Monday, June 29, 2009

Mental Health: Comes With FREE Serotonin Syndrome

21 of the 23 Psychiatric Poisons in our FDA Adverse Reaction section feature Serotonin Syndrome as an FDA reported Adverse Reaction with each Drug Individually identified as 'The Primary Suspect Drug' responsible for that Adverse Reaction

Abilify: Serotonin Syndrome
Adderall: Serotonin Syndrome
Celexa: Serotonin Syndrome
Clozapine: Serotonin Syndrome
Cymbalta: Serotonin Syndrome
Depakote:
Effexor: Serotonin Syndrome
Geodon: Serotonin Syndrome
Klonopin: Serotonin Syndrome
Lamactil: Serotonin Syndrome
Lexapro: Serotonin Syndrome
Neurontin: Serotonin Syndrome
Paxil: Serotonin Syndrome
Prozac: Serotonin Syndrome
Risperdal: Serotonin Syndrome
Ritalin/Concerta: Serotonin Syndrome
Seroquel: Serotonin Syndrome
Strattera: Serotonin Syndrome
Tegretol: Serotonin Syndrome
Wellbutrin: Serotonin Syndrome
Xanax:
Zoloft: Serotonin Syndrome
Zyprexa: Serotonin Syndrome


And This piece of Better Living (or Dying) Through Modern Chemistry, known as,

SEROTONIN SYNDROME

is Wiki described below.

Serotonin syndrome


Serotonin syndrome
Classification and external resources
Serotonin
ICD-9 333.99
DiseasesDB 30044
eMedicine ped/2786
MeSH C21.613.276.720

Serotonin syndrome is a potentially life-threatening adverse drug reaction that may occur following therapeutic drug use, inadvertent interactions between drugs, overdose of particular drugs, or the recreational use of certain drugs. Serotonin syndrome is not an idiosyncratic drug reaction; it is a predictable consequence of excess serotonergic activity at central nervous system (CNS) and peripheral serotonin receptors. For this reason, some experts strongly prefer the terms serotonin toxicity or serotonin toxidrome because these more accurately reflect the fact that it is a form of poisoning. It may also be called serotonin storm, hyperserotonemia, or serotonergic syndrome.

The excess serotonin activity produces a spectrum of specific symptoms including cognitive, autonomic, and somatic effects. The symptoms may range from barely perceptible to fatal. Numerous drugs and drug combinations have been reported to produce serotonin syndrome. Diagnosis of serotonin syndrome includes observing the symptoms produced and a thorough investigation of the patient's history. The syndrome has a characteristic picture but can be mistaken for other illnesses in some patients, particularly those with neuroleptic malignant syndrome. No laboratory tests can currently confirm the diagnosis.

Treatment consists of discontinuing medications which may contribute and in moderate to severe cases administering a serotonin antagonist. An important adjunct treatment includes controlling agitation with benzodiazepine sedation. The high profile case of Libby Zion, who died from serotonin syndrome, resulted in changes to graduate medical education in New York State.

Signs and symptoms

Symptom onset is usually rapid, often occurring within minutes. Serotonin syndrome encompasses a wide range of clinical findings. Mild symptoms may only consist of increased heart rate, shivering, sweating, dilated pupils, myoclonus (intermittent tremor or twitching), as well as overresponsive reflexes. Moderate intoxication includes additional abnormalities such as hyperactive bowel sounds, high blood pressure and hyperthermia; a temperature as high as 40 °C (104 °F) is common in moderate intoxication. The overactive reflexes and clonus in moderate cases may be greater in the lower limbs than in the upper limbs. Mental status changes include hypervigilance and agitation. Severe symptoms include severe increases in heart rate and blood pressure that may lead to shock. Severe cases often have agitated delirium as well as muscular rigidity and high muscular tension. Temperature may rise to above 41.1 °C (106.0 °F) in life-threatening cases. Other abnormalities include metabolic acidosis, rhabdomyolysis, seizures, renal failure, and disseminated intravascular coagulation; these effects usually arise as a consequence of hyperthermia.

The symptoms are often described as a clinical triad of abnormalities:

Pathophysiology

Serotonin is a neurotransmitter involved in multiple states including aggression, pain, sleep, appetite, anxiety, depression, migraine, and vomiting. In humans the effects of serotonin excess were first noted in 1960 in patients receiving a monoamine oxidase inhibitor (MAOI) and tryptophan. The syndrome is caused by increased serotonin in the central nervous system. It was originally suspected that agonism of 5-HT1A receptors in central grey nuclei and the medulla was responsible for the development of the syndrome. Further study has determined that overstimulation of primarily the 5-HT2A receptors appears to contribute substantially to the condition. The 5-HT1A receptor may still contribute through a pharmacodynamic interaction in which increased synaptic concentrations of a serotonin agonist saturate all receptor subtypes. Additionally, noradrenergic CNS hyperactivity may play a role as CNS norepinephrine concentrations are increased in serotonin syndrome and levels appear to correlate with the clinical outcome. Other neurotransmitters may also play a role; NMDA receptor antagonists and GABA have been suggested as affecting the development of the syndrome. Serotonin toxicity is more pronounced following supra-therapeutic doses and overdoses, and they merge in a continuum with the toxic effects of overdose.

Drugs which may contribute

A large number of drugs and drug combinations have been reported to produce serotonin syndrome.

Class Drugs
Antidepressants Monoamine oxidase inhibitors (MAOIs),[1] TCAs,[1] SSRIs,[1] SNRIs,[1] bupropion,[10] nefazodone,[11] trazodone[11]
Opioids tramadol,[1] pethidine,[1] fentanyl,[1] pentazocine,[1] buprenorphine[12] oxycodone,[13] hydrocodone[13]
CNS stimulants phentermine,[14] diethylpropion,[14] amphetamines,[3][14] sibutramine,[1] methylphenidate,[14] methamphetamine,[14] cocaine[14]
5-HT1 agonists triptans[1][14]
Psychedelics MDMA,[1] MDA,[1] 5-Methoxy-diisopropyltryptamine,[1] LSD[15][16]
Herbs St John's Wort,[1] Syrian rue,[1] Panax ginseng,[1] Nutmeg[17]
Others tryptophan,[1] L-Dopa,[18] valproate,[1] buspirone,[1] lithium,[1] linezolid,[1] dextromethorphan,[1] 5-hydroxytryptophan,[11] chlorpheniramine,[14] risperidone,[19] olanzapine,[20] ondansetron,[1] granisetron,[1] metoclopramide,[1] ritonavir[1]

Many cases of serotonin toxicity occur in patients who have ingested drug combinations that synergistically increase synaptic serotonin. It may also occur in patients following ingestion of a single serotonergic agent. The combination of MAOIs and other serotonin agonists or precursors pose a particularly severe risk of a life-threatening serotonin syndrome. Many MAOIs inhibit monoamine oxidase irreversibly, so that the enzyme cannot function until it has been replaced by the body, which can take at least four weeks.

Many medications may have been incorrectly thought to cause serotonin syndrome. For example, some case reports have implicated atypical antipsychotics in serotonin syndrome, but it appears based on their pharmacology that they are unlikely to cause the syndrome.

