Hi. This is my first posting. We have a son who is 13 yrs. and was started on abilify in the past two weeks. Was on resperdal since he was 6 yrs. old. All of a sudden his vocal tics became escalated since Christmas. Now vocal tics are very loud, grunting, and now beginning to do the semi-swearing (which we were praying wouldn't happen). Has anyone had any experience with abilify increasing the tics? We are wondering if the increase in the abilify (now up to 15mg a day) is having an adverse effect and making things worse? Any reply would be appreciated !! Thanks !

Hi marge,
Just wanted to say "Welcome". I'm sorry to read that your son is having such a difficult time right now.

I've no personal experience at all with Abilify so can't really help too much. I have read a few reports from people saying it helped them. One friend though had increase in their OCD while taking it, but it helped her tics. 15mg seems high, but I'm no expert. I was just looking for dose info. and found TSA-USA newsletter where they mention doses of 5mg to 10mg. I'll go check on doses and post back if I find something important.

[A lot of the info. about Abilify gives doses for other conditions like Bipolar or Schizophrenia. The doses used for tics is usually much lower.]

I checked in PubMed in a couple of articles there and also on the TSA-USA site, but couldn't find anything too specific.

The doses used in one study were from 10mg to 20mg but the 11 patients varied in age from 7 to 50 years of age, so that's pretty large difference in size and weight. My son was pretty heavy while on the Risperdal so I guess if he'd gone onto Abilify he would have needed probably larger dose than some children his same age.

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum

A case series of patients with Tourette's syndrome in the United Kingdom treated with aripiprazole.
Davies L, Stern JS, Agrawal N, Robertson MM.

"A case series of 11 consecutive patients with TS (age range 7-50 years; M = 7)

"The successful aripiprazole doses were between 10-20 mg daily."

__________

Just wondering if the Risperdal was tapered off or if the Abilify was added and the Risperdal ceased at the same time. What dose Risperdal was your son on when it was ceased?

When my son was on the Risperdal, he felt it helped him a lot for a while, but he also had increase in OC symptoms and the Risperdal seemed to hit a "wall" where it appeared to stop helping him with his tics altogether. His doctors wanting to keep upping the doses, and the dose was high enough. It's better to find the lowest dose for the maximum relief, then to tip the scales and go on a dose that is detrimental as far as side effects and cognitive blunting is concerned. Anyway, once he was finally tapered, and that wasn't at all easy to begin with, he went through some difficult weeks, but then really settled and has never taken anything since. That was around the age of 13 as well.

There is an older thread where some questions were asked about Abilify. I'm not sure if there's anything in there that is of help for you, but here's the thread... http://neurotalk.psychcentral.com/showthread.php?t=3636
Experience with Abilify??

take care,
Lara

Hi Marge and welcome to NeuroTalk

I am not personally "up" on medication info as we dont use any meds because my son had bad side effects from the ones he was prescribed

Some people have reported good results with Abilify, but others seem to have not had positive effects. I think, as with all meds, it is very dependent on the individual person's biochemistry.

I was also wondering whether the Risperdal was tapered down before or when the abilify was added as that too can be significant

Thanks to Laura and Chemar for the reply. My son was tapered off of the risperdal while starting the abilify. He's a good size kid at 5'9" and almost
160 lbs. (Husbands 6'5"!) So maybe the dose is according to his size. What we really feel he needs is an antianxiety med along with the abilify, maybe xanax? He has anxiety as well, but the anxiety comes with the increase in the tics. Poor kid is afraid to be around alot of people, really feel for him. He , nor we, have had to experience tics to this degree before all these years, so needless to say, it's stressful. His present dr. (since he's been 6yrs) doesn't want to perscribe an antianxiety. This is a Cleveland Clinic dr. since we live so close, but now we are going to move on and switch dr.'s in hope of helping the poor kid, he's miserable. Have an appointment with new dr. this coming Thursday. I've read alot of threads in which other children are on xanax or another form of antianxiety med. My husband and I are both Rn's so we understand the meds, but the alilify is new to us.

