- Generalized Anxiety Disorder (GAD)
- Social Phobia
- Obsessive-Compulsive Disorder
- Panic Attacks
- Post-Traumatic Stress Disorder (PTSD)
- Attention-Deficit Hyperactivity Disorder (ADHD)
- Eating Disorders (Anorexia, Bulimia, Bingeing and Purging, etc.)
- Borderline Personality Disorder (BPD)
Does Abilify Come with a Black Box Warning?
Yes, the FDA issued a “Black Box Warning” for Abilify after cases of suicidal thoughts and attempts were reported. People under the age of 24 and older adults with dementia are especially susceptible to suicidal ideation.
So, Abilify is Not FDA-Approved for Anxiety Conditions?
No, it is not.
As prefaced above, Abilify is not approved to treat anxiety conditions, like OCD. But, it is sometimes used “off-label” to treat these conditions.
Studies suggest that Abilify may be a viable alternative treatment option for people, who are struggling with treatment-resistant OCD and anxiety conditions. However, it is important to note that Abilify may worsen anxiety and OCD symptoms – in some people. Thus, this antipsychotic medication may not be right for all people with anxiety or OCD. The exact Abilify dosage is unknown, primarily because there are no FDA regulations associated with it.
A 2014 study confirmed the previous results when it also found that Abilify could help reduce OCD symptoms (obsessions and compulsions), especially when combined with SSRIs. So, your doctor may prescribe a low dose of Abilify coupled with an SSRI to help control your OCD symptoms.
What Forms Does Abilify Come In?
Abilify comes in tablet form, and is available in the following strengths:
Aripiprazole (the generic version) is available in the following forms:
- Dissolvable tablets (to be placed under the tongue)
- Liquid version (to be swallowed)
- Injectable version (to be injected into a muscle)
Is Abilify an Antidepressant?
No, it is not.
As mentioned previously, Abilify is an antipsychotic. More specifically, it is a second-generation antipsychotic or atypical antipsychotic. Second-generation medications are the newer versions of the medications. They are typically safer, more effective, and have fewer side effects associated with them (as compared to first-generation medications). Abilify also is not a mood stabilizer, like lithium.
So, no, Abilify is not an antidepressant. However, when this medication is used to treat mood conditions, like bipolar disorder or major depressive disorder (MDD), it is usually combined with an antidepressant.
How Does Abilify Work?
Truthfully, researchers are unsure exactly how Abilify affects the brain. However, the consensus is that it attaches to dopamine and serotonin receptors in the brain. Dopamine is responsible for regulating your thoughts and emotions. While serotonin is responsible for controlling your moods and behaviors.
Too little serotonin and dopamine in the brain may lead to mental health conditions, like anxiety, depression, OCD (i.e., repetitive thoughts), etc. Abilify “restores” and “balances” these levels, thereby reducing your anxiety, depression, OCD symptoms (obsessions and compulsions), etc. “Balanced” or regulated serotonin and dopamine levels make having rational thoughts more likely.
When Can I Expect to See Results?
Abilify should start to work after taking it for your OCD symptoms. However, the longer you take it, the more noticeable the results (i.e., fewer obsessions and/or compulsions). You should reach the maximum benefits level after you have been taking it for about 14 days. However, it is possible to see a slight improvement in your OCD symptoms (i.e., fatigue, irritability, insomnia, anxiety, stress, etc.) after the first dose.
Can Abilify Worsen My OCD Symptoms?
It is possible.
More specifically, Abilify could cause you to experience violent OCD thoughts.
These urges could include the following.
- To Gamble (The Most Common OCD Urge Associated with Abilify Use)
- To Have Unprotected Sex or Sex with Multiple People
- To Excessively Shop
- To Overeat or Binge Eat
Note: It is important to develop a strong support system consisting of close friends and family members, who can be there for you while you address your OCD symptoms. You may not notice or be aware of your behavior (compulsions), so it may be up to your support group to alert you that your OCD symptoms are “getting out of control” again.
