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Depakote vs Abilify
Introduction
For patients with bipolar disorder or other types of mood disorders, certain drugs that regulate the balance of neurotransmitters in the brain can help maintain emotional stability and manage symptoms. Depakote and Abilify are two such medications frequently prescribed for these conditions. They each affect different neurotransmitters in the brain but both play a role in stabilizing mood fluctuations experienced by those with mood disorders. Depakote is classified as an anticonvulsant and mood-stabilizer which increases levels of gamma-aminobutyric acid (GABA), a calming neurotransmitter in the brain. On the contrary, Abilify operates as an atypical antipsychotic; it regulates dopamine and serotonin levels by acting as a partial agonist at dopamine D2 receptors and serotonin 5-HT1A receptors while also antagonising serotonin 5-HT2A receptors.
What is Depakote?
Divalproex sodium (the generic name for Depakote) is a widely used mood stabilizer and anticonvulsant, first approved by the FDA in 1983. It's often prescribed to manage bipolar disorder, seizures, and migraines. The exact way it works remains unclear, yet it's believed to increase levels of gamma-aminobutyric acid (GABA), a neurotransmitter that calms nerve activity in the brain.
On the other hand, Aripiprazole (Abilify) belongs to a newer class of medications called atypical antipsychotics and was approved by the FDA in 2002. Unlike traditional antipsychotics which primarily work by blocking dopamine receptors in the brain, Abilify acts as a partial agonist at dopamine D2 receptors meaning it both enhances and reduces dopamine signaling based on what your body needs.
While both drugs have proven effective for managing psychiatric disorders, their side effects vary significantly due to their different mechanisms of action. Always consult with your healthcare provider before starting any new medication regimen.
What conditions is Depakote approved to treat?
Depakote and Abilify are approved for the treatment of different mental health conditions:
Depakote is used in the management of:
- Various types of seizures
- Manic episodes associated with bipolar disorder
- Prevention of migraine headaches
Abilify, on the other hand, is used for:
- Schizophrenia
- Bipolar I disorder (both manic and mixed episodes)
- Adjunctive therapy to either antidepressants for patients with major depressive disorder who have had an inadequate response to antidepressant therapy.
How does Depakote help with these illnesses?
Depakote assists in managing bipolar disorder by increasing the amount of gamma-aminobutyric acid (GABA) available in the synapses of the brain. It accomplishes this by inhibiting an enzyme that breaks down GABA, thereby allowing its levels to remain elevated for more extended periods. GABA is a neurotransmitter—a chemical messenger within the brain and body—that plays a critical role in reducing neuronal excitability, inducing relaxation, and enhancing sleep quality among other things. It's believed individuals with bipolar disorder have relatively lower levels of GABA. Thus, by augmenting GABA concentration, Depakote can help curtail manic episodes associated with bipolar disorder and aid patients in stabilizing their mood swings.
On another hand, Abilify works on two neurotransmitters—dopamine and serotonin—to alleviate symptoms of mental disorders like schizophrenia or bipolar disorder. Instead of just boosting these chemicals' levels as many antipsychotics do, it stabilizes them by acting as a partial agonist at dopamine D2 receptors and serotonin 5-HT1A receptors while also being an antagonist at 5-HT2A receptor sites. This unique mechanism helps balance out both under or overactivity leading to better symptom control without causing severe side effects often seen with traditional treatments.
What is Abilify?
Abilify is a brand name for aripiprazole, an antipsychotic medication that modifies the actions of chemicals in the brain. It acts as a partial agonist at dopamine D2 and serotonin 5HT1A receptors and antagonist at serotonin 5HT2A receptor. Aripiprazole was first approved by the FDA in 2002, and it's primarily used to treat psychiatric conditions like schizophrenia, bipolar disorder, major depressive disorder, or irritability associated with autism.
Unlike Depakote (valproate semisodium), which is often used as a mood stabilizer and also has anti-seizure properties, Abilify doesn't directly affect gamma-aminobutyric acid (GABA) neurotransmitters but works mainly through dopamine modulation. This difference makes its side-effect profile distinct from that of medications like Depakote; common side effects can include weight gain, movement disorders (extrapyramidal symptoms), fatigue and insomnia among others. As such Abilify might be better suited for patients who do not respond well to typical mood stabilizers or other antipsychotics.
What conditions is Abilify approved to treat?
Abilify has been granted approval by the FDA for managing a range of conditions, including:
- Schizophrenia, which is characterized by symptoms such as hallucinations, disorganized thinking and behavior; emotional flatness or lack of pleasure in life.
- Bipolar disorder (manic depression), where individuals experience periods of unusually high mood and energy levels that alternate with episodes of low mood and energy.
- As an add-on treatment to antidepressants for major depressive disorder (MDD) when an adequate response isn't achieved with the initial therapy.
How does Abilify help with these illnesses?