It has also been suggested that mirtazapine has no significant serotonergic effects, and is therefore not a dual action drug. In 2006 the United States Food and Drug Administration issued an alert suggesting that the combined use of SSRIs or SNRIs and triptan medications or sibutramine could potentially lead to severe cases of serotonin syndrome. This has been disputed by other researchers as none of the cases reported by the FDA met the Hunter criteria for serotonin syndrome. The condition has however occurred in surprising clinical situations, and because of phenotypic variations among individuals, it has been associated with unexpected drugs, including mirtazapine.

Spectrum concept

A postulated ‘spectrum concept’ of serotonin toxicity emphasises the role that progressively increasing serotonin levels play in mediating the clinical picture as side effects merge into toxicity. The dose-effect relationship is the term used to describe the effects of progressive elevation of serotonin, either by raising the dose of one drug, or combining it with another serotonergic drug which may produce large elevations in serotonin levels.

Risk and severity

The relative risk and severity of serotonergic side effects and serotonin toxicity, with individual drugs and combinations, is complex. Serotonin syndrome has been reported in patients of all ages, including the elderly, children, and even newborn infants due to in utero exposure. The serotonergic toxicity of SSRIs increases with dose, but even in over-dose it is insufficient to cause fatalities from serotonin syndrome in healthy adults. Elevations of central nervous system serotonin will typically only reach potentially fatal levels when drugs with different mechanisms of action are mixed together. Various drugs, other than SSRIs, also have clinically significant potency as serotonin reuptake inhibitors, e.g. tramadol, amphetamine, and MDMA are associated with severe cases of the syndrome.

Diagnosis

There is no laboratory test for serotonin syndrome, therefore diagnosis is by symptom observation and investigation of the patient's history. Several diagnostic criteria have been proposed. The first criteria that was rigorously evaluated was introduced in 1991 by Harvey Sternbach, a professor of psychiatry at UCLA. Researchers in Australia have later developed the Hunter Serotonin Toxicity Criteria, which has better sensitivity and specificity, 84% and respectively 97%. As of 2007, Sternbach's criteria were still the most commonly used.

The most important symptoms for diagnosing serotonin syndrome are tremor, akathisia, or clonus (spontaneous, inducible and ocular). Physical examination of the patient should include assessment of deep-tendon reflexes and muscle rigidity, the dryness of the oral mucosa, the size and reactivity of the pupils, the intensity of bowel sounds, skin color, and the presence or absence of sweating. The patient's history also plays an important role in diagnosis, investigations should include enquries about the use of prescription and over-the-counter drugs, illicit substances, and dietary supplements, as all these agents have been implicated in the development of serotonin syndrome. The Hunter Serotonin Toxicity Criteria suggests serotonin syndrome if the patient has taken a serotonergic agent and has symptoms of:

  • Spontaneous clonus, or
  • Inducible clonus or ocular clonus with agitation or diaphoresis, or
  • Tremor and hyperreflexia, or
  • Hypertonism and temperature > 38 °C (100 °F) and ocular clonus or inducible clonus

Differential diagnosis

Serotonin toxicity has a characteristic picture which is generally hard to confuse with other medical conditions, but in some situations it may go unrecognized because it may be mistaken for a viral illness, anxiety, neurological disorder, anticholinergic poisoning, sympathomimetic toxicity, or worsening psychiatric condition. The condition most often confused with serotonin syndrome is neuroleptic malignant syndrome (NMS). The clinical features of neuroleptic malignant syndrome and serotonin syndrome share some features which can make differentiating them difficult. In both conditions, autonomic dysfunction and altered mental status develop. However, they are actually very different conditions with different underlying dysfunction (serotonin excess vs dopamine blockade). Both the time course and the clinical features of NMS differ significantly from those of serotonin toxicity. Serotonin toxicity has a rapid onset after the administration of a serotonergic drug and responds to serotonin blockade such as drugs like chlorpromazine and cyproheptadine. Dopamine receptor blockade (NMS) has a slow onset and typically evolves over several days after administration of a neuroleptic drug and responds to dopamine agonists such as bromocriptine.

Differential diagnosis may become difficult in patients recently exposed to both serotonergic drugs and neuroleptic drugs. Features that are classically present in NMS, that are useful for differentiating the two, are bradykinesia and extrapyramidal "lead pipe" rigidity, whereas serotonin syndrome causes hyperkinesia and clonus.

Management

There is no antidote to the condition itself, and management involves the removal of the precipitating drugs and the initiation of supportive care. Supportive care includes the control of agitation, the administration of serotonin antagonists (cyproheptadine or methysergide), the control of autonomic instability, and the control of hyperthermia. The intensity of therapy depends on the severity of symptoms. If the symptoms are mild, treatment may only consist of discontinuation of the offending medication or medications, offering supportive measures, giving benzodiazepines for myoclonus, and waiting for the symptoms to resolve. Moderate cases should have all thermal and cardiorespiratory abnormalities corrected and can benefit from serotonin antagonists. Critically ill patients should receive the above therapies as well as sedation or neuromuscular paralysis.

Specific treatment for some symptoms may be required. One of the most important treatments is the control of agitation with benzodiazepines. Patient who have low blood pressure require treatment with direct-acting sympathomimetics such as epinephrine, norepinephrine, or phenylephrine. Conversely, hypertension or tachycardia can be treated with short-acting antihypertensive drugs such as nitroprusside or esmolol; longer acting drugs such as propranolol should be avoided as they may lead to hypotension and shock. Treatment for hyperthermia includes reducing muscle over-activity with benzodiazepine sedation. More severe cases may, however, require muscular paralysis with vecuronium along with intubation and artificial ventilation. Antipyretic agents are not recommended as the increase in body temperature is due to muscular activity not a hypothalamic temperature set point abnormality. Physical restraints are not recommended for agitation or delirium as they may contribute to mortality by enforcing isometric muscle contractions that are associated with severe lactic acidosis and hyperthermia.

Upon initiation of therapy and the discontinuation of serotonergic drugs, most cases of serotonin syndrome resolve within 24 hours, although delirium may persist for a number of days. Symptoms typically persist for a longer time frame in patients taking drugs which have a long elimination half-life, active metabolites, or a protracted duration of action. Cases have reported muscle pain and weakness persisting for months, although antidepressant discontinuation may contribute to ongoing features. Following appropriate medical management, serotonin syndrome is generally associated with a favorable prognosis.

Epidemiology

Epidemiological studies of serotonin syndrome are difficult as many physicians are unaware of the diagnosis or the physician may miss the syndrome due to its variable manifestations. In 1998 a survey conducted in England found that 85% of the physicians that had prescribed the antidepressant nefazodone were unaware of serotonin syndrome. The incidence may be increasing as a larger number of pro-serotonergic drugs (drugs which increase serotonin levels) are now being used in clinical practice. One post-marketing surveillance study identified an incidence of 0.4 cases per 1000 patient-months for patients who were taking nefazodone. Additionally, around 14 to 16 percent of persons who overdose on SSRIs are thought to develop serotonin syndrome.