Hi Marge....
My son is 16 and is 6'5 so i know what you mean when you say hes pretty good size. Scott has been taking clonodine since he was 7 and at one time was up to 0.4 mg a day. Hes down to 2 1/2 now and is doing very good. One thing i noticed when scott hit puberty, (which was early for him) his vocalizations incresed tremendously and also increased in volume. His body tics increased just a bit, but it was the vocalizations we noticed the most. Once he got into highschool they started decreasing. I think it was the middleschool environment to that put alot of stress on him. The kids were just ruthless. needless to say, his principal and counselor got to know me quite well as i was always up there.
I'm not familiar with abifily at all. At one time his neurologist was talking about putting him on something for anxiety, but Scott didn't want to go that route.
maybe you should tell his dr. about the increase in vocalizations and see what they think. Good luck, and welcome!!!!
vicky

I've never taken abilify or risperadol myself for tics... i tend to stick with the benzo's... but i can say from experience that when i hit my teen years my tics also got worse, especially my vocals... but mine were more high pitched whinning and screeching than grunting (so high pitched it sometimes annoyed the dog)... and holidays were always a big stresser for me as well.

It could be the increase in tics has nothing to do with the meds at all, and is purely environmental... does he maybe have a big project, or a dance, or maybe he's worried about a bully at school, or a girl... i remember middle school/high school all too well and there are so many little things that would stress me out to the max....

at 13 he might not want to tell his mum whats on his mind, but it might be good to just remind him of any calming techniques u have... breathing, relaxing, video games etc... that he can turn to when things are getting to stressful for him....

anyway, just a thought.

Well, had our dr.'s appointment today, definitely taking him off the abilify. Not doing him any good at all. The swearing is really hard to deal with that started this past sat. YIKES. Tough on him , he beggs me to help him stop saying these things. He's always been a very well behaved and polite kid. The kind his teachers have loved all these years. This is killing him and us. Feel helpless because we can't take them away ! He would never use swear words or profanity, ever. What a terrible thing for him to be going through. Dr. is going to keep him on klonopin (had to get stern and demand something yesterday from the dr.'s nurse to calm him down). The klonopin has helped to calm his nerves. Then dr. said to start on Orap in a week or so if the swearing and intense vocal tics are still around. Thanks for all the replies, this really helps me to talk to others who are experiencing these tics as well.

Marge

when my son had his probs with coprolalia (swearing tics) he found ways to still say the words so as to satisfy the tic urge but he masked the word with other sounds so as to lessen the unacceptable social impact. This really worked well for him.

hopefully this will wane for your son quickly...my son's coprolalia was a very short term tic and has thankfully never returned....it was when he was on the meds and we really do feel that for him, many of his more severe symptoms were in some way related to adverse reactions to the medications. The worst tics and OCD he ever had was during the year he was on medications.

I know this is reply is to an old posting but I am a new member and was wondering if anyone had anymore current information on proper dosage for Abilify. My son is 12 years old but is 180lb.. He has been on abilify for about 6 mo. It was an instant success for his tics, both motor and vocals as well as his OCD. Just in the last two weeks some minor vocals have returned with some regularity. He is on 10mg per day. His body weight has gone up markedly in the last 6 mo. Wondering if an increase dosage may be needed?

Hi again Dan

I would urge caution on increasing the dose of Abilify without careful monitoring from your son's physician.
There are some concerns on it for teens and elderly people, plus it could also be the reason for your child's weight gain

I do know for some people it has tremendous benefit in relieving the tics so it's good to hear your son has had positive results from it

sometimes, as you no doubt know, TS tics can wax and wane nomatter the treatments being used, so you son may just be in a waxing mode, or some other factor could have triggered the tic increase. Not sure if you have ever seen the triggers for Tics article by Sheila Rogers
http://www.latitudes.org/articles/finding_triggers.htm



The FDA did issue an alert on Abilify http://www.fda.gov/medwatch/SAFETY/2004/abilify_pi.pdf
and here too is the manufacturer's info
www.abilify.com

you may also want to ask about the optimum dose info on our medications forum as mrsD might have that info for you
http://neurotalk.psychcentral.com/forum72.html

as an aside
many people with TS have found L-carnitine (an amino acid) to help greatly reduce vocal tics
HOWEVER
please do discuss this with the doc before trying it as it may have interaction with abilify!!

hope that helps a bit and all the best