Dopamine is a neurotransmitter that plays vital roles in numerous processes within the body, including attention, memory recall, mood regulation and pleasure. It's also involved in the "reward system," which motivates certain behaviors. Abilify operates by partially blocking dopamine receptors while still allowing some activity - this mechanism is known as partial agonism. Though it also affects serotonin levels to some extent, its primary action involves modulating dopamine function in the brain to help alleviate symptoms of psychiatric conditions like bipolar disorder and schizophrenia. This approach differs from Depakote's use mainly as a mood stabilizer with anti-seizure properties. The ability of Abilify to adjust both too high and too low dopamine levels makes it effective for treating a wider range of patients with complex mental health disorders than typical antipsychotics or mood stabilizers such as Depakote.
How effective are both Depakote and Abilify?
Both divalproex sodium (Depakote) and aripiprazole (Abilify) have established histories of success in treating patients with bipolar disorder, and they were approved by the FDA several years apart. Since they act on different neurotransmitters, they may be prescribed under different circumstances. The effectiveness of Depakote and Abilify in managing symptoms of bipolar disorder was directly studied; the two drugs exhibited similar efficacy as well as its own unique safety profiles. In these studies, none of the different metrics used to measure efficacy differed significantly between patients receiving Depakote or Abilify.
A 2006 review demonstrated that Depakote is effective in alleviating manic episodes from the first week of treatment, shows fewer side effects than many other mood stabilizers, and is well-tolerated even in elderly populations. Further investigations show that it has become one of the most widely prescribed medications for bipolar disorder due to its robust effect on mania. Its optimal dose varies greatly among individuals but often falls within a certain therapeutic blood level range.
A 2011 review indicated that aripiprazole seems to be more effective than placebo in controlling both manic and depressive symptoms associated with bipolar disorder while displaying an acceptable safety profile. Nonetheless, like any medication, there are potential adverse effects ranging from common ones such as restlessness or weight gain to rarer serious consequences such as tardive dyskinesia—a condition involving involuntary movements—although this outcome appears less likely with aripiprazole compared to older antipsychotics.
At what dose is Depakote typically prescribed?
Oral dosages of Depakote for adults range from 750 mg to 3000 mg/day, depending upon the nature and severity of their condition. Children's dosage begins at around 10-15 mg/kg/day and may be increased gradually every week. However, Abilify doses typically start at a lower dose—2 mg to 5 mg per day—for both children (aged over 13) and adults. The dosage can be adjusted after two weeks based on response and tolerability, up to a maximum of 30mg/day in any case. Both medications' exact dosages will depend on individual patient circumstances, so they should always be taken under the guidance of a healthcare provider.
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At what dose is Abilify typically prescribed?
Abilify treatment generally starts at a dosage of 10-15 mg/day. The dose can then be adjusted within the range of 5–30 mg/day, based on individual patient response and tolerability. Doses above 15 mg/day have shown no additional benefits in clinical studies and are therefore not typically used. It may be taken with or without food and it is usually administered once daily, preferably around the same time each day to maintain an even level in your body. The maximum daily dose should not exceed 30mg per day unless specifically directed by your healthcare provider. If there is no sufficient response to treatment after two weeks, consultation with a medical professional is advised for possible dosage adjustment.
What are the most common side effects for Depakote?
Common side effects of Depakote may include:
- Nervousness
- Drowsiness or fatigue
- Diarrhea, nausea, vomiting, and indigestion
- Tremors or uncontrolled body movements
- Hair loss
- Weight changes (gain)
- Changes in menstrual cycles
- Enlargement of breasts (in men)
Abilify may cause side effects like:
- Anxiety and restlessness
- Insomnia or drowsiness
- Headache
- Constipation, nausea, and vomiting
- Increased appetite and weight gain
- Lightheadedness or fainting when standing up suddenly from a sitting position.
Are there any potential serious side effects for Depakote?
When comparing Depakote to Abilify, both medications come with the potential for serious side effects. For Depakote, these may include:
- Suicidal thoughts or behavior
- Serious allergic reactions: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing
- Change in vision like blurred vision or seeing spots
- Fast or irregular heartbeats and feeling faint
- Low body temperature - cold feeling, slow heartbeat (in neonates)
- Disturbance in attention and memory impairment
- Liver problems manifested as nausea/vomiting that doesn't stop, loss of appetite, stomach/abdominal pain, yellowing eyes/skin
For Abilify users should watch out for symptoms such as:
- Increased risk of suicidal thinking especially in children and young adults.
- Severe allergic reaction including hives; difficulty breathing; swelling of your face/lips/tongue/throat.
- Blurred vision
-Uncontrolled movements (tardive dyskinesia), muscle stiffness or shakiness
-Fast/irregular heartbeat accompanied by sudden dizziness/fainting
-Signs suggestive of neuroleptic malignant syndrome: confusion/agitation/high fever/sweating/muscle rigidity/fast heart rate/rapid breathing/faintness/trouble speaking.
If you experience any signs indicative of these conditions while taking either medication it is crucial to seek immediate medical help.
What are the most common side effects for Abilify?
Abilify, another medication used for managing bipolar disorder and schizophrenia, can cause a different set of side effects. Some common ones include:
- Headache
- Anxiety or restlessness
- Insomnia or other sleep problems
- Nausea, vomiting, constipation
- Weight gain (which may be significant)
- Increased salivation or drooling
- Dizziness upon standing up (orthostatic hypotension)
- Tremors or uncontrolled muscle movements These are not all the side effects that Abilify might cause but they are some of the most commonly reported ones. As with any medication decision, it's important to weigh these potential adverse events against the benefits in treating your condition.