Phenelzine is a MAOI which contributed to serotonin syndrome in the Libby Zion Case

Notable cases

The most widely recognized example of serotonin syndrome was the death of Libby Zion in 1984. Libby was a freshman at Bennington College at her death on March 5, 1984, at age 18. She died within 8 hours of her emergency admission to the New York Hospital Cornell Medical Center. She had an ongoing history of depression, and came to the Manhattan hospital on the evening of March 4, 1984, with a fever, agitation and "strange jerking motions" of her body. She also seemed disoriented at times. The emergency room physicians were unable to diagnose her condition definitively, but admitted her for hydration and observation. Her death was caused by a combination of pethidine (aka meperidine (Demerol(R))) and phenelzine. The doctor who prescribed the pethidine was a medical intern. The case had an impact on graduate medical education and residency work hours. Limits were set on working hours for medical post graduates, commonly referred to as interns or residents, in hospital training programs, and they also now require closer senior physician supervision.


Sunday, June 28, 2009

Mental Health: Comes With FREE Tardive Dyskinesia

22 of the 23 Psychiatric Poisons in our FDA Adverse Reaction section feature Tardive Dyskinesia as an FDA reported Adverse Reaction with each Drug Individually identified as 'The Primary Suspect Drug' responsible for that Adverse Reaction

Abilify: Tardive Dyskinesia
Adderall: Tardive Dyskinesia
Celexa: Tardive Dyskinesia
Clozapine: Tardive Dyskinesia
Cymbalta: Tardive Dyskinesia
Depakote: Tardive Dyskinesia
Effexor: Tardive Dyskinesia
Geodon: Tardive Dyskinesia
Klonopin: Tardive Dyskinesia
Lamactil: Tardive Dyskinesia
Lexapro: Tardive Dyskinesia
Neurontin: Tardive Dyskinesia
Paxil: Tardive Dyskinesia
Prozac: Tardive Dyskinesia
Risperdal: Tardive Dyskinesia
Ritalin/Concerta: Tardive Dyskinesia
Seroquel: Tardive Dyskinesia
Strattera: Tardive Dyskinesia
Tegretol: Chorea
Wellbutrin: Tardive Dyskinesia
Xanax: Tardive Dyskinesia
Zoloft: Tardive Dyskinesia
Zyprexa: Tardive Dyskinesia

Wiki has:

Cause

Despite the fact that tardive dyskinesia has existed for over 50 years, its etiology is poorly understood due to the limited research conducted on psychiatric drug side effects. The cause of tardive dyskinesia appears to be related to damage to the system that uses and processes the neurotransmitter dopamine. The most compelling line of evidence suggests that tardive dyskinesia may result primarily from neuroleptic-induced dopamine supersensitivity in the nigrostriatal pathway, with the D2 dopamine receptor being most affected. Neuroleptics act primarily on this dopamine system, and older neuroleptics, which have greater affinity for the D2 binding site, are associated with high risk for tardive dyskinesia. The D2 hypersensitivity hypothesis is also supported by evidence of a dose-response relationship, withdrawal effects, studies on D2 agonists and antagonists, animal studies, and genetic polymorphism research.

Given similar doses of the same neuroleptic individual differences still exist in the likelihood of developing tardive dyskinesia. Such individual differences may be due to genetic polymorphisms, which code for D2 receptor binding site affinity, or prior exposure to environmental toxins. Decreased functional reserve or cognitive dysfunction, associated with aging, mental retardation, alcohol and drug abuse, or traumatic head injuries, has also been shown to increase risk of developing the disorder among those treated with neuroleptics.

The available research seems to suggest that the concurrent prophylactic use of a neuroleptic and an antiparkinsonian drug is useless to avoid early extrapyramidal side-effects and may render the patient more sensitive to tardive dyskinesia. Since 1973 the use of these drugs have been found to be associated with the development of tardive dyskinesia (Crane, 1973). Since some of the symptoms of tardive dyskinesia can be interpreted as schizophrenia by doctors, they may prescribe additional neuroleptic drugs to treat it, leading to increased risk of more prevalent tardive dyskinesia. Several studies have indicated that long-term neuroleptic use is associated with both cognitive deterioration and atrophy of the brain.


We also have videos of what it looks like in previous posts. Hit the Labels.

Saturday, June 27, 2009

Rebound Effect: Discontinuation May Be WORSE Than Never Starting

The Rebound Effect

From Wiki

Note #14 (a 2006 Can J Clin Pharmacol Study) may interest Paxil/Seroxat campaigners.


REBOUND EFFECT:

is the tendency of a medication, when discontinued, to cause a return of the symptoms being treated (rebounding) more severe than before. Medications with a known rebound effect can be withdrawn gradually or in conjunction with another medication which does not exhibit a rebound effect. The symptom will be more pronounced after the medication is withdrawn than before it was used.

Sedative hypnotics

Rebound anxiety

Several anxiolytics and hypnotics have a rebound effect: For example, benzodiazepine withdrawal can cause severe anxiety and insomnia worse than the original insomnia or anxiety disorder. Approximately 70% of patients who discontinue a benzodiazepine experience a rebound effect. Rebound withdrawal can be a factor in chronic use of medications and drug dependence with patients taking the medications only to ward off withdrawal or rebound withdrawal effects.

Rebound insomnia

Rebound insomnia is insomnia that occurs following discontinuation of sedative substances taken to relieve primary insomnia. Regular use of these substances can cause a person to become dependent on its effects in order to fall asleep through the process of classical conditioning. Therefore, when a person has stopped taking the medication and is 'rebounding' from its effects, he or she may experience insomnia as a symptom of withdrawal. Occasionally, this insomnia may actually be worse than the insomnia the drug was intended to treat.

Common medicines known to cause this problem are Lunesta and Ambien, which are prescribed to people having difficulties falling or staying asleep. This phenomenon can also occur with regular use of anxiolytic drugs, such as benzodiazepines.

Daytime rebound

Rebound phenomena does not necessarily only occur on discontinuation of a prescribed dosage. For example day time rebound effects of anxiety, metallic taste, perceptual disturbances which are typical benzodiazepine withdrawal symptoms can occur the next day after a short acting benzodiazepine hypnotic wears off. Another example is early morning rebound insomnia which may occur when a rapidly eliminated hypnotic wears off which leads to rebounding awakeness forcing the person to become wide awake before he or she has had a full night's sleep. One drug which seems to be commonly associated with these problems is triazolam due to its high potency and ultra short half life but these effects can occur with other short acting hypnotic drugs. Quazepam due to its selectivity for type1 benzodiazepine receptors and long half life does not cause day time anxiety rebound effects during treatment, showing that half life is very important for determining whether a night time hypnotic will cause next day rebound withdrawal effects or not. Day time rebound effects are not necessarily mild but can sometimes produce quite marked psychiatric and psychological disturbances.

Stimulants

Rebound effects can also occur from stimulants such as methylphenidate or dextroamphetamine. Rebound effects from these medications can include psychosis, depression and a return of ADHD symptoms but in a temporarily exaggerated form. Up to a third of ADHD children experience a rebound effect when methylphenidate is withdrawn.

Antidepressants

Many antidepressants, such as SSRIs, can cause rebound depression or panic attacks and anxiety when discontinued.

alpha-2 adrenergic agents

Rebound effects can occur after discontinuation of alpha-2 adrenergic agents such as clonidine and guanfacine. The most notable rebound effect of alpha-2 adrenergic agents is rebound hypotension.

Others

Other rebound effects

An example is the use of highly potent corticosteroids, such as Clobetasol for psoriasis. Abrupt withdrawal can cause a much more severe case of the psoriasis to develop. Therefore, withdrawal should be gradual, diluting the medication with lotion perhaps, until very little actual medication is being applied.

Another example of pharmaceutical rebound is a rebound headache from painkillers when dose is lowered, medication wears off or the drug is abruptly discontinued.

Continuous usage of topical decongestants (nasal sprays) can lead to constant nasal congestion, known as Rhinitis medicamentosa.

See also

References

  1. ^ Kales A, Scharf MB, Kales JD (September 1978). "Rebound insomnia: a new clinical syndrome". Science (journal) 201 (4360): 1039–41. PMID 684426.
  2. ^ Tsutsui S (2001). "A double-blind comparative study of zolpidem versus zopiclone in the treatment of chronic primary insomnia". J. Int. Med. Res. 29 (3): 163–77. PMID 11471853. http://openurl.ingenta.com/content/nlm?genre=article&issn=0300-0605&volume=29&issue=3&spage=163&aulast=Tsutsui.
  3. ^ Hohagen F, Rink K, Käppler C, et al. (1993). "Prevalence and treatment of insomnia in general practice. A longitudinal study". Eur Arch Psychiatry Clin Neurosci 242 (6): 329–36. PMID 8323982.
  4. ^ Reber, Arthur S.; Reber, Emily S. (2001). Dictionary of Psychology. Penguin Reference. ISBN 0-140-51451-1.
  5. ^ Kales A, Soldatos CR, Bixler EO, Kales JD (April 1983). "Early morning insomnia with rapidly eliminated benzodiazepines". Science (journal) 220 (4592): 95–7. PMID 6131538.
  6. ^ Lee A, Lader M (January 1988). "Tolerance and rebound during and after short-term administration of quazepam, triazolam and placebo to healthy human volunteers". Int Clin Psychopharmacol 3 (1): 31–47. PMID 2895786.
  7. ^ Kales A (1990). "Quazepam: hypnotic efficacy and side effects". Pharmacotherapy 10 (1): 1–10; discussion 10–2. PMID 1969151.
  8. ^ Hilbert JM, Battista D (September 1991). "Quazepam and flurazepam: differential pharmacokinetic and pharmacodynamic characteristics". J Clin Psychiatry 52 Suppl: 21–6. PMID 1680120.
  9. ^ Adam K; Oswald I (May 1989). "Can a rapidly-eliminated hypnotic cause daytime anxiety?". Pharmacopsychiatry 22 (3): 115–9. doi:10.1055/s-2007-1014592. PMID 2748714.
  10. ^ Garland EJ (1998). "Pharmacotherapy of adolescent attention deficit hyperactivity disorder: challenges, choices and caveats". J. Psychopharmacol. (Oxford) 12 (4): 385–95. PMID 10065914.
  11. ^ Rosenfeld AA (February 1979). "Depression and psychotic regression following prolonged methylphenidate use and withdrawal: case report". Am J Psychiatry 136 (2): 226–8. PMID 760559. http://ajp.psychiatryonline.org/cgi/pmidlookup?view=long&pmid=760559.
  12. ^ Smucker WD, Hedayat M (September 2001). "Evaluation and treatment of ADHD". Am Fam Physician 64 (5): 817–29. PMID 11563573. http://www.aafp.org/afp/20010901/817.html.
  13. ^ Riccio CA, Waldrop JJ, Reynolds CR, Lowe P (2001). "Effects of stimulants on the continuous performance test (CPT): implications for CPT use and interpretation". J Neuropsychiatry Clin Neurosci 13 (3): 326–35. PMID 11514638. http://neuro.psychiatryonline.org/cgi/content/full/13/3/326.
  14. ^ Bhanji NH, Chouinard G, Kolivakis T, Margolese HC (2006). "Persistent tardive rebound panic disorder, rebound anxiety and insomnia following PAROXETINE WITHDRAWAL: a review of rebound-withdrawal phenomena". Can J Clin Pharmacol 13 (1): e69–74. PMID 16456219. http://www.cjcp.ca/pdf/CJCP_04-032_e69.pdf.
  15. ^ Vitiello B (April 2008). "Understanding the risk of using medications for attention deficit hyperactivity disorder with respect to physical growth and cardiovascular function" (PDF). Child Adolesc Psychiatr Clin N Am 17 (2): 459–74, xi. doi:10.1016/j.chc.2007.11.010. PMID 18295156. PMC: 2408826. http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2408826&blobtype=pdf.
  16. ^ Maizels M (December 2004). "The patient with daily headaches". Am Fam Physician 70 (12): 2299–306. PMID 15617293.

Friday, June 26, 2009

DÍNE NAVAJO: ABILIFY Is Coming: What Is ABILIFY?

The Atypical Antipsychotic Drug Abilify is Coming to the Four Corners Area.

See our label Mothers Act to understand Why.

Abilify, 1,182 Distinct Adverse Reactions

Between 2004 and 2006 the FDA MedWatch program received 3,979 Individual Safety Reports naming Abilify (aripiprazole) the Primary Suspect Drug for 1,182 distinct adverse reactions ranging from ageusia (loss of the sense of taste) to xanthopsia (visual defect in which everything appears yellow).

All 1,182 Abilify side effects are listed below in alphabetical order.


