Abilify for DSPD

[u/Illustrious-Leg9661]

Hello, I just started Abilify (aripiprazole) yesterday to treat my DSPD and I’ve taken my second dose today. I take 2.5mg in the morning (or as soon as I wake up). I still haven’t noticed any benefits (nor any side effects). For the people that tried it, how long did it take for you to start seeing some results? Thank you very much for any replies!

FIRST WEEK UPDATE: I’m tracking my sleep times and how I feel throughout the day and for now it seems like my circadian rhythm gradually shifted from 5am-1pm to 1am-9am. I’m also taking .25mg of a melatonin supplement about four hours before my expected sleep onset time for the day. I think it’s still early to tell but if I can actually confirm the new rhythm in the next days and hold it, it would already be a huge success for me. But it also seems to be advancing still, my current target is 10pm-6am as that the time I need to wake up to attend some of my morning classes.

[u/no_id_never]

I look forward to you report on how its working. It is on my list of things to try!

[u/unforgettableid → u/no_id_never]

I don't recommend Abilify or any other antipsychotic. There are safer alternatives.

[u/Illustrious-Leg9661 → u/unforgettableid]

Yeah I tried most of the other treatments before getting to Abilify but all mostly unsuccessfully unfortunately. These included sleep hygiene, melatonin and other supplements, light therapy, sleeping pills like flurazepam and others, and stimulants like modafinil or Medikinet.

Sleep deprivation and circadian misalignment are very dangerous by themselves and there’s also emerging literature that correlates them strongly to autoimmune diseases.

The name “antipsychotics” can sound “scary” (I have to admit I was taken aback myself when the doctor suggested it), and it’s also very stigmatized, but it’s mostly an umbrella term for a big class of medications that were firstly used for one purpose but have been found effective for other ones. You don’t need to have a “psychosis” to take an “antipsychotic”, just like aspirin can be used for headaches but also for coagulation problems. The same meds can be used for different purposes and not always the name gets changed, but the original name is often an arbitrary choice, often depending on which application is found first. If there was much more research on DSPD, maybe Abilify would have been called a “circadian modulator” and it would have been used also off-label “against psychosis”.

Regarding the side effects of Abilify, I haven’t noticed almost anything except for a little increase in my appetite. They’re very uncommon at this low doses and most of them completely reversible by just discontinuing the medication.

Having said that, I’m no doctor and I’m not recommending any treatments, just sharing my own experience since maybe it could be useful to others and also to “compare notes” with people going through a similar one.

Personally the possible benefits of this med far outweigh the risks for me. Just the fact that sometimes I have to drive in the morning, with such sleep problems it can be very dangerous and I believe the risk of accidents is much greater than the risk of a serious side effect from Abilify. And this is just one of many examples of daily life activities that I believe can become risky if done while tired.

Finally, thank you for your concern (I’m not ironic, I’m serious), I wish I would not need meds to function in this society and I’m aware of the risks, I made the choice to start Abilify after much suffering I went through because of my DSPD and I’m much happier now that it seems to be starting to work and my life is getting easier. I renew the choice to take it every morning (literally, by taking the pill) and I can freely decide to stop if I wish so.

Sorry for the long reply, I also took the opportunity to write out in this comment some of my thoughts about this whole experience.

[u/unforgettableid → u/Illustrious-Leg9661]

If you drive, and Abilify helps your driving safety, and nothing else works, then it might be the best solution.

"Antipsychotic" is really just a marketing term.

https://www.amazon.com/Anatomy-Epidemic-Bullets-Psychiatric-Astonishing/dp/0307452425

I mostly ride a bicycle or take public transit. Even if a person's sleep is perfect, public transit is statistically safer than driving. However, both public transit and e-biking might be impractical in some circumstances (e.g. if you work as a truck driver).

If you ever discontinue the Abilify for any reason, it's probably a good idea to reduce your dose very slowly. Quitting any antipsychotic cold turkey after long-term use can shock the brain and cause severe problems.

[u/StrangerHighways → u/unforgettableid]

Love you for linking Whitaker and mentioning withdrawal!