Are there any potential serious side effects for Abilify?
Abilify, while often effective in treating certain mental health conditions, can have serious side effects that should not be ignored. If you experience any of the following symptoms after taking Abilify, seek immediate medical attention:
- Allergic reactions such as hives or itching, fever or swollen glands
- Difficulty breathing and swelling in your face or throat which may indicate anaphylaxis
- Increased thoughts about suicide or self-harm
- Seizures (convulsions)
- Confusion or sudden unusual changes in mood and behavior
- Vision problems like blurred sight, tunnel vision, eye pain or seeing halos around lights
- Rapid heartbeat which could be a sign of a heart condition
- Signs of hyperactivity: racing thoughts, heightened energy levels leading to reckless behavior; extreme happiness followed by irritability; increased talking than usual; severe sleep disturbances.
Remember that these are rare but serious side effects. It is essential to communicate with your healthcare provider if you notice any adverse reactions after starting Abilify.
Contraindications for Depakote and Abilify?
Both Abilify and Depakote, along with other mood stabilizers and antipsychotic medications, may exacerbate symptoms of depression or bipolar disorder in some individuals. If you notice your mental health deteriorating, or an increase in suicidal ideation, thoughts or behaviors while taking these medications, it is crucial to seek immediate medical assistance.
Neither Abilify nor Depakote should be taken if you are currently on certain types of medicines such as MAO inhibitors (MAOIs), atypical antipsychotics or specific anti-seizure drugs. Always inform your healthcare provider about the medications you're presently taking; substances like MAOIs will necessitate a period of approximately two weeks to clear from your system before initiating treatment with Abilify or Depakote to prevent potentially dangerous drug interactions.
How much do Depakote and Abilify cost?
For the brand name versions of these drugs:
- The price of 60 tablets of Abilify (10 mg) averages around $1300, which works out to between $21–43/day, depending on your dose.
- The price for 100 Depakote ER tablets (500 mg) averages about $560, working out to approximately $5.60/day.
Thus, if you are in a higher dosage range for Abilify (i.e., 30 mg/day or more), then brand-name Depakote is less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration when determining which drug is right for you.
When it comes to generic versions - Aripiprazole and Divalproex sodium - costs are significantly lower:
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Aripiprazole can be found in packs from 30 tablets and above with approximate costs ranging from $1.20 to $3.80 per day at dosages of 10mg/day or between $2.40 and $7.50 per day if taking doses closer to the maximum (upwards of 30mg).
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Divalproex sodium is available in packs from as low as 60 up to over several hundred pills with prices starting at roughly $.70/day (for larger quantities upfront) and rarely exceeding about $1.90/Day even at higher dosages.
Popularity of Depakote and Abilify
Divalproex sodium, also known by its brand name Depakote, was prescribed to approximately 3 million people in the US in 2020. Widely used as an anticonvulsant and mood stabilizer, it accounted for around 10% of all prescriptions for bipolar disorder medication. Despite being developed over three decades ago, Depakote remains a commonly prescribed treatment for epilepsy and bipolar disorder.
Aripiprazole, marketed under the brand name Abilify among others, had about 8.7 million prescriptions filled in the USA in 2020. This makes it one of the most frequently prescribed atypical antipsychotics – medications that do not fit into larger categories like SSRI or other broad classes of antidepressants or mood stabilizers. Aripiprazole is primarily used to treat schizophrenia and bipolar disorder but has been gaining popularity due to its use in treating irritability associated with autism as well as augmenting antidepressants in cases of resistant depression.
Conclusion
Both Depakote (divalproex sodium) and Abilify (aripiprazole) have extensive histories of use in treating psychiatric conditions, with ample clinical studies attesting to their efficacy over placebo. In certain situations, they may be used together under a physician's supervision, but caution is required due to potential drug interactions. Their respective mechanisms of action differ - Depakote stabilizes electrical activity in the brain that can lead to seizures or mood episodes by increasing GABA levels and reducing glutamate signaling; whereas Abilify is an atypical antipsychotic working principally on dopamine and serotonin receptors.
Depakote often serves as a first-line treatment for bipolar disorder and epilepsy, while Abilify might typically be added to augment the effects of other medications in cases where patients do not respond adequately to initial therapies or when targeting specific symptoms such as agitation in schizophrenia or mania in bipolar disorder.
Both drugs are available as generics offering cost savings especially for those paying out-of-pocket. The onset of therapeutic effects may take some time with both medications requiring an adjustment period during which benefits might not be immediately apparent.
Side effect profiles are similar between these two drugs – generally well tolerated but with different focuses: weight gain and hand tremors being common side effects associated with Depakote usage whereas Abilify might cause less weight gain but comes with potential side-effects like restlessness or insomnia. For both medications, close monitoring especially at the initiation phase is vital; any worsening condition or emergence of suicidal thoughts must prompt immediate medical attention.