Abasia, Abdominal Discomfort, Abdominal Distension, Abdominal Pain, Abdominal Pain Upper, Abdominal Sepsis, Abnormal Behaviour, Abnormal Dreams, Abnormal Sensation In Eye, Abortion, Abortion Induced, Abortion Missed, Abortion Spontaneous, Acarodermatitis, Accident, Accidental DEATH, Accidental Drug Intake By Child, Accidental Exposure, Accidental Overdose, Accommodation Disorder, Acidosis, Acne, Activated Partial Thromboplastin Time Prolonged, Activated Partial Thromboplastin Time Shortened, Activities of Daily Living Impaired, Acute Coronary Syndrome, Acute Febrile Neutrophilic Dermatosis, Acute Generalised Exanthematous Pustulosis, Acute Myeloid Leukaemia, Acute Myocardial Infarction, Acute Psychosis, Acute Pulmonary Oedema, Acute Respiratory Distress Syndrome, Adrenal Carcinoma, Adrenergic Syndrome, Adverse Event, Affect Lability, Affective Disorder, Ageusia, Aggression, Agitation, Agoraphobia, Agranulocytosis, Akathisia, Akinesia, Alanine Aminotransferase Increased, Alcohol Interaction, Alcohol Poisoning, Alcohol Use, Alcohol Withdrawal Syndrome, Alcoholism, Alopecia, Alpha 1 Foetoprotein Amniotic Fluid Increased, Altered Visual Depth Perception, Amenorrhoea, Amnesia, Anaemia, Anaemia Macrocytic, Anal Atresia, Anaphylactic Reaction, Anaphylactic Shock, Anger, Angina Pectoris, Angioneurotic Oedema, Anhedonia, Anhidrosis, Anion Gap, Anorexia, Anorgasmia, Anosmia, Antepartum Haemorrhage, Anticonvulsant Drug Level Decreased, Anticonvulsant Drug Level Increased, Antidepressant Drug Level Increased, Antineutrophil Cytoplasmic Antibody Positive, Antipsychotic Drug Level Below Therapeutic, Antisocial Behaviour, Anxiety, Anxiety Disorder, Aortic Stenosis, Aortic Surgery, Aortic Valve Stenosis, Apathy, Aphasia, Aphonia, Apnoea, Appendicectomy, Appendicitis, Areflexia, Arnold-Chiari Malformation, Arrhythmia, Arterial Thrombosis, Arteriosclerosis, Arthralgia, Arthritis, Arthropathy, Aspartate Aminotransferase Increased, Asperger's Disorder, Asphyxia, Aspiration, Asthenia, Asthma, Astigmatism, Ataxia, Atrial Fibrillation, Atrial Flutter, Atrial Septal Defect, Atrial Tachycardia, Atrioventricular Block, Atrioventricular Block First Degree, Auricular Swelling, Autistic Disorder, Autonomic Failure Syndrome, Back Injury, Back Pain, Bacteria Urine Identified, Balance Disorder, Benign Intracranial Hypertension, Benign Prostatic Hyperplasia, Biliary Colic, Biliary Dilatation, Bipolar Disorder, Bipolar I Disorder, Bipolar II Disorder, Bladder Candidiasis, Bladder Prolapse, Bladder Spasm, Blepharospasm, Blindness, Blindness Transient, Blister, Blood Alkaline Phosphatase Increased, Blood Amylase Increased, Blood Bilirubin Abnormal, Blood Bilirubin Increased, Blood Calcium Decreased, Blood Catecholamines Decreased, Blood Chloride Increased, Blood Cholesterol Abnormal, Blood Cholesterol Increased, Blood Creatine Increased, Blood Creatine Phosphokinase Increased, Blood Creatinine Increased, Blood Culture Positive, Blood Disorder, Blood Fibrinogen Increased, Blood Glucose Abnormal, Blood Glucose Decreased, Blood Glucose Fluctuation, Blood Glucose Increased, Blood Human Chorionic Gonadotropin Decreased, Blood Iron Decreased, Blood Lactate Dehydrogenase Increased, Blood Magnesium Decreased, Blood Magnesium Increased, Blood PH Decreased, Blood Phosphorus Decreased, Blood Phosphorus Increased, Blood Potassium Decreased, Blood Potassium Increased, Blood Pressure Abnormal, Blood Pressure Decreased, Blood Pressure Diastolic Decreased, Blood Pressure Fluctuation, Blood Pressure Increased, Blood Pressure Systolic Decreased, Blood Pressure Systolic Increased, Blood Prolactin Decreased, Blood Prolactin Increased, Blood Sodium Decreased, Blood Sodium Increased, Blood Test Abnormal, Blood Thyroid Stimulating Hormone Increased, Blood Triglycerides Increased, Blood Urea Increased, Blood Urine, Blood Urine Present, Bloody Discharge, Blunted Affect, Body Height Increased, Body Temperature Decreased, Body Temperature Fluctuation, Body Temperature Increased, Bone Marrow Depression, Bone Pain, Bradycardia, Bradykinesia, Bradyphrenia, Brain Contusion, Brain Death, Brain Oedema, Breast Cancer, Breast Discharge, Breast Engorgement, Breast Feeding, Breast Pain, Breast Tenderness, Breech Presentation, Bronchitis, Bronchitis Acute, Bronchitis Chronic, Bronchopneumonia, Bronchospasm, Bruxism, Bulimia Nervosa, Bundle Branch Block, Bundle Branch Block Left, Bundle Branch Block Right, Burning Sensation, Burns Second Degree, Caesarean Section, Candidiasis, Carbon Dioxide Decreased, Carcinoma, Cardiac Arrest, Cardiac Arrest Neonatal, Cardiac DEATH, Cardiac Disorder, Cardiac Failure, Cardiac Failure Acute, Cardiac Failure Congestive, Cardiac Murmur, Cardiogenic Shock, Cardiomegaly, Cardiomyopathy, Cardio-Respiratory Arrest, Cardiotoxicity, Cardiovascular Disorder, Carotid Artery Dissection, Cataract, Catatonia, Cellulitis, Cerebellar Infarction, Cerebral Artery Embolism, Cerebral Infarction, Cerebrovascular Accident, Cerebrovascular Disorder, Chest Discomfort, Chest Pain, Chills, Choking, Cholangitis Acute, Cholecystectomy, Cholelithiasis, Cholinergic Syndrome, Chorea, Chromatopsia, Chromaturia, Chronic Obstructive Airways Disease, Circulatory Collapse, Clavicle Fracture, Clonus, Clostridium Colitis, Clumsiness, Coagulopathy, Cognitive Deterioration, Cognitive Disorder, Cogwheel Rigidity, Cold Sweat, Colitis Ulcerative, Collagen Disorder, Collapse of Lung, Coma, Communication Disorder, Compartment Syndrome, Completed SUICIDE, Complex Partial Seizures, Complications of Maternal Exposure To Therapeutic Drugs, Condition Aggravated, Conduction Disorder, Confusional State, Congenital Anomaly, Congenital Cystic Kidney Disease, Congenital Ectopic Bladder, Congestive Cardiomyopathy, Conjunctivitis, Constipation, Contusion, Conversion Disorder, C-Reactive Protein Increased, Convulsion, Coordination Abnormal, Coronary Artery Atherosclerosis, Coronary Artery Disease, Coronary Artery Occlusion, Cough, Creatinine