If you're living with the condition, there are a variety of treatment options.
Erin Crown, PA-C, CAQ-Psychiatry is a paid consultant of ®2024 Otsuka America Pharmaceutical, Inc. and Lundbeck, manufacturers of
ABILIFY ASIMTUFII (aripiprazole) and
ABILIFY MAINTENA (aripiprazole). Please see IMPORTANT SAFETY INFORMATION, including BOXED WARNING for INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS, for
ABILIFY ASIMTUFII and ABILIFY MAINTENA below.
For the 4.8 million Americans living with bipolar I disorder, developing a long-term treatment plan is essential. Long-term treatment, or what's often called "maintenance," is how people diagnosed with the condition can help reduce the chance of the highs and lows of the mood disorder.
Many people with bipolar I, one of the most common and often severe forms of the illness, will have issues with their long-term treatment plans. This can be for any number of reasons -- they can't afford their medication, they don't like the side effects from medication, or they don't have adequate support from a healthcare provider, as just a few common examples.
Erin Crown, a certified physician assistant, is passionate about helping people with mental health disorders to find a treatment plan that works for them long-term, including those with bipolar I disorder. "When working with patients, one of my primary goals is to identify and remove barriers to them adhering to their prescribed treatment plan," she says. That means addressing issues from multiple angles, in partnership with the patient's healthcare provider. If you or a loved one are struggling to manage your bipolar I disorder, here are her top tips for finding an effective treatment plan.
Having a healthcare team that understands your diagnosis and makes you feel supported is key. With the shortage of providers in the U.S., she knows it can be difficult to find someone, but patients with bipolar I really need to have a healthcare team that is familiar with and comfortable treating the disorder.
Crown suggests widening your provider search to include advanced practice providers, such as physician assistants and nurse practitioners. These professionals, who work under a supervising physician, can perform many of the same functions as physicians -- including diagnosing conditions, creating treatment plans, and prescribing medication -- and may have more availability to get appointments with psychologists and psychiatrists.
Additionally, having a primary care provider who understands and supports your bipolar I disorder diagnosis may help you with your treatment plan and your long-term health.
If you're living with bipolar I, your treatment plan may include some form of therapy in addition to psychoeducation and medication. There are options here, too. Cognitive behavioral therapy, which involves talking to a therapist about ways to manage negative thoughts, is commonly recommended, but other types of therapy exist too. Dialectical behavior therapy can help you learn mindfulness and acceptance skills to better cope with negative emotions.
Group therapy and support groups also can be helpful. The newly diagnosed can get insight and advice from people who have been in their shoes, and those who have more experience living with bipolar I benefit from sharing their experiences and helping others.
Living with bipolar I disorder can be challenging. Talk with your healthcare provider to discuss treatment options available. Your healthcare provider will ask you questions, ask about your treatment goals, and discuss the treatment options available to you such as oral medications or long-acting injectables, or LAIs. LAIs work by administering a dose of a medication that slowly releases medication into the blood over a longer period of time.
Sometimes people who have bipolar I disorder may believe they can stray from their treatment plan because they think they don't need it any longer and don't know the consequences of stopping. Periods of "remission" without symptoms can last for several weeks or months. So even if you haven't had an episode in a long time, it's important to maintain your treatment plan. This may reduce the chance for a mood episode and may reduce the emotional highs and lows to a minimum when you do have a recurrence. Never stop treatment without talking to your provider first.
Treatment plans are not set in stone, and sometimes it takes a few tries to settle on something that works for a patient. You must communicate with your provider for this to take place. "Often we find that patients might not be aware that there are multiple treatment options that can help with their symptoms," Crown says. "Talking through preferences and experiences is a big part of determining the correct treatment option for a patient."
If any element of your plan is not working for you, talk to your provider about it. They will work with you to find a medication and dosage that you're comfortable with. If you don't feel like you are being heard, it may be beneficial to find another provider who will.
ABILIFY ASIMTUFII is an extended-release injectable suspension for the maintenance monotherapy treatment of bipolar I disorder in adults. Administered by a healthcare professional to appropriate patients, a dose is given every two months via intramuscular injection in the gluteal muscle. The efficacy and safety of
ABILIFY ASIMTUFII is based on the pivotal studies of
ABILIFY MAINTENA (aripiprazole), a once-monthly medication indicated for maintenance monotherapy treatment for bipolar I disorder in adults. Work with your healthcare provider to make sure you can tolerate aripiprazole prior to starting treatment. Please see complete IMPORTANT SAFETY INFORMATION, including BOXED WARNING for INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS, below.
ABILIFY ASIMTUFII is a prescription medicine given by injection by a healthcare professional:
ABILIFY MAINTENA is a prescription medicine given by injection by a healthcare professional:
It is not known if ABILIFY ASIMTUFII or
ABILIFY MAINTENA is safe and effective in children under 18 years of age.
IMPORTANT SAFETY INFORMATION:
Increased risk of death in elderly people with dementia-related psychosis.
ABILIFY ASIMTUFII and ABILIFY MAINTENA increase the risk of death in elderly people who have lost touch with reality (psychosis) due to confusion and memory loss (dementia).
ABILIFY ASIMTUFII and ABILIFY MAINTENA are not for the treatment of people with dementia-related psychosis.
Do not receive ABILIFY ASIMTUFII or
ABILIFY MAINTENA if you are allergic to aripiprazole or any of the ingredients in
ABILIFY ASIMTUFII or ABILIFY MAINTENA.