If you start to experience violent or dangerous OCD urges (that were not there before) or if these urges worsen while on the medication, contact your doctor. He or she will likely lower your Abilify dosage or replace the medication with one that has fewer side effects – if possible
What Side Effects Are Associated with Abilify Use For OCD?
Like all mental health medications, Abilify can cause mild-to-serious side effects, such as:
- Gastrointestinal Distress – i.e., Nausea, Vomiting, Diarrhea, Abdominal Pain, Upset Stomach, and/or Constipation
- Memory Loss
- Blurry vision
- An Increased Risk of Upper Respiratory Infections – i.e., a cold
- Sleepiness or Drowsiness
- Insomnia – i.e., Trouble Falling Asleep and/or Staying Asleep)
- Skin Rashes
- Hair Loss
- Sexual Dysfunction – i.e., Low Sex Drive and/or Erectile Dysfunction (ED)
Note: Most of these side effects should disappear a few days or a couple of weeks after starting Abilify. However, if the symptoms persist or worsen, contact your doctor for guidance.
Serious Side Effects (Adults)
- Strokes – i.e., Especially in Older People with Psychosis
- Numbness or Weakness on One Side of the Body
- Mental Confusion
- Mobility Issues – i.e., tremors, tics, or Tardive Dyskinesia (TD)
- An Increased Risk of Neuroleptic Malignant Syndrome
- High Fevers
- An Accelerated Heart Rate
- Rigid Muscles
- Metabolism Changes – i.e., Diabetes or High Cholesterol
- Excessive Thirst or Hunger
- Sudden and Unexplained Weight Gain
- Urges or Impulses to Engage in Unusual Activities
- Binge Eating
- Excessive Gambling
- Compulsive Shopping
- Persistent Sexual Urges or Obsessions
- A Decline in Blood Pressure When Standing and/or Sitting
- Dizziness or Feeling Faint
- A Decline in Neutrophils, a Type of White Blood Cells
- Treatment-Resistant or Recurrent Infections
- Extreme Fatigue or Lethargy
- Temperature Control Issues
- Profuse Sweating
- Facial Flushing or Redness
- Trouble Swallowing – i.e., Pain and/or a Feeling of Having Food Stuck in Your Throat
- Unrelenting Heartburn
- A Heighten Risk of Extrapyramidal Disorder
- Speaking Difficulties
- Severe Anxiety
- An Allergic Reaction
- An Increased Risk of Death (Especially in Older Adults)
- Suicidal Ideation – i.e., Thoughts and/or Attempts (Especially in Young Adults)
Side Effects (Children)
- Sleepiness or Drowsiness
- Nausea and/or Vomiting
- Blurry Vision
- Drooling or Excessive Saliva
- An Increased or Decreased Appetite
- Nasal Congestion (a Stuffy Nose)
- Sudden and/or Unexplained Weight Gain
- Stiff Muscles
What is the Recommended Abilify Dosage for OCD?
The Abilify dosage your doctor prescribes will depend on several factors, such as the type and severity of OCD, your age, your weight, and your current medical state or conditions.
Usually, a doctor will start you on the lowest dosage, if possible. If this dosage is ineffective or if you experience severe side effects, he or she may gradually up or lower the dosage until the right dosage is found for your type of OCD.
For OCD (Adults)
- Your doctor may initially prescribe a 1 or 2mg tablet, per day (lower dosages of Abilify are less likely to cause severe side effects).
- Keep in mind, however, that some antidepressants may trigger a CYP450 drug interaction. This drug interaction could cause you to have too much Ability in your system, which could worsen your OCD symptoms – instead of improving them.
- Gradually increasing your Abilify dosage (i.e., at one- to four-week intervals) can help your body better adjust to the medication.
Note: Some OCD sufferers may experience a mild reduction in obsessions and compulsions when taking 5 to 7.5mg, per day. If a lower dose of Abilify is taken for several weeks with no noticeable results, you may be asked to try a higher dosage (to at least 15mg, per day) before your doctor will decide that is time to gradually taper you off of the medication.
