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Abilify has effectively cured my BPD. Info why Abilify may be the first proper "BPD

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modafinilguy

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Abilify has effectively cured my BPD. Info why Abilify may be the first proper "BPD

Disclaimer: These are my opinions and summary of scientific facts only.

Well I have been diagnosed over a dozen times in my life with Borderline Personality Disorder. Certainly I have scars on my arms- a lot- from self harm.

I have been on the drug Abilify for 3 months now. It has been incredible for me.
There is NO OTHER drug available currently on the world market which has such a good profile at potently modifying the response of specific, important Serotonin receptors. Abilify is currently one of a kind in its overall effects.

I have not lost control of my emotions a single time, I am not depressed or anxious, and my tolerance to stress and "provocation" is massively higher than before I went on the medication. And there have been all sorts of big dramas to test me! Indeed even if I have barely slept and I am woken up- I still am in emotional control!

Just a week before I went on the medication, I had a huge angry spastic at my housemate, and we were fighting a great deal. They were about to move out. Since I have been on the medication, we have not had a single fight in 3 months.

I have been on many, many different medications in the past, none of them were helpful. Honestly probably about 30 different medications in my lifetime.

I am not advocating Abilify, but I think there is some information, that people with BPD should be aware of, because I know without a doubt, that for some people with BPD, Abilify can be a massive help. I think this drug is so important, that people with BPD at least deserve it brought to their attention.

Please note I am only on 5mg per day. I would strongly advocate only taking 5-10mg per day to minimize potential side effects. It takes about 10 days to build up fully in your body, but may start working within a few days (if its going to help).

Abilify is classified as an atypical anti-psychotic, but the classification is misleading, because Ability really has a profile more similar to a next generation anti-depressant.

(1) Abilify is the only atypical anti-psychotic that does not blatantly block and reduce dopamine. It is a partial agonist of the dopamine receptors- meaning it tends to INCREASE dopamine. Well the mathematics of how it effects receptors are complex, but the idea is it "modulates" dopamine averages. If your dopamine levels are way too high (ie psychosis), it tends to reduce them, but conversely if dopamine in parts of your brain are too low, it can increase them.

No other "anti-psychotic" on the market is a partial dopamine agonist (activator).

(2) But the likely mood regulating effects come from its unique serotonin receptor binding profile. It is very potent on 4 main serotonin receptor types, but first a bit of theory.

Various serotonin receptors have been implicated in being abnormal in numbers in the brains of people that have experience prolonged childhood stress and trauma.

For example, the serotonin 1a receptor, can be reduced in number by exposure to childhood trauma, and the 2a receptor can be increased in number.

What needs to be understood, is that many of these serotonin receptors have opposite effects to each other. There is a lot of evidence linking to them to various areas of the Prefrontal Cortex, such as the Medial area. The idea is this, that these areas of the Prefrontal Cortex are involved in regulating, and resisting the influence of stress and emotion on cognition and concentration.

When the Prefrontal Cortex areas that regulate emotion are underactive, emotion and stress is not controlled and filtered out, thus a person is easily "overpowered" and "triggered" by stress and emotion. When there is not enough chemical and electrical energy in these brain areas, the end is result is as if the "volume" or "signal strength" of emotion and stress being processed by the brain is amplified or turned to "maximum volume".

The serotonin 1a receptor activates and powers these "emotional control" areas of the Prefrontal Cortex.

However the Serotonin 2a receptor has the opposite effect, when activated, it reduces the signaling and "power" in these areas.

Likewise the Serotonin 2C, and Serotonin 7 receptors also, when activated they block various neurotransmitters that power the area, such as Dopamine and Noradrenalin.

There is a lot of evidence, as I said, that those "bad" Serotonin receptors (2a, 2C and 7) become increased in number as a result of childhood trauma, and the "good" Serotonin receptor "1a" becomes reduced in number.