ABILIFY ASIMTUFII or ABILIFY MAINTENA may cause serious side effects, including:
● Increased risk of stroke and ministroke has been reported in clinical studies with oral aripiprazole of elderly people with dementia-related psychosis and can lead to death.
● Neuroleptic malignant syndrome (NMS), a serious condition that can lead to death. Call your healthcare provider or go to the nearest emergency room right away if you have some or all of the following signs and symptoms of NMS: high fever, confusion, changes in pulse, heart rate, and blood pressure, stiff muscles, and increased sweating.
● Uncontrolled body movements (tardive dyskinesia).
ABILIFY ASIMTUFII and ABILIFY MAINTENA may cause movements that you cannot control in your face, tongue, or other body parts. Tardive dyskinesia may not go away, even if you stop receiving
ABILIFY ASIMTUFII or ABILIFY MAINTENA. Tardive dyskinesia may also start after you stop receiving
ABILIFY ASIMTUFII or ABILIFY MAINTENA.
● Problems with your metabolism such as:
o High blood sugar (hyperglycemia) and diabetes: Increases in blood sugar can happen in some people who are treated with
ABILIFY ASIMTUFII or ABILIFY MAINTENA. Extremely high blood sugar can lead to coma or death. If you have diabetes or risk factors for diabetes such as being overweight or a family history of diabetes, your healthcare provider should check your blood sugar before you start treatment with
ABILIFY ASIMTUFII or ABILIFY MAINTENA, and during treatment.
Call your healthcare provider if you have any of these symptoms of high blood sugar during treatment with
ABILIFY ASIMTUFII or ABILIFY MAINTENA:
o Increased fat levels (cholesterol and triglycerides) in your blood.
o Weight gain. You and your healthcare provider should check your weight regularly during treatment.
● Unusual and uncontrollable (compulsive) urges. Some people receiving
ABILIFY ASIMTUFII or ABILIFY MAINTENA have had unusual strong urges, to gamble and gambling that cannot be controlled (compulsive gambling). Other compulsive urges include sexual urges, shopping, and eating or binge eating. If you or your family members notice that you are having unusual urges or behaviors, talk to your healthcare provider.
● Decreased blood pressure (orthostatic hypotension). You may feel lightheaded or faint when you rise too quickly from a sitting or lying position.
● Falls. ABILIFY ASIMTUFII and ABILIFY MAINTENA may make you sleepy or dizzy, may cause a decrease in your blood pressure when changing position (orthostatic hypotension), and can slow your thinking and motor skills which may lead to falls that can cause fractures or other injuries.
● Low white blood cell count. Your healthcare provider may do blood tests during the first few months of treatment.
● Seizures (convulsions)
● Sleepiness, drowsiness, feeling tired, difficulty thinking and doing normal activities. Do not drive a car, operate machinery, or do other dangerous activities until you know how
ABILIFY ASIMTUFII or ABILIFY MAINTENA affects you.
ABILIFY ASIMTUFII or ABILIFY MAINTENA may make you feel drowsy and affect your judgement, thinking, or motor skills.
● Problems controlling your body temperature so that you feel too warm. Do not become too hot or dehydrated during treatment with
ABILIFY ASIMTUFII or ABILIFY MAINTENA. Do not exercise too much. In hot weather, stay inside in a cool place if possible. Stay out of the sun. Do not wear too much clothing or heavy clothing. Drink plenty of water.
● Difficulty swallowing that can cause food or liquid to get into your lungs.
Do not drink alcohol during treatment with
ABILIFY ASIMTUFII or ABILIFY MAINTENA.
Before receiving
ABILIFY ASIMTUFII or ABILIFY MAINTENA, tell your healthcare provider about all your medical conditions, including if you:
Tell your healthcare provider about all the medicines you take, including prescription medicine and over-the-counter medicines, vitamins, and herbal supplements.
ABILIFY ASIMTUFII or ABILIFY MAINTENA and other medicines may affect each other causing possible serious side effects. Do not start or stop any medicines during treatment with
ABILIFY ASIMTUFII or ABILIFY MAINTENA without talking to your healthcare provider first.
The most common side effects of
ABILIFY ASIMTUFII or ABILIFY MAINTENA include: weight gain, restlessness or feeling like you need to move (akathisia), injection site pain, or sleepiness (sedation).
It is important to contact your healthcare provider if you experience prolonged, abnormal muscle spasms or contractions, which may be signs of a condition called dystonia.
These are not all the possible side effects of
ABILIFY ASIMTUFII or ABILIFY MAINTENA.
If you have any questions about your health or medicines, talk to your healthcare provider.
You are encouraged to report side effects of
ABILIFY ASIMTUFII and ABILIFY MAINTENA.
Please contact Otsuka America Pharmaceutical, Inc. at 1-800-438-9927 or FDA at 1-800-FDA-1088 (www.fda.gov/medwatch).
Please see FULL PRESCRIBING INFORMATION, including BOXED WARNING, and MEDICATION GUIDE for
ABILIFY ASIMTUFII and ABILIFY MAINTENA.
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Kora K, Saylan M, Akkaya C, Karamustafalioglu N, Tomruk N, Yasan A, Oral T. Predictive factors for time to remission and recurrence in patients treated for acute mania: health outcomes of manic episodes (HOME) study. Primary Care Companion to the Journal of Clinical Psychiatry.