you don't use it very frequently because you don't consider it as effective for acute psychosis as other antipsychotics, and the reason you feel this way is because that's what others(probably your last few attendings) told you.
There are other reasons for this, namely in that on an inpatient psychiatric unit, you're constantly chasing your tail with Abilify because it has a 75-hour half-life. Two-weeks after you start a dose, you get a steadystate level. By that time, the patient is likely long gone from the inpatient unit.
I like Abilify on the outpatient side. I've had multiple patients who have gained large amounts of weight successfully transition from risperidone to Abilify or Zyprexa to Abilify, maintain their level of functioning, and lose a lot of weight.
One of my biggest "minor successes" began to clean his home, walk to the grocery store, occasionally walk in the park, and spend more time around his support group after losing 45 pounds on transitioning to Abilify, largely because his knees and back stopped hurting him. Yes, I push my patients to be physically active and get some sunshine, so that plays a role, as well.
The idea of monthly injectables is also appealing. I have many a patient where it's a hardship on the fmaily to take them to the clinic every two weeks. Once monthly injections would be welcome. You also will likely have fewer patients going off their meds and showing up in the hospital after doing such. Granted, PAC teams do far more than inject patients, but I guess if the budget gets slashed, monthly injectables at least ensure twice as many patients get injections as Consta on the same budget / number of workers.
Yes, we have Invega Sustena with all the weight gain and Zyprexa Relprevv with more weightgain and a risk for coma. I welcome the atypicals with ligher metabolic profiles.