Can Abilify Be Combined with Antidepressants?
Yes, it can.
Your doctor may prescribe Abilify, along with an antidepressant or mood stabilizer to treat a comorbid condition involving OCD and schizophrenia or OCD and depression.
Listed below are antidepressants or mood stabilizers that may be taken with Abilify:
- Lexapro (Escitalopram)
- Zoloft (Sertraline)
- Celexa (Citalopram)
- Prozac (Fluoxetine)
- Wellbutrin (Bupropion)
- Effexor (Venlafaxine)
- Cymbalta (Duloxetine)
- Paxil (Paroxetine)
- Depakote (Divalproex)
- Lamictal (Lamotrigine)
Can Abilify Be Combined with Stimulants?
Yes, it can.
Your doctor may combine Abilify with a stimulant to treat a comorbid condition of OCD and ADHD or narcolepsy.
Listed below are prescription stimulants that may be taken with Abilify:
- Vyvanse (Lisdexamphetamine)
- Adderall (Mixed Amphetamine Salts)
- Ritalin or Metadate (Methylphenidate)
Can Abilify Be Combined with Other Antipsychotics?
What is the Best Way to Discontinue Abilify for My OCD Symptoms?
If you want to stop taking Abilify for your OCD symptoms because it is ineffective and/or causing too many side effects, it is best to consult your doctor in advance. Your doctor will likely suggest that you taper off the medication instead of quitting it “cold turkey.” Tapering off the medication will get your body time to adjust to the removal of it, thereby, reducing your risk of Abilify withdrawal symptoms and/or an OCD relapse. Your doctor may taper you down by 2mg each week until you are completely off the medication. Also, keep in mind that if you are only taking the lowest dose of Abilify (2mg), your doctor may have you stop the medication without tapering off of it.
Will I Have to Take Abilify for My OCD Symptoms Forever?
Yes, there is a good chance that you will end up taking Abilify indefinitely.
Abilify was created to be a long-term treatment for a specific mental health condition, like depression. However, it can also be used “off-label” for other conditions, such as OCD. If Abilify is effective and safe for you to take for your OCD symptoms, you will likely stay on it forever or at least for years or decades.
Is Abilify Effective for OCD?
Yes, it appears that Abilify is effective for most OCD sufferers. However, more research on Abilify for the treatment of OCD is needed before definitively saying that OCD is effective for most OCD sufferers.
According to a Drugs.com user survey, 7 out of 10 OCD sufferers recommend Abilify for OCD (citing that it helped reduce their obsessions and/or compulsions), A eHealth.com user survey found that only 3 out of 5 people found Abilify effective for their OCD overall. However, 4 out of 5 people found Abilify to be effective for OCD long-term. What does that mean? It means there is a good chance Abilify will effectively reduce your OCD symptoms.
Note: Several clinical trials have found that Abilify is effective for depression and bipolar disorder.
What is it Like to Take Abilify for OCD?
Listed below are real-life accounts of what it is like to take Abilify for OCD:
“I took both Wellbutrin and Zoloft for my OCD symptoms and still experienced severe anxiety every day. I was eventually diagnosed with suicidal OCD; however, this was the most terrifying experience I have ever had. Suicidal OCD caused me to be paralyzed with fear – so much that I was put on “suicide watch” intermittingly for 4 weeks.
I was eventually able to meet with a psychiatrist, who put me on a low dose of Abilify (2mg). It did not take long for me to experience it. In fact, within a few days, I experienced a mind-blowing reduction in my suicidal thoughts, urges, and behaviors. Abilify saved my life. I have been able to stay on the same dosage (2mg) for 6 months now, and everything is still stable – without any side effects. This medication has changed my life.”
