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Perphenazine vs Abilify

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Overview

Perphenazine Details

Abilify Details

Comparative Analysis

Perphenazine Prescription Information

Abilify Prescription Information

Perphenazine Side Effects

Abilify Side Effects

Safety and Precautions

Cost Analysis

Market Analysis

Summary

Introduction

For patients with psychotic disorders such as schizophrenia, certain medications that modify the concentrations of neurotransmitters in the brain can help manage symptoms and improve quality of life. Perphenazine and Abilify are two such drugs often prescribed for these conditions. They each impact different neurotransmitters in the brain, but both have effects that can stabilize mood and reduce psychosis-related symptoms. Perphenazine is a typical antipsychotic that works primarily by blocking dopamine receptors in the brain, reducing overactivity of this neurotransmitter thought to be related to psychotic symptoms. Abilify (aripiprazole), on the other hand, is an atypical antipsychotic drug which acts as a partial agonist at dopamine D2 receptors and serotonin 5-HT1A receptors while also being an antagonist at serotonin 5-HT2A receptor, providing a balance effect on these key neurotransmitters involved in psychosis.

Perphenazine vs Abilify Side By Side

AttributeTrilafonAbilify
Brand NameTrilafonAbilify
ContraindicationsShould not be taken with strong CYP2D6 inhibitors (e.g., quinidine) and strong CYP3A4 inhibitors (e.g., itraconazole).Should not be taken with strong CYP2D6 inhibitors (e.g., quinidine) and strong CYP3A4 inhibitors (e.g., itraconazole).
CostAbout $7/day for brand name, as low as about $1.50/day for genericAbout $23–$46 per day for brand name, $2 to $4 per day for generic
Generic NamePerphenazineAripiprazole
Most Serious Side EffectSevere nervous system reactions including very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.Symptoms of neuroleptic malignant syndrome (NMS), a rare but serious condition that can cause high fever, stiff muscles, sweating, confusion, and fast heartbeats.
Severe Drug InteractionsMay worsen symptoms of depression, increase suicidal ideation. Requires caution with medications that can lower the seizure threshold or those that can cause electrolyte imbalance.Risk of worsening depression or suicidal thoughts, especially in young adults. Interaction with medications that may increase the risk of serotonin syndrome.
Typical Dose4-8 mg/day up to a maximum of 64 mg/day for adults. 2-3 mg per day for children aged 12 and older.10–15 mg/day up to a maximum of 30mg/day. For pediatric patients, starting at about 2mg per day.

What is Perphenazine?

Perphenazine (the generic name for Trilafon) is an antipsychotic medication, part of a class known as phenothiazines, and was one of the first drugs used to treat serious mental disorders like schizophrenia. It was initially approved by the FDA in 1957. Perphenazine works by blocking dopamine receptors in the brain, effectively reducing its excess levels which are often associated with mental health disorders. It's prescribed for treating psychotic disorders such as schizophrenia and severe nausea and vomiting in adults.

Aripiprazole (the generic name for Abilify), on the other hand, is a newer generation or 'atypical' antipsychotic authorized by the FDA in 2002. Unlike perphenazine that primarily targets dopamine receptors only, aripiprazole acts on both serotonin and dopamine receptors thereby producing more balanced effects with fewer side effects than older medications like perphenazine that have stronger influences solely on dopamine neurotransmitters.

What conditions is Perphenazine approved to treat?

Perphenazine is approved for the treatment of various mental/mood disorders:

  • Schizophrenia

  • Severe nausea and vomiting in adults (as an antiemetic)

  • Non-psychotic anxiety On the other hand, Abilify (Aripiprazole) is used to treat certain mood/mental disorders:

  • Schizophrenia

  • Bipolar disorder

  • Tourette’s disorder

  • Irritability associated with autistic disorder.

How does Perphenazine help with these illnesses?

Perphenazine is an antipsychotic medication that helps to manage symptoms of schizophrenia by adjusting the levels of dopamine in certain areas of the brain. It does this by blocking dopamine receptors, which prevents excessively high levels of dopamine from over-stimulating these receptors. Dopamine is a neurotransmitter, a chemical messenger in the brain and throughout the body, that plays significant roles in mood regulation, cognition, reward-driven learning, and motor control. People with schizophrenia often have irregularities in their dopamine system; thus, perphenazine can help regulate this imbalance and alleviate some symptoms associated with this condition. On the other hand, Abilify (Aripiprazole) works slightly differently: it acts as both partial agonist at D2 type dopamine receptors and serotonin 5-HT1A receptors but also as antagonist on serotonin 5-HT2A receptor. This unique mechanism allows it to increase or decrease dopaminergic activity depending on its level—therefore potentially leading to fewer side effects compared to traditional antipsychotics like Perphenazine.

What is Abilify?

Abilify, also recognized as aripiprazole, is an atypical antipsychotic and partial dopamine agonist. This means that it partially activates the dopamine receptors in the brain without overstimulating them. It also modulates serotonin levels by acting on serotonin receptors. Abilify gained FDA approval in 2002 for use in schizophrenia treatment and has since been approved for other applications such as bipolar disorder, major depressive disorder, and irritability associated with autistic disorders.

Unlike perphenazine which is a typical antipsychotic known to block various neurotransmitters including dopamine causing more side effects like extrapyramidal symptoms (involuntary muscle movements), Abilify’s unique mechanism of action allows it to balance both dopamine and serotonin levels thereby reducing these kinds of side effects while still remaining effective. Its less sedative effect compared to typical antipsychotics like perphenazine can be beneficial especially for patients who have issues with excessive sedation or those who need a clearer mind during daytime.

What conditions is Abilify approved to treat?

Abilify, also known as aripiprazole, has gained approval from authorities for the treatment of several conditions:

  • Schizophrenia
  • Bipolar disorder
  • Major depressive disorder (MDD), as an adjunctive therapy to antidepressants.
  • Irritability associated with autistic disorders in pediatric patients.

How does Abilify help with these illnesses?

Abilify (Aripiprazole) is a medication that primarily targets dopamine and serotonin receptors, playing important roles in mood regulation, reward-seeking behaviors, and motivation. As with norepinephrine, imbalance of these neurotransmitters has been implicated in mental health disorders like schizophrenia and bipolar disorder. Abilify works by stabilizing the levels of dopamine and serotonin available in the brain, thereby alleviating some symptoms associated with these conditions. Its action as an agonist-antagonist on certain dopamine and serotonin receptors may also play a significant role in its effectiveness as an antipsychotic drug. Since it also affects other neurotransmitter systems such as adrenergic and histaminergic ones to lesser degrees than typical antipsychotics like perphenazine do, Abilify often results in fewer side effects such as sedation or weight gain. It can be used when a patient does not respond well to "typical" antipsychotics or may be combined with them for better efficacy.

How effective are both Perphenazine and Abilify?

Perphenazine and aripiprazole (Abilify) are both antipsychotic medications, but they belong to different generations and have distinct mechanisms of action. Perphenazine is a typical or first-generation antipsychotic that was initially approved by the FDA in 1957, while aripiprazole is an atypical or second-generation antipsychotic approved in 2002.

A double-blind clinical trial conducted in 2006 compared the efficacy of perphenazine with several newer drugs including aripiprazole. In this study, it was reported that all tested drugs resulted in similar improvements for patients suffering from schizophrenia. No significant differences were observed between these two specific drugs with respect to their ability to manage psychotic symptoms.

A meta-analysis done on perphenazine studies showed it to be effective beginning from the onset of treatment, though its side effect profile includes extrapyramidal symptoms such as tremors and restlessness more frequently than many newer antipsychotics like Abilify. Nonetheless, perphenazine has demonstrated effectiveness over time and remains useful particularly for those who respond poorly to other treatments.

On the other hand, research into Abilify suggests it holds comparable efficacy to other popular atypical antipsychotics on multiple parameters. However, due to its unique pharmacological profile as a partial dopamine agonist unlike most others which are antagonists - some consider Abilify after trying first-line options without success or if certain common side effects like metabolic syndrome associated with most atypicals need avoiding.

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At what dose is Perphenazine typically prescribed?

Oral dosages of Perphenazine for adults typically start from 4-8 mg/day and can be increased slowly to a maximum of 64 mg/day based on patient response. Children aged 12 and older may be started at lower doses, usually around 2-3 mg per day, depending on their weight and severity of symptoms. For Abilify (Aripiprazole), adult oral dosage starts from a range of 10–15 mg/day which is generally sufficient in treating psychotic disorders. Pediatric patients aged between 13 to17 years may begin with smaller doses, often starting at about 2mg per day. Increases can occur after two weeks if there is no noticeable improvement in symptoms, but the maximum daily dose should not exceed more than 30mg.

At what dose is Abilify typically prescribed?

Abilify treatment is typically initiated at a dosage of 10–15 mg/day. The dose can then be increased up to a maximum of 30mg/day, divided into two doses, spaced about 12 hours apart. This increase may only occur if there is no response to the initial treatment after several weeks. In some cases, when treating schizophrenia or bipolar disorder in adults for instance, the recommended starting and maintenance dose is 15 mg once daily as monotherapy and 10mg to 15mg once daily as an adjunctive therapy with lithium or valproate. Always consult your healthcare provider before making any changes to medication dosages.

What are the most common side effects for Perphenazine?

Common side effects of Perphenazine can include:

  • Blurred vision
  • Constipation
  • Drowsiness, fatigue or weakness
  • Dry mouth
  • Nausea or vomiting
  • Skin rash or itching
  • Unusual secretion of milk (in females)

On the other hand, common side effects associated with Abilify are:

  • Anxiety and nervousness
  • Insomnia (trouble sleeping)
  • Headache
  • Restlessness or feeling the need to move constantly
  • Dizziness, drowsiness, weakness
  • Nausea, vomiting, changes in appetite
  • Constipation

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Perphenazine?

Although both Perphenazine and Abilify are used to treat mental/mood disorders, they come with their own sets of potential side effects. For instance:

  • Increased thoughts about suicide or self-harm: Although rare, this can happen particularly in people under 24 who just started the treatment or when doses are changed.
  • Signs of allergic reaction or severe skin reaction to either drug: These may include hives, difficult breathing, swelling in your face or throat; fever; sore throat; burning eyes; skin pain; red or purple skin rash with blistering and peeling.
  • Eye problems such as blurred vision, tunnel vision, eye pain or swelling could be signs of serious conditions that require immediate medical attention.
  • Cardiovascular symptoms like fast heartbeats, fluttering in your chest, shortness of breath and sudden dizziness might indicate serious heart issues.
  • Low sodium levels - Symptoms like headache confusion slurred speech severe weakness vomiting loss of coordination feeling unsteady should prompt you to seek medical help immediately
  • Severe nervous system reactions including very stiff (rigid) muscles high fever sweating confusion fast uneven heartbeats tremors feeling like you might pass out is a sign that something isn't right. Seek emergency care right away. -Symptoms associated with serotonin syndrome which include agitation hallucinations fever sweating shivering fast heart rate muscle stiffness twitching loss of coordination nausea vomiting diarrhea need urgent treatment.

In case any such symptoms appear after taking either Perphenazine or Abilify medication it's imperative to consult your doctor promptly for further guidance.

What are the most common side effects for Abilify?

Side effects associated with Abilify can include:

  • Dry mouth, stuffy nose
  • Headache or light-headedness
  • Nausea, vomiting, changes in appetite and weight (either loss or gain)
  • Sleep problems such as insomnia
  • Tremors, restlessness or feeling anxious
  • Fast heartbeat
  • Constipation and other digestive problems
  • Blurred vision
  • Increased frequency of urination -Sweating excessively -Pain in the muscles or joints.

It's essential to understand that these side effects are potential but not guaranteed. Many people using this medication do not experience severe side effects. Always consult with a healthcare provider for personalized advice before starting any new medication regimen.

Are there any potential serious side effects for Abilify?

Abilify (aripiprazole) is an antipsychotic medication used to treat conditions like schizophrenia and bipolar disorder. However, some people may experience severe side effects when taking Abilify. These may include:

  • Allergic reactions such as hives, itching, fever or swollen glands
  • Breathing difficulty or swelling in your face or throat
  • Unusual mood changes that could lead to suicidal thoughts
  • Seizures
  • Eye pain, blurred vision or seeing halos around lights
  • Fast heartbeat rate which might indicate a medical emergency
  • Symptoms of neuroleptic malignant syndrome (NMS), a rare but serious condition that can cause high fever, stiff muscles, sweating, confusion and fast heartbeats.

If you notice any of these symptoms after taking Abilify it's important to get immediate medical attention. Also note that stopping this medication suddenly can cause withdrawal symptoms. Always consult with your doctor before making any adjustments to the dosage.

Contraindications for Perphenazine and Abilify?

Both perphenazine and Abilify, along with most other antipsychotic medications, may worsen symptoms of depression in some people. If you notice your depression worsening or an increase in suicidal ideation, thoughts, or behavior while taking these drugs, please seek immediate medical attention.

Neither perphenazine nor Abilify should be taken if you are using certain types of medications such as strong CYP2D6 inhibitors (e.g., quinidine) and strong CYP3A4 inhibitors (e.g., itraconazole). Always inform your physician about all the medications or substances you are currently consuming; it requires time for these substances to clear from the system to prevent potentially harmful interactions with either perphenazine or Abilify. It's also critical that both these medicines aren't stopped abruptly without doctor's advice as this could lead to withdrawal symptoms.

How much do Perphenazine and Abilify cost?

For the brand name versions of these drugs:

  • The price for 60 tablets of Abilify (5mg) averages around $1400, which works out to be approximately $23–$46 per day, depending on your dose.
  • The price for 30 capsules of Perphenazine (8 mg) is about $200, averaging at roughly $7/day.

Thus, if you are in the higher dosage range for Abilify (i.e., 10 mg/day or higher), then brand-name Perphenazine is less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which of these drugs is right for you.

For the generic versions of Perphenazine and Abilify costs are significantly lower:

  • Aripiprazole (generic version of Abilify; 5mg tablets) can be bought in packs starting from 30 tablets and above with approximate costs ranging between $2 to $4 per day based on usual dosages between 5 to15 mg/day.
  • Generic Perphenazine starts from as low as about $1.50/day when bought in larger quantities. Not exceeding more than an average cost estimate of about $3/day even if you're taking typical doses.

Popularity of Perphenazine and Abilify

Perphenazine, a typical antipsychotic medication, and Aripiprazole, under the brand name Abilify and considered an atypical antipsychotic, are both used in the treatment of various psychiatric disorders.

Aripiprazole (Abilify) was estimated to have been prescribed to about 7 million people in the US in 2020. It accounted for just over 14% of atypical antipsychotic prescriptions in the US. However, it appears to be one of the most common “atypical” antipsychotics (not classified as a first-generation or typical class of antipsychotics). The prevalence of Aripiprazole has been generally increasing since its introduction.

On the other hand, Perphenazine was prescribed to fewer patients compared to Aripiprazole. In 2020 alone it was given to approximately half a million people across USA. Given its status as one of many first-generation or "typical" antipsychotics available on market today, perphenazine accounts for just under 5% of this older class prescriptions overall nationwide. Its use has remained relatively steady over time with minor fluctuations due likely more due changes within prescribing habits rather than drug efficacy itself.

Conclusion

Both Perphenazine and Abilify (aripiprazole) have long-standing records of usage in patients with psychological disorders such as schizophrenia, bipolar disorder, and severe depression. They are backed by numerous clinical studies indicating their effectiveness over placebo treatments. While both drugs can be used in combination therapies, this requires careful consideration by a physician due to potential drug interactions.

Perphenazine is a typical antipsychotic that primarily blocks dopamine receptors, whereas Abilify is an atypical antipsychotic acting on both dopamine and serotonin receptors. This unique mechanism of action makes Abilify suitable for use as an adjunct therapy to antidepressants in cases of treatment-resistant depression.

Both medications are available in generic form offering significant cost savings for patients, especially those paying out of pocket. It's worth noting that the effects may not be immediately noticeable; hence it could require some adjustment period for the full benefits to manifest.

Although their side effect profiles are somewhat similar - including drowsiness, weight changes or extrapyramidal symptoms -Abilify tends to have fewer incidences of these adverse reactions than perphenazine. However, all patients must closely monitor any changes in mood or behavior while taking these medications and seek immediate medical attention if they notice worsening mental health symptoms.

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