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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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I would like to know if ability can cause the

Answered by
Dr.
Dr. Ashok Kumar

Psychiatrist

Practicing since :2000

Answered : 3120 Questions

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Posted on Wed, 20 Mar 2019 in Mental Health
Question: I would like to know if ability can cause the issues listed below. My mother is currently on a dosage of 1.25mg/day, previously the dosage was 5mg/day and then 2.5mg/day. We have been weaning down to see if the issues below goes away but they have not. She denies these issues exits but anyone who sees her in person can see and hear they exist.

Issues:
-Ticking noise from throat, doesn't happen when sleeping but happens through out the day. She will stop it if confronted about it but then resumes again right afterwards.
-Constant repetitive movement in one leg, whether standing or sitting, But not when sleeping.

She experienced an issue with her hand being held in a stiff position unconsciously when she was on 5mg/day, but that is not an issue now.

She is 62 years old and weighs 77lbs.

Her current doctor says the throat noise is a tick and doesnt recommend any treatment or investigation. The leg movement he was unable to see or advise on yet.
doctor
Answered by Dr. Ashok Kumar 4 hours later
Brief Answer:
Most likely no

Detailed Answer:
Hello,
Thanks for using Ask A Doctor service.

I read your query and understand your concerns.

From the available description it appears that your mother is dealing with dyskinetic movements as all the three description can occur in individuals with dyskinesia. Having said this it is also true that Abilify belongs to class of medications which cause dyskinesia sooner or later.
However among the available options on the current date there is little association between dyskinesia and Abilify as the abilify is considered one of the safest option to prevent dyskinesia.

I mean to say that theoretically abilify can cause all these problems however the available literature and experience of scientific community is very much limited in this regard.

Considering the fact that the problem is dyskinesia I feel you need to discuss option of tetrabenazine with vitamin E with her doctor. These two medications are highly useful in treatment of dyskinesia.

I hope this helps you.
Feel free to write back to me if you have more questions.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ashok Kumar 23 hours later
Thank you for the reply, so given her low weight and current condition, would you recommend staying on the current dose (1.25mg/daily) of abilify or to increase to the 5mg as prescribed by her general doctor?
doctor
Answered by Dr. Ashok Kumar 12 hours later
Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for follow up.

I do not think 1.25 mg have any therapeutic value for adult patients. The minimum effective dose of abilify is 5 mg per day and the maximum dose can be 30 mg per day. Considering this fact I feel the dose should be given as per the recommendation of her doctor.

I hope this answers you.
Feel free to write back to me if you have more questions.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ashok Kumar 2 hours later
Thanks for your advice, i have few questions; is it ok to increase dosage to the 5mg/daily right away or does it need to be done gradually? does her small size and low weight have any barring on how strong the drug's effects will be on her? Also, she is VERY hesitant to go see a doctor, even if i try to force her. She continues to say she's normal and fine, when i asked her about the leg movement today she stopped it for 30-40 seconds and said "im fine see i can stand still no problem" and then immediately disengaged from the conversation. Do you have any advice on how i can guide her better? Anything i can do from home?

doctor
Answered by Dr. Ashok Kumar 10 hours later
Brief Answer:
Follow up

Detailed Answer:
Dear XXXXXXX
Thanks for follow up.

Considering the fact that she is just 77 lb (which is equal to 10 year kid) I think 2.5 mg can be used for time being. In case this remains ineffective or partially effective the dose can be increased to 5mg after an interval of two weeks or more.

I do not think you need to do it at home as Abilify is one of antispsychotic medication and have number of side effects if not used in proper guidance of a doctor. There is also need for blood investigations before starting medication and at the interval of 3-6 months in most patients.

Sometime when the patient is hesitant to see a doctor, she can be asked to accompany you saying that you need to visit a doctor for one or another reason. There is no point in forcing as it becomes more difficult for the patient.

I hope this helps you further.
Thanks again.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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