Renal Clearance Decreased, Crohn's Disease, Croup Infectious, Crying, Cutaneous Lupus Erythematosus, Cyanosis, Cystitis, Cytolytic Hepatitis, Deafness, DEATH, DEATH Neonatal, Decreased Activity, Decreased Appetite, Deep Vein Thrombosis, Defaecation Urgency, Dehydration, Deja Vu, Delirium, Delusion, Dementia, Dementia Alzheimer's Type, Demyelination, Dental Caries, Depersonalisation, Depressed Level of Consciousness, Depressed Mood, Depression, Depressive Symptom, Dermatitis Exfoliative, Detoxification, Diabetes Insipidus, Diabetes Mellitus, Diabetes Mellitus Inadequate Control, Diabetes Mellitus Insulin-Dependent, Diabetes Mellitus Non-Insulin-Dependent, Diabetic Hyperglycaemic Coma, Diabetic Hyperosmolar Coma, Diabetic Ketoacidosis, Diabetic Neuropathy, Dialysis, Diarrhoea, Difficulty In Walking, Diplopia, Discomfort, Disease Recurrence, Disinhibition, Disorientation, Disseminated Intravascular Coagulation, Dissociation, Dissociative Disorder, Disturbance In Attention, Disturbance In Social Behaviour, Dizziness, Dizziness Postural, Drooling, Drowning, Drug Abuser, Drug Administration Error, Drug Dependence, Drug Effect Decreased, Drug Eruption, Drug Exposure During Pregnancy, Drug Exposure Via Breast Milk, Drug Hypersensitivity, Drug Ineffective, Drug Interaction, Drug Level Above Therapeutic, Drug Level Decreased, Drug Level Increased, Drug Screen False Positive, Drug Screen Positive, Drug Toxicity, Drug Withdrawal Syndrome, Dry Eye, Dry Mouth, Dry Skin, Dysaesthesia, Dysarthria, Dysfunctional Uterine Bleeding, Dysgeusia, Dysgraphia, Dyskinesia, Dyskinesia Oesophageal, Dysmenorrhoea, Dyspepsia, Dysphagia, Dysphasia, Dysphemia, Dysphonia, Dyspnoea, Dysstasia, Dystonia, Dysuria, Ear, Ear Infection, Ear Pain, Eating Disorder, Ecchymosis, Echocardiogram Abnormal, Economic Problem, Ectopic Pregnancy, Eczema, Eczema Infected, Ejaculation Delayed, Ejaculation Disorder, Ejection Fraction Decreased, Electrocardiogram Abnormal, Electrocardiogram Change, Electrocardiogram Pr Prolongation, Electrocardiogram Qrs Complex Prolonged, Electrocardiogram QT Corrected Interval Prolonged, Electrocardiogram QT Prolonged, Electrocardiogram QT Shortened, Electrocardiogram Repolarisation Abnormality, Electrocardiogram St Segment Depression, Electrocardiogram St Segment Elevation, Electrocardiogram T Wave Amplitude Decreased, Electrocardiogram T Wave Inversion, Electroencephalogram Abnormal, Electrolyte Imbalance, Embolic Stroke, Emotional Disorder, Emotional Distress, Encephalopathy, Encopresis, Endocarditis Bacterial, Enuresis, Eosinophil Count Increased, Epiglottic Oedema, Epilepsy, Epistaxis, Epstein-Barr Virus Infection Secretion, Erectile Dysfunction, Erection Increased, Erosive Oesophagitis, Erythema, Erythema Multiforme, Escherichia Urinary Tract Infection, Euphoric Mood, Excitability, Excoriation, Exercise Tolerance Decreased, Exhibitionism, Exophthalmos, Extraocular Muscle Disorder, Extrapyramidal Disorder, Extrasystoles, Eye Disorder, Eye Movement Disorder, Eye Pain, Eye Rolling, Eye Swelling, Eyelid Disorder, Eyelid Function Disorder, Eyelid Ptosis, Face Injury, Face Oedema, Facial Palsy, Facial Paresis, Facial Spasm, Factitious Disorder, Faecal Incontinence, Faecaloma, Faeces Discoloured, Failure To Thrive, Fall, False Positive Laboratory Result, Family Stress, Fatigue, Fear, Feeding Disorder, Feeding Disorder Neonatal, Feeling Abnormal, Feeling Cold, Feeling Drunk, Feeling Hot, Feeling Hot and Cold, Feeling Jittery, Feeling of Despair, Feelings of Worthlessness, Femur Fracture, Flat Affect, Flatulence, Flight of Ideas, Fluid Intake Reduced, Fluid Retention, Flushing, Foetal Alcohol Syndrome, Foetal Growth Retardation, Foetal Movements Decreased, Food Craving, Foot Fracture, Foreign Body Aspiration, Formication, Fracture, Frequent Bowel Movements, Furuncle, Gait Disturbance, Galactorrhoea, Gambling, Gamma-Glutamyltransferase Increased, Gastric Disorder, Gastritis, Gastroenteritis, Gastrointestinal Disorder, Gastrointestinal Haemorrhage, Gastrointestinal Pain, Gastroesophageal Reflux Disease, Gaze Palsy, General Physical Health Deterioration, Gilbert's Syndrome, Gingival Bleeding, Gingivitis, Glasgow Coma Scale Abnormal, Glaucoma, Glossitis, Glossodynia, Glucose Tolerance Impaired, Glycosylated Haemoglobin Increased, Grand Mal Convulsion, Grandiosity, Granulocytopenia, Granuloma, Grimacing, Groin Abscess, Gynaecomastia, Haematemesis, Haematochezia, Haematocrit Decreased, Haematocrit Increased, Haematoma, Haematuria, Haemoglobin Decreased, Haemoglobin Increased, Haemolysis, Haemolytic Anaemia, Haemorrhage, Haemorrhage Intracranial, Haemorrhage Subcutaneous, Hair Growth Abnormal, Halitosis, Hallucination, Hallucination (Auditory), Hallucination (Visual), Hallucinations (Mixed), Halo Vision, Head Banging, Head Injury, Headache, Heart Disease Congenital, Heart Rate Decreased, Heart Rate Increased, Heart Rate Irregular, Heart Transplant, Heat Stroke, Hemiparesis, Hemiplegia, Heparin-Induced Thrombocytopenia, Hepatic Enzyme Increased, Hepatic Failure, Hepatic Fibrosis, Hepatic Function Abnormal, Hepatic Mass, Hepatic Steatosis, Hepatitis, Hepatitis Acute, Hepatocellular Damage, Hepato-Lenticular Degeneration, Hepatomegaly, Hepatorenal Failure, Hepatotoxicity, Herpes Zoster, Hiccups, High Density Lipoprotein Decreased, High Density Lipoprotein Increased, High-Pitched Crying, Hip Arthroplasty, Hirsutism, Hoarseness, Homicidal Ideation, HOMICIDE, Hospitalisation, Hostility, Hot Flush, Humerus Fracture, Hunger, Hyperacusis, Hyperaesthesia, Hypercalcaemia, Hyperchloraemia, Hyperchlorhydria, Hyperglycaemia, Hyperglycaemic Hyperosmolar Nonketotic Syndrome, Hyperhidrosis, Hyperkalaemia, Hyperkinesia, Hyperlipidaemia, Hypernatraemia, Hyperphagia, Hyperprolactinaemia, Hyperpyrexia, Hyperreflexia, Hypersensitivity, Hypersomnia, Hypertension, Hypertensive Crisis, Hypertensive Encephalopathy, Hypertensive Heart Disease, Hyperthermia, Hyperthyroidism, Hypertonia, Hypertrophy Breast, Hyperventilation, Hypervigilance, Hypoacusis, Hypoaesthesia, Hypoaesthesia Oral, Hypoalbuminaemia, Hypoglycaemia, Hypokalaemia, Hypokinesia, Hypomania, Hypomenorrhoea, Hyponatraemia, Hypoplastic Anaemia, Hypoproteinaemia, Hyporeflexia, Hypotension, Hypothermia, Hypothyroidism, Hypotonia, Hypotonic-Hyporesponsive Episode, Hypoventilation, Hypovolaemia, Hypovolaemic Shock, Hypoxia, Ileus, Ileus Paralytic, Ill-Defined Disorder, Illusion, Impaired Driving Ability, Impaired Gastric Emptying, Impaired Self-Care, Impaired Work Ability, Impatience, Impulse-Control Disorder, Impulsive Behaviour, Inappropriate Affect, Inappropriate Antidiuretic Hormone Secretion, Incoherent, Incontinence, Incorrect Dose Administered, Increased Appetite, Increased Tendency To Bruise, Increased Upper Airwayancreatic Pseudocyst Infection, Influenza, Influenza Like Illness, Inhalation Therapy, Injury, Injury Asphyxiation, Insomnia, Insulin Resistance, Intentional Drug Misuse, Intentional Misuse, Intentional Overdose, Intentional Self-Injury, Intercepted Drug Dispensing Error, International Normalised Ratio Decreased, International Normalised Ratio Fluctuation, International Normalised Ratio Increased, Interstitial Lung Disease, Intervertebral Disc Disorder, Intestinal Obstruction, Intracranial Pressure Increased, Intraocular Pressure Increased, Intraocular Pressure Test, Intra-Uterine DEATH, Irritability, Irritable Bowel Syndrome, Ischaemic Stroke, Jaundice, Jaw Disorder, Joint Hyperextension, Joint Sprain, Joint Stiffness, Joint Swelling, Ketonuria, Kidney Malformation, Kidney Transplant Rejection, Knee Operation, Labile Blood Pressure, Laboratory Test Abnormal, Laceration, Lack of Satiety, Lacrimation Increased, Lactic Acidosis, Lacunar Infarction, Laryngospasm, Legal Problem, Lethargy, Leukocytosis, Leukopenia, Libido Increased, Limb Malformation, Lipase Increased, Liver Disorder, Liver Function Test Abnormal, Lobar Pneumonia, Locked-In Syndrome, Logorrhoea, Loss of Consciousness, Loss of Libido, Low Density Lipoprotein Increased, Lower Limb Fracture, Lower Respiratory Tract Infection, Lung Disorder, Lung Neoplasm Malignant, Lupus-Like Syndrome, Lymphadenopathy, Macrocytosis, Macroglossia, Major Depression, Malaise, Malnutrition, Mania, Markedly Reduced Dietary Intake, Masked Facies, Maternal Condition Affecting Foetus, Maternal Drugs Affecting Foetus, Mean Cell Haemoglobin Decreased, Mean Cell Volume Decreased, Medication Error, Memory Impairment, Meningomyelocele, Menorrhagia, Menstrual Disorder, Menstruation Irregular, Mental Disorder, Mental Impairment, Mental Retardation Severity Unspecified, Mental Status Changes, Metabolic Acidosis, Metabolic Disorder, Metabolic Encephalopathy, Metrorrhagia, Microcephaly, Micrographia, Micturition Disorder, Micturition Urgency, Middle Insomnia, Migraine, Miosis, Mitral Valve Incompetence, Moaning, Mobility Decreased, Mononeuritis, Mood Altered, Mood Swings, Morbid Thoughts, Motor Dysfunction, Mouth Haemorrhage, Movement Disorder, Multi-Organ Failure, Multiple Allergies, Multiple Congenital Abnormalities, Multiple Drug Overdose, Multiple Drug Overdose Intentional, Multiple Fractures, Munchausen's Syndrome, Muscle Atrophy, Muscle Contractions Involuntary, Muscle Contracture, Muscle Cramp, Muscle Fatigue, Muscle Hypertrophy, Muscle Rigidity, Muscle Spasms, Muscle Strain, Muscle Tightness, Muscle Twitching, Muscular Weakness, Musculoskeletal Pain, Musculoskeletal Stiffness, Mutism, Myalgia, Myasthenia Gravis, Mydriasis, Myeloid Maturation Arrest, Myocardial Infarction, Myocardial Ischaemia, Myoclonus, Myoglobin Blood Increased, Myoglobin Urine Present, Myopia, Myositis, Nail Discolouration, Nasal Congestion, Nasopharyngitis, Nausea, Neck Deformity, Neck Pain, Negative Thoughts, Neonatal Disorder, Neonatal Oversedation, Neonatal Respiratory Distress Syndrome, Neoplasm Malignant, Nephritis, Nephrolithiasis, Nervous System Disorder, Nervousness, Neuroleptic Malignant Syndrome, Neuropathy, Neuropathy Peripheral, Neutropenia, Neutropenic Sepsis, Neutrophil Count Decreased, Neutrophil Count Increased, Night Sweats, Nightmare, Nipple Pain, No Adverse Effect, No Therapeutic Response, Nocturia, Nodding of Head, Normal Newborn, Nose and Throat Examination Abnormal, Nuchal Rigidity, Nystagmus, Obsessive Thoughts, Obsessive-Compulsive Disorder, Obstructive Airways Disorder, Ocular Hypertension, Oculogyration, Odynophagia, Oedema, Oedema Peripheral, Oesophageal Disorder, Oesophageal Spasm, Oesophagitis, Oligomenorrhoea, Onychorrhexis, Optic Neuritis, Oral Candidiasis, Oral Discomfort, Oral Infection, Oral Intake Reduced, Organ Failure, Orgasm Abnormal, Oropharyngeal Spasm, Orthopnoea, Orthostatic Hypotension, Orthostatic Proteinuria, Osteoarthritis, Otitis Media, Ovarian Cyst, Overdose, Oxygen Saturation Decreased, Pain, Pain In Extremity, Pain In Jaw, Pain of Skin, Painful Erection, Pallor, Palpitations, Pancreatitis, Pancreatitis Acute, Pancreatitis Necrotising, Pancytopenia, Panic Attack, Panic Disorder, Papilloedema, Paradoxical Drug Reaction, Paraesthesia, Paralysis, Paranasal Sinus Hypersecretion, Paranoia, Paraphilia, Parkinsonian Gait, Parkinsonian Rest Tremor, Parkinsonism, Parkinson's Disease, Patient Restraint, Penile Pain, Performance Status Decreased, Pericardial Effusion, Pericarditis, Periostitis, Peripheral Coldness, Peripheral Vascular Disorder, Peritonitis, Persecutory Delusion, Personality Change, Personality Disorder, Petit Mal Epilepsy, Phaeochromocytoma, Phagophobia, Pharyngeal Oedema, Pharyngitis Streptococcal, Pharyngolaryngeal Pain, Phlebitis, Phobia of Driving, Photophobia, Photopsia, Photosensitivity Reaction, Physical Assault, Pigmentation Disorder, Pitting Oedema, Pituitary Tumour, Platelet Aggregation Decreased, Platelet Count Decreased, Platelet Count Increased, Pleural Effusion, Pleurothotonus, Pneumonia, Pneumonia Aspiration, Pneumonitis, Poisoning, Pollakiuria, Polycystic