“My psychotherapist recommended it for OCD, but it caused me to develop tardive dyskinesia (TD), a side effect of Abilify. I could not sit still even though I was tired. This medication also made me wander aimlessly, while I was on it. I also could not sleep while on it, so my doctor had to prescribe pregabalin and alprazolam to help me get some rest at night. I stopped taking Abilify, and thank God, the TD stopped. Once I stopped the medication I was finally able to get some sleep.”
“My doctor prescribed me 5mg of Abilify, per day. It helped somewhat with my intrusive thoughts, however, it also ramped up my anxiety, causing me to smoke to ease my nerves. Overall, Abilify just did not work well for me. My doctor is getting ready to help me get off of Amplify so I can try another antipsychotic.”
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- Veale, D., Miles, S., Smallcombe, N., Ghezai, H., Goldacre, B., & Hodsoll, J. (2014). Atypical antipsychotic augmentation in SSRI treatment refractory obsessive-compulsive disorder: a systematic review and meta-analysis. BMC Psychiatry, 14, 317. Retrieved from https://doi.org/10.1186/s12888-014-0317-5
- Connor, K. M., Payne, V. M., Gadde, K. M., Zhang, W., & Davidson, J. R. (2005). The use of aripiprazole in obsessive-compulsive disorder: preliminary observations in 8 patients. The Journal of Clinical Psychiatry, 66(1), 49–51. Retrieved from https://doi.org/10.4088/jcp.v66n0107
- Sayyah, M., Sayyah, M., Boostani, H., Ghaffari, S. M., & Hoseini, A. (2012). Effects of aripiprazole augmentation in treatment-resistant obsessive-compulsive disorder (a double-blind clinical trial). Depression and Anxiety, 29(10), 850–854. Retrieved from https://doi.org/10.1002/da.21996
- Denys, D., Zohar, J., & Westenberg, H. G. (2004). The role of dopamine in obsessive-compulsive disorder: preclinical and clinical evidence. The Journal of Clinical Psychiatry, 65(14), 11–17. Retrieved from https://pubmed.ncbi.nlm.nih.gov/15554783/
- Baumgarten, H. G., & Grozdanovic, Z. (1998). Role of serotonin in obsessive-compulsive disorder. The British Journal of Psychiatry, 35, 13–20. Retrieved from https://pubmed.ncbi.nlm.nih.gov/9829022/
- Zocchi, A., Fabbri, D., & Heidbreder, C. A. (2005). Aripiprazole increases dopamine but not noradrenaline and serotonin levels in the mouse prefrontal cortex. Neuroscience Letters, 387(3), 157–161. Retrieved from https://doi.org/10.1016/j.neulet.2005.06.035
- National Institute of Neurological Disorders and Stroke. (n.d.). Tardive dyskinesia. Retrieved from https://www.ninds.nih.gov/health-information/disorders/tardive-dyskinesia
- National Institute of Neurological Disorders and Stroke. (n.d.). Neuroleptic malignant syndrome. Retrieved from https://www.ninds.nih.gov/health-information/disorders/neuroleptic-malignant-syndrome
- D’Souza, R. S., & Hooten, W. M. (2022). Extrapyramidal symptoms. National Library of Medicine. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK534115/
- Drugs.com. (n.d.). User reviews for aripiprazole to treat obsessive-compulsive disorder. Retrieved from https://www.drugs.com/comments/aripiprazole/for-obsessive-compulsive-disorder.html
- eHealth.com. (n.d.). How effective is Abilify for obsessive-compulsive disorder? Retrieved from https://www.ehealthme.com/cd/obsessive-compulsive-disorder/abilify/
- ClinicalTrials.gov. (2010). Abilify in bipolar disorder for 6 weeks treatment effectiveness (SMART-A). Retrieved from https://clinicaltrials.gov/ct2/show/NCT00545142
- ClinicalTrials.gov. (2015). Abilify as an adjunctive treatment for refractory depression. Retrieved from https://clinicaltrials.gov/ct2/show/results/NCT00220636
- Watson, A. (2021). All about Abilify. Healthline. Retrieved from https://www.healthline.com/health/drugs/abilify#_noHeaderPrefixedContent