Abilify activates the Serotonin 1a receptor in the brain, improving Medial prefrontal cortex area functioning. But Abilify also BLOCKS the Serotonin 2a, 2C, and 7 receptors from activating, preventing them from "reducing" the activity in the areas of the prefrontal cortex associated with emotional control. There is also a lot of research showing these actions reduce (or stop entirely) the effects of stress.

The above is my explanation (and interpretation) of the theory, there is thousands of pages to read through.

Unfortunately there is a lack of good research on Abilify for usage in BPD, and PTSD to yet absolutely claim it is an effective treatment, however the research which has been done is very, very interesting.

Not only is Abilify FDA approved for the use in treatment resistant Major Depression, but all trials I have found indicate it is highly effective for BPD and PTSD, and there is a lot of evidence supporting its use in people with anger problems, anxiety and general depression.

I am going to cite some of the Borderline Personality Disorder studies:

*** NOTE Aripiprazole is the chemical name for Abilify ***

Aripiprazole in the treatment of patients with borderline personality disorder: a double-blind, placebo-controlled study.

"CONCLUSIONS:

Aripiprazole appears to be a safe and effective agent in the treatment of patients with borderline personality disorder."

Aripiprazole in the treatment of patients wi... [Am J Psychiatry. 2006] - PubMed - NCBI


Aripiprazole in treatment of borderline patients, part II: an 18-month follow-up.

"CONCLUSION:

Aripiprazole appears to be an effective and relatively safe agent in the long-term treatment of patients with BPD."

Aripiprazole in treatment of borde... [Psychopharmacology (Berl). 2007] - PubMed - NCBI


Efficacy and tolerability of aripiprazole augmentation in sertraline-resistant patients with borderline personality disorder.

"Aripiprazole is an efficacious and well-tolerated add-on treatment for sertraline-resistant BPD patients. It acts on impulsive and psychotic-like symptoms."

Efficacy and tolerability of aripiprazole aug... [Psychiatry Res. 2008] - PubMed - NCBI


Meta-analyses of mood stabilizers, antidepressants and antipsychotics in the treatment of borderline personality disorder: effectiveness for depression and anger symptoms.

"Antipsychotics had a moderate effect on anger; however aripiprazole had a much larger effect-size than other antipsychotics."

Meta-analyses of mood stabilizers, antidepress... [J Pers Disord. 2009] - PubMed - NCBI


Most of us are aware of the overlap that often occurs between BPD and Post Traumatic Stress Disorder. The fact that Abilify seems highly effective for the later, is further suggestive that it can help both:

An open-label pilot study of aripiprazole for male and female veterans with chronic post-traumatic stress disorder who respond suboptimally to antidepressants.

"Aripiprazole was generally well tolerated and associated with a significant improvement in PTSD symptoms, as measured by the Clinician-Administered PTSD Scale (primary outcome measure) and by the Short PTSD Rating Interview, the Treatment Outcome PTSD Scale, and the Davidson Trauma Scale. An improvement was also observed on all three Positive and Negative Syndrome Scale subscales and the Beck Depression Inventory-Fast Screen, and the average Clinical Global Impressions-Improvement ratings indicated that patients were 'much improved'. These promising initial results merit further investigation in a larger, randomized-controlled trial."

An open-label pilot study of aripip... [Int Clin Psychopharmacol. 2012] - PubMed - NCBI


Aripiprazole augmentation in the treatment of military-related PTSD with major depression: a retrospective chart review.

"CONCLUSIONS:

The addition of aripiprazole contributed to a reduction in both PTSD and depression symptomatology in a population that has traditionally demonstrated poor pharmacological response. Further investigations, including double-blind, placebo-controlled studies, are essential to confirm and further demonstrate the benefit of aripiprazole augmentation in the treatment of military related PTSD."

Aripiprazole augmentation in the treatment of... [BMC Psychiatry. 2011] - PubMed - NCBI


Well there are a lot more PTSD studies, all that I read are positive. There are also a lot of studies indicating it useful in people with severe anger problems, such as teenagers with conduct disorder. And of course, there is a lot of evidence of its anti-anxiety and anti-depressant effects.

It has certainly worked for me like a miracle. Not only does it work on 4 major serotonin receptors associated with emotional disturbance and stress, it also blocks Alpha 1 adrenoreceptors as an antagonist, this is also supposed to potentially assist the prefrontal cortex in functioning effectively.

The Prefrontal Cortex has of course been implicated in the pathology of BPD, from Wikipedia:

"Prefrontal cortex (From Wikipedia)

The prefrontal cortex tends to be less active in people with BPD, especially when recalling memories of abandonment.[79] This relative inactivity occurs in the right anterior cingulate (areas 24 and 32).[79] Given its role in regulating emotional arousal, the relative inactivity of the prefrontal cortex might explain the difficulties people with BPD experience in regulating their emotions and responses to stress."

Also the Amygdala has been associated with BPD, however the Prefrontal Cortex strongly influences and controls reactions from the Amygdala via a complex feedback mechanism, and (don't ask me to find it), I did read that the serotonin networks effected by Abilify are implicated in strengthening handling of signals from the Amygdala. Also the "Hypothalamic-pituitary-adrenal axis" is also regulated by some of the Serotonin networks moderated by Abilify.

I have hundreds of scientific citations I have saved (too many to post here), which demonstrate how important the Serotonin 1a, 2a, 2c and 7 receptors are to emotional regulation and how they are very implicated in Prefrontal Cortex Functioning in regards to processing emotions and stress.

If anyone actually wants more info, I can post a lot more here.

Edit: Sorry I pressed enter and messed up the title.
 
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Lousie

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My CPN suggested Aripiprazole for my 'emotional dysregulation PD' (BPD) and I am going to see the doctor tomorrow to ask him if I can give it a ago. I had tried the older antipsychotics as was worried about weight gain with the atypicals but CPN said little or no weight gain with Aripiprazole. Hence, I am glad I came across your post as I feel hopeful that this will help. I like the way you emphasied about the role of childhood trauma causing BPD as I truly believe that the brain's development is affected from this. In fact, I wish they would rename BPD to something like 'emotional dysregulation caused by severe childhood trauma' as the personality disorder label is enough to make anyone emotional! Anyway, thanks again.
 
keepsafe

keepsafe

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Wow yes I have to agree and would now consider being put back on it even though I was asked to on Thursday and did take it for three weeks a couple of months ago - being setraline resistant just made me high I go with this research defo - of course in my opinion only I reckon when I was on 40mg of aripiprazole I was dead in control - ithers on here I am sure woukd agree and about me being out of control with my thoughts word actions now they would agree also - they put me on 10mg didn;t seem to be doing owt but it may have been considering - I will try to go back on it I think cos can;t cope with the medicine he has put me on panic attacks at the very least and bad bad mares
 
valleygirl

valleygirl

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I tried taking Abilify for about 3 weeks, but it gave me insomnia and extreme restlessness and increased my anxiety. I was hoping to go on Abilify and come off quetiapine because of extreme weight gain on quetiapine.
 
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Dory

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So glad that it works for a lot of people,that's great.ive tried abilify twice,and both times it was horrendous for me.we are all different aren't we, wouldn't the world be a dull place if we where all the same.again,so pleased it works for some of you guys.x
 
Drooo

Drooo

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I'm glad you've found something that helps. It didn't work for me at all and instead totally wrecked my head and made me a confused, bumbling idiot. It just goes to show that different things work for different people, and that you really do have to experiement to find the right thing for you.
 
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shivvy

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Abilify to treat Emotionally Unstable Borderline Personality

Thank you so much for your detailed and scientific explanation about how Abilify works. I found it so interesting and informative and as I have been prescribed 5mg starting today I hope that it has the same effect on my BPD symptoms which are bad at the moment. I upped my sertraline from 100mg to 150mg about 3 months ago to try and shift this long standing depression, I am in bed over 12 hours a day as getting up and facing the world is difficult so I am living in my pyjamas, but I have seen no improvement so I suggested starting Abilify with my GP after doing some research online. I knew I had to try something as I cant get to see my Psychiatrist for 2 months and I had started self harming again after a 6 year break following Dialectical Behavioural therapy which I found so helpful. I was diagnosed with EUPD after 4 serious suicide attempts 6 years ago. I cant get to see the psychologist who took me off the waiting list after a year on it as she said I had already done the DBT course. But that was 6 years ago, surely top ups or refresher courses would be beneficial. I also asked my GP for Lamictal but he said I should only start one new med as I wouldnt be able to tell which one was working. Thank you so much for your great post, I will look at the studies you listed. You have given me hope for the future, plus it helps to know what a med is doing to your brain. My naughty serotonin receptors can get ready for a battle......
 
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On Fire

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I came across this thread and want to add that Aripiprazole has been an absolute life saver for my Emotionally Unstable Personality Disorder. I had very strong paranoia and psychosis due to my Emotionally Unstable Personality Disorder. I was prescribed 10mg/day of Aripiprazole by an NHS psychiatrist. It started gradually working in about a week, and over the last year I have made great strides in getting my life back on track. Quetiapine even at 400mg/day did not work, and I still had psychosis. Also, Sodium Valproate did not work. So really Aripiprazole has been a life saver (for me getting rid of psychosis also seems to have helped my mood problems), and I am very lucky it works.
I now don't take any other medication, just the 10mg/day Aripiprazole.
 
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Girl interupted

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What is it like coming off of it?

i know when I tried pristique it was like a miracle mood lifter, but I started having terrible nightmares and had to come off it. Was the worst experience, took two full months to get rid of the withdrawal effects.
 
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On Fire

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What is it like coming off of it?

i know when I tried pristique it was like a miracle mood lifter, but I started having terrible nightmares and had to come off it. Was the worst experience, took two full months to get rid of the withdrawal effects.
I imagine coming off Aripiprazole (an antipsychotic) I would get psychosis fairly soon. I don't want to loose my life again, or to end up in mental hospital.
 
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Nukelavee

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I'm on an anti-psychotic "Brexpiprazole", or Rexulti, here in Canada. I dunno how similar it is to Abilify.

.25mg a day makes a huge difference for me.
 
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On Fire

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I'm on an anti-psychotic "Brexpiprazole", or Rexulti, here in Canada. I dunno how similar it is to Abilify.

.25mg a day makes a huge difference for me.
Wikipedia says Brexpiprazole was, "developed by Otsuka and Lundbeck, and is considered to be a successor[4] of Otsuka's top-selling atypical antipsychotic aripiprazole (Abilify). Otsuka's U.S. patent on aripiprazole expired on October 20, 2014;[5] and a generic was approved in April, 2015.[6]".


I don't think Brexpiprazole is available here in the UK.
 
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shivvy

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On Fire I am so pleased to hear that Abilify worked for you. I posted back in June 2018 and had just started Abilify for my EUPD following reading this thread. It changed my life too, almost immediately. I am calmer, more reasonable, my moods are more stable and the depression is not as bad. For me it really was a game changer and has changed my life so much more for the better.
 
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jed

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I tried taking Abilify for about 3 weeks, but it gave me insomnia and extreme restlessness and increased my anxiety. I was hoping to go on Abilify and come off quetiapine because of extreme weight gain on quetiapine.
If you take it in the morning it does not cause insomnia.
 
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On Fire

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On Fire I am so pleased to hear that Abilify worked for you. I posted back in June 2018 and had just started Abilify for my EUPD following reading this thread. It changed my life too, almost immediately. I am calmer, more reasonable, my moods are more stable and the depression is not as bad. For me it really was a game changer and has changed my life so much more for the better.
Thank you.

Are you still taking just 5mg/day of Abilify? And it is still working just as well?
 
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