Ovaries, Polycythaemia, Polydipsia, Polydipsia Psychogenic, Polymenorrhoea, Polytraumatism, Polyuria, Poor Peripheral Circulation, Poor Personal Hygiene, Poor Quality Drug Administered, Poriomania, Porphyria, Post Procedural Haemorrhage, Postoperative Infection, Post-Traumatic Stress Disorder, Posture Abnormal, Pregnancy, Premature Baby, Premature Ejaculation, Premature Labour, Premature Rupture of Membranes, Prescribed Overdose, Priapism, Procedural Complication, Prothrombin Level Decreased, Prothrombin Time Prolonged, Pruritus, Pruritus Generalised, Pseudoporphyria, Psoriasis, Psychiatric Symptom, Psychomotor Hyperactivity, Psychomotor Retardation, Psychomotor Skills Impaired, Psychosocial Support, Psychotic Disorder, Pulmonary Artery Thrombosis, Pulmonary Embolism, Pulmonary Fibrosis, Pulmonary Hypertension, Pulmonary Oedema, Pulse Abnormal, Pulse Absent, Pupil Fixed, Pupillary Reflex Impaired, Pyrexia, Pyromania, Rash, Rash Erythematous, Rash Generalised, Rash Maculo-Papular, Rash Papular, Rash Pruritic, Rash Pustular, Rash Scaly, Rash Vesicular, Reading Disorder, Rebound Effect, Rectal Haemorrhage, Red Blood Cell Count Increased, Red Blood Cell Sedimentation Rate Increased, Refusal of Treatment By Patient, Refusal of Treatment By Relative, Renal Disorder, Renal Failure, Renal Failure Acute, Renal Pain, Renal Tubular Necrosis, Respiration Abnormal, Respiratory Acidosis, Respiratory Arrest, Respiratory Depression, Respiratory Disorder, Respiratory Distress, Respiratory Failure, Respiratory Rate Decreased, Respiratory Rate Increased, Restless Legs Syndrome, Restlessness, Retching, Retinal Disorder, Retinal Vein Occlusion, Rhabdomyolysis, Rheumatoid Arthritis, Rhinitis, Rhinorrhoea, Road Traffic Accident, Salivary Hypersecretion, Schizoaffective Disorder, SCHIZOPHRENIA, Screaming, Sedation, Self Esteem Decreased, Self Injurious Behaviour, Self Mutilation, Self-Induced Vomiting, Self-Injurious Ideation, Self-Medication, Sensation of Blood Flow, Sensation of Foreign Body, Sensation of Heaviness, Sensory Disturbance, Sensory Loss, Sepsis, Serotonin Syndrome, Sexual Dysfunction, Shock, Sick Sinus Syndrome, Simple Partial Seizures, Sinus Arrhythmia, Sinus Bradycardia, Sinus Congestion, Sinus Pain, Sinus Tachycardia, Sinusitis, Skin Discolouration, Skin Disorder, Skin Haemorrhage, Skin Hyperpigmentation, Skin Laceration, Skin Ulcer, Skin Warm, Skull Fracture, Skull Fractured Base, Sleep Disorder, Sleep Talking, Sleep Terror, Sleep Walking, Small for Dates Baby, Smoker, Snoring, Social Avoidant Behaviour, Social Fear, Social Phobia, Social Problem, Soliloquy, Somatoform Disorder, Somnolence, Speech Disorder, Spina Bifida, Splenic Infarction, Splenic Injury, Splenomegaly, Spontaneous Penile Erection, Staphylococcal Bacteraemia, Staphylococcal Infection, Staring, Starvation, Status Epilepticus, Stevens-Johnson Syndrome, Stillbirth, Stomach Discomfort, Stomatitis, Strabismus, Stress, Stress Symptoms, Stupor, Subclavian Artery Thrombosis, Subileus, Sudden Cardiac DEATH, Sudden DEATH, Suffocation Feeling, Suicidal Ideation, SUICIDE Attempt, Sunburn, Superior Sagittal Sinus Thrombosis, Supraventricular Tachycardia, Suspiciousness, Swelling, Swelling Face, Swollen Tongue, Syncope, Syndactyly, Synostosis, Syphilis Test Positive, Systemic Lupus Erythematosus, Tachycardia, Tachypnoea, Tardive Dyskinesia, Tearfulness, Temperature Intolerance, Tension, Therapeutic Agent Toxicity, Therapeutic Response Decreased, Therapy Non-Responder, Therapy Regimen Changed, Thermal Burn, Thinking Abnormal, Thirst, Thought Blocking, Throat Tightness, Thrombocythaemia, Thrombocytopenia, Thrombophlebitis, Thrombosis, Thyroid Neoplasm, Tic, Tinnitus, Tongue Biting, Tongue Disorder, Tongue Dry, Tongue Oedema, Tongue Paralysis, Tongue Spasm, Tooth Discolouration, Tooth Disorder, Tooth Fracture, Torsade De Pointes, Torticollis, Tourette's Disorder, Toxic Epidermal Necrolysis, Trance, Transaminases Increased, Transient Ischaemic Attack, Traumatic Brain Injury, Treatment Noncompliance, Tremor, Tricuspid Valve Incompetence, Trismus, Trisomy 21, Troponin Increased, Tuberous Sclerosis, Tunnel Vision, Twin Pregnancy, Tympanic Membrane Perforation, Ulcer, Ultrasound Foetal, Umbilical Cord Abnormality, Unexpected Therapeutic Drug Effect, Univentricular Heart, Unresponsive To Pain Stimuli, Unresponsive To Verbal Stimuli, Upper Limb Fracture, Upper Respiratory Tract Infection, Urinary Incontinence, Urinary Retention, Urinary Tract Infection, Urine Analysis Abnormal, Urine Ketone Body Present, Urine Output Decreased, Urine Output Increased, Urosepsis, Urticaria, Urticaria Generalised, Vaginal Haemorrhage, Vasculitis, Ventricular Arrhythmia, Ventricular Extrasystoles, Ventricular Hypertrophy, Ventricular Pre-Excitation, Ventricular Septal Defect, Ventricular Tachycardia, Verbal Abuse, Vertigo, Very Low Density Lipoprotein Increased, VICTIM OF HOMICIDE, Viral Infection, Vision Blurred, Visual Acuity Reduced, Visual Disturbance, Visual Field Defect, Vith Nerve Paralysis, Vitiligo, Vomiting, Vomiting Projectile, Water Intoxication, Weight Decreased, Weight Increased, Weight Loss Poor, Wheezing, White Blood Cell Count Decreased, White Blood Cell Count Increased, Wolff-Parkinson-White Syndrome, Wound, Xanthopsia, Yawning.


Abilify's top 20 side effects reported to MedWatch between Jan. 2004 and Dec. 2006:

Insomnia - 171 Cases
Increased Weight - 155 Cases
Tremor - 150 Cases
Dystonia - 132 Cases
Nausea - 110 Cases
Psychotic Disorder - 106 Cases
Dyskinesia - 103 Cases
Tardive Dyskinesia - 101 Cases
Neuroleptic Malignant Syndrome - 99 Cases
Completed Suicide - 98 Cases
Agitation - 97 Cases
Extrapyramidal Disorder - 86 Cases
Vomiting - 86 Cases
Convulsion - 81 Cases
Somnolence - 78 Cases
Dizziness - 76 Cases
Drug Ineffective - 76 Cases
Drug Interaction - 76 Cases
Anxiety - 73 Cases
Akathisia - 72 Cases

Thanks to psychdrugdangers.com and bonkersinstitute.org for making the MedWatch data available to the public.