Erin Crown, PA-C, CAQ-Psychiatry is a paid consultant of ®2024 Otsuka America Pharmaceutical, Inc. and Lundbeck, manufacturers of
ABILIFY ASIMTUFII® (aripiprazole) and
ABILIFY MAINTENA® (aripiprazole). Please see IMPORTANT SAFETY INFORMATION, including BOXED WARNING for INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS, for
ABILIFY ASIMTUFII and ABILIFY MAINTENA below.

October 10th marks World Mental Health Day, a global movement that provides the opportunity to raise awareness for mental health issues and support individuals managing complex mental health conditions. This observance also aims to reduce the stigma surrounding the many mental health disorders that affect people worldwide and provide hope for those impacted by these conditions.

On average, more than 50 percent of people will be diagnosed with a mental illness or disorder at some point in their life. When people talk about mental health in the United States, conditions like depression and anxiety tend to be the focus. However, many are surprised to learn that one in 17 American adults lives with a serious mental illness, such as bipolar I disorder or schizophrenia.

Identifying Bipolar I Disorder or Schizophrenia

Bipolar I disorder is one of the most common and often severe forms of bipolar disorder. It is a recurrent, lifelong mood disorder that is characterized by recurrent manic and depressive episodes. Schizophrenia is a mental illness that affects how a person thinks, feels, and behaves, which may make it seem like they have a disconnection from or have lost touch with reality.

In the United States, schizophrenia affects 2.8 million adults, and bipolar I disorder affects nearly 4.8 million adults. Schizophrenia or bipolar I disorder diagnoses are often not made until patients are in their late adolescence or early adulthood. Just as with physical disorders, mental health disorders are much easier to treat when diagnosed early. The good news is that mental health screenings are one tool that can be used to help diagnose patients early.

What to Expect with a Mental Health Screening

In honor of World Mental Health Day, it’s a good time to discuss what mental health screenings are, who should be screened for these conditions, and when to be screened. “Mental health screenings are noninvasive,” says Erin Crown, a certified physician assistant who works primarily in psychiatry. An evaluation starts with a standard set of questions from a primary care provider or a mental health professional—psychiatrists, psychologists, physician assistants, and licensed social workers—to determine if a person should be screened further for a particular disorder.

“If you or a loved one is experiencing marked changes in personality, or in eating or sleeping patterns, it’s a good idea to get screened for a mental health disorder,” Crown says, especially if any of the following symptoms are present:

  • Dramatic sleep and appetite changes or decline in personal care
  • Rapid or dramatic shifts in emotions or depressed feelings, greater irritability
  • Recent social withdrawal and loss of interest in activities previously enjoyed
  • An unusual drop in functioning, at school, work or social activities, such as quitting sports, failing in school or having difficulty performing familiar tasks
  • Problems with concentration, memory or logical thought and speech that are hard to explain
  • Heightened sensitivity to sights, sounds, smells or touch; avoidance of over-stimulating situations
  • Loss of initiative or desire to participate in any activity
  • A vague feeling of being disconnected from oneself or one’s surroundings; a sense of unreality
  • Unusual or exaggerated beliefs about personal powers to understand meanings or influence events; illogical or “magical” thinking typical of childhood in an adult
  • Fear or suspiciousness of others or a strong nervous feeling
  • Odd, uncharacteristic, peculiar behavior
  • Increased absenteeism, worsening performance, and difficulties in relationships with peers and co-workers

After the initial assessment, healthcare providers may conclude that further evaluation is needed. “At this point, we’ll get a patient’s full health history and discuss the family history of mental health disorders,” Crown says. “Then I’ll ask about the symptoms they’re experiencing—when they started, how long they have lasted, how severe they are, whether they have occurred before, and if so, how they were treated.”

Being open and honest with your provider is essential to getting a proper diagnosis. “As healthcare professionals, we are here to help people feel healthy and safe,” Crown says. If you think you might have difficulty remembering or expressing what you’ve been experiencing, consider taking some notes beforehand, or ask a loved one who can help you articulate your concerns to accompany you to your appointment.

Finding the Best Treatment Option for You

After a diagnosis, your healthcare provider will share more information about your condition and work with you to develop a treatment plan. Treatment for bipolar I disorder or schizophrenia typically consists of prescription medication as well as some form of psychological therapy. Despite this, less than 10 percent of patients who have a mental health disorder receive effective treatment. Often, it can take trying a few different approaches to find the best fit for you, as treatment is not one-size-fits-all.

“There are many treatment options available for patients with either bipolar I disorder or schizophrenia, and the variety is important because not every patient is the same. Treatment types and plans that work for some may not work for others,” Crown says. “We’ll consider the patient’s lifestyle, schedule, occupation, family, and more when considering a treatment plan.”

Sometimes, sticking with a treatment plan as prescribed is easier said than done. About 40 to 50 percent of patients with schizophrenia experience issues with following a treatment plan and 60 percent of patients stop medication use after 2 to 3 months. Likewise, about half of bipolar I disorder patients have issues with their treatment plan long-term, with about 90 percent of people experiencing recurrences during their lifetime.

This is why long-acting injectables (also known as LAIs) are changing the conversation surrounding treatment. LAIs offer a treatment option to maintain stability for patients living with bipolar I disorder or schizophrenia. “Long-acting injectables are a form of medication that are designed to work for an extended period with just one dose,” Crown says. “They’re administered differently than oral medications. These medications provide continuous delivery of antipsychotic medication by injection.”

Patients and their caregivers should speak with their healthcare professionals about the treatments available to them. Getting proper support is key, too. Regular appointments with an experienced therapist, leaning on trusted loved ones, and engaging in online or in-person support groups can help you maintain your treatment plan.

ABILIFY ASIMTUFII® (aripiprazole)

ABILIFY ASIMTUFII® (aripiprazole) is an extended-release injectable suspension for the maintenance monotherapy treatment of bipolar I disorder in adults. Administered by a healthcare professional to appropriate patients, a dose is given every two months via intramuscular injection in the gluteal muscle. The efficacy and safety of ABILIFY ASIMTUFII is based on the pivotal studies of
ABILIFY MAINTENA®(aripiprazole), a once-monthly medication indicated for maintenance treatment for bipolar I disorder in adults. Work with your healthcare provider to make sure you can tolerate aripiprazole prior to starting treatment. Please see the complete IMPORTANT SAFETY INFORMATION, including BOXED WARNING for INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS, below.

For patients living with bipolar I disorder or schizophrenia, maintaining treatment or finding the treatment plan that works best for them may not be easy. Patients and caregivers should feel empowered to have an active role in the care of their mental health. Talk to your provider this World Mental Health Day to determine if a long-acting injectable, such as ABILIFY ASIMTUFII or
ABILIFY MAINTENA, is the right fit for you and your lifestyle. To learn more, visit abilifymaintena.com.

INDICATIONS and IMPORTANT SAFETY INFORMATION for
ABILIFY ASIMTUFII® (aripiprazole) and
ABILIFY MAINTENA® (aripiprazole)

INDICATIONS:

ABILIFY ASIMTUFII is a prescription medicine given by injection by a healthcare professional:

  • for the treatment of schizophrenia in adults
  • alone as maintenance treatment of bipolar I disorder in adults

ABILIFY MAINTENA is a prescription medicine given by injection by a healthcare professional:

  • for the treatment of schizophrenia in adults
  • alone as maintenance treatment of bipolar I disorder in adults

It is not known if ABILIFY ASIMTUFII or ABILIFY MAINTENA is safe and effective in children under 18 years of age.

IMPORTANT SAFETY INFORMATION:

Increased risk of death in elderly people with dementia-related psychosis.
ABILIFY ASIMTUFII and ABILIFY MAINTENA increase the risk of death in elderly people who have lost touch with reality (psychosis) due to confusion and memory loss (dementia).
ABILIFY ASIMTUFII and ABILIFY MAINTENA are not for the treatment of people with dementia-related psychosis.

Do not receive ABILIFY ASIMTUFII or
ABILIFY MAINTENA if you are allergic to aripiprazole or any of the ingredients in
ABILIFY ASIMTUFII or ABILIFY MAINTENA.

ABILIFY ASIMTUFII or ABILIFY MAINTENA may cause serious side effects, including:

● Increased risk of stroke and ministroke has been reported in clinical studies with oral aripiprazole of elderly people with dementia-related psychosis and can lead to death.

● Neuroleptic malignant syndrome (NMS), a serious condition that can lead to death. Call your healthcare provider or go to the nearest emergency room right away if you have some or all of the following signs and symptoms of NMS: high fever, confusion, changes in pulse, heart rate, and blood pressure, stiff muscles, and increased sweating.

● Uncontrolled body movements (tardive dyskinesia).
ABILIFY ASIMTUFII and ABILIFY MAINTENA may cause movements that you cannot control in your face, tongue, or other body parts. Tardive dyskinesia may not go away, even if you stop receiving
ABILIFY ASIMTUFII or ABILIFY MAINTENA. Tardive dyskinesia may also start after you stop receiving
ABILIFY ASIMTUFII or ABILIFY MAINTENA.

● Problems with your metabolism such as:

o High blood sugar (hyperglycemia) and diabetes: Increases in blood sugar can happen in some people who are treated with
ABILIFY ASIMTUFII or ABILIFY MAINTENA. Extremely high blood sugar can lead to coma or death. If you have diabetes or risk factors for diabetes such as being overweight or a family history of diabetes, your healthcare provider should check your blood sugar before you start treatment with
ABILIFY ASIMTUFII or ABILIFY MAINTENA, and during treatment.
Call your healthcare provider if you have any of these symptoms of high blood sugar during treatment with
ABILIFY ASIMTUFII or ABILIFY MAINTENA:

      • feel very thirsty
      • need to urinate more than usual
      • feel very hungry
      • feel weak or tired
      • feel sick to your stomach
      • feel confused, or your breath smells fruity

      o Increased fat levels (cholesterol and triglycerides) in your blood.

      o Weight gain. You and your healthcare provider should check your weight regularly during treatment.

      ● Unusual and uncontrollable (compulsive) urges. Some people receiving
      ABILIFY ASIMTUFII or ABILIFY MAINTENA have had unusual strong urges, to gamble and gambling that cannot be controlled (compulsive gambling). Other compulsive urges include sexual urges, shopping, and eating or binge eating. If you or your family members notice that you are having unusual urges or behaviors, talk to your healthcare provider.

      ● Decreased blood pressure (orthostatic hypotension). You may feel lightheaded or faint when you rise too quickly from a sitting or lying position.

      ● Falls. ABILIFY ASIMTUFII and ABILIFY MAINTENA may make you sleepy or dizzy, may cause a decrease in your blood pressure when changing position (orthostatic hypotension), and can slow your thinking and motor skills which may lead to falls that can cause fractures or other injuries

      ● Low white blood cell count. Your healthcare provider may do blood tests during the first few months of treatment.

      ● Seizures (convulsions)

      ● Sleepiness, drowsiness, feeling tired, difficulty thinking and doing normal activities. Do not drive a car, operate machinery, or do other dangerous activities until you know how
      ABILIFY ASIMTUFII or ABILIFY MAINTENA affects you.
      ABILIFY ASIMTUFII or ABILIFY MAINTENA may make you feel drowsy and affect your judgement, thinking, or motor skills.

      ● Problems controlling your body temperature so that you feel too warm. Do not become too hot or dehydrated during treatment with
      ABILIFY ASIMTUFII or ABILIFY MAINTENA. Do not exercise too much. In hot weather, stay inside in a cool place if possible. Stay out of the sun. Do not wear too much clothing or heavy clothing. Drink plenty of water.

      ● Difficulty swallowing that can cause food or liquid to get into your lungs.

      Do not drink alcohol during treatment with
      ABILIFY ASIMTUFII or ABILIFY MAINTENA.

      Before receiving ABILIFY ASIMTUFII or
      ABILIFY MAINTENA, tell your healthcare provider about all your medical conditions, including if you:

      • have never taken aripiprazole before
      • have or had diabetes or high blood sugar or a family history of diabetes or high blood sugar. Your healthcare provider should check your blood sugar before you start receiving
        ABILIFY ASIMTUFII or ABILIFY MAINTENA and during your treatment.
      • have or had high levels of total cholesterol, LDL cholesterol, or triglycerides, or low levels of HDL cholesterol
      • have or had low or high blood pressure
      • have or had heart problems or a stroke
      • have or had a low white blood cell count
      • have or had seizures (convulsions)
      • have problems that may affect you receiving an injection in your buttocks
        (ABILIFY ASIMTUFII and ABILIFY MAINTENA) or arm
        (ABILIFY MAINTENA)
      • are pregnant or plan to become pregnant.
        ABILIFY ASIMTUFII or ABILIFY MAINTENA may harm your unborn baby. If you become pregnant during treatment with
        ABILIFY ASIMTUFII or ABILIFY MAINTENA, talk to your healthcare provider about the risk to your unborn baby and about registering with the National Pregnancy Registry for Atypical Antipsychotics. You can register by calling 1-866-961-2388 or visit http://womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/
      • are breastfeeding or plan to breastfeed.
        ABILIFY ASIMTUFII or ABILIFY MAINTENA can pass into your milk and may harm your baby. Talk to your healthcare provider about the best way to feed your baby if you receive
        ABILIFY ASIMTUFII or ABILIFY MAINTENA.

      Tell your healthcare provider about all the medicines you take, including prescription medicine and over-the-counter medicines, vitamins, and herbal supplements.

      ABILIFY ASIMTUFII or ABILIFY MAINTENA and other medicines may affect each other causing possible serious side effects. Do not start or stop any medicines during treatment with
      ABILIFY ASIMTUFII or ABILIFY MAINTENA without talking to your healthcare provider first.

      The most common side effects of
      ABILIFY ASIMTUFII or ABILIFY MAINTENA include:       weight gain, restlessness or feeling like you need to move (akathisia), injection site pain, or sleepiness (sedation).

      It is important to contact your healthcare provider if you experience prolonged, abnormal muscle spasms or contractions, which may be signs of a condition called dystonia.

      These are not all the possible side effects of
      ABILIFY ASIMTUFII or ABILIFY MAINTENA.

      If you have any questions about your health or medicines, talk to your healthcare provider.

      You are encouraged to report side effects of
      ABILIFY ASIMTUFII and ABILIFY MAINTENA.

      Please contact Otsuka America Pharmaceutical, Inc. at 1-800-438-9927 or FDA at 1-800-FDA-1088 (www.fda.gov/medwatch).

      Please see FULL PRESCRIBING INFORMATION,
      including BOXED WARNING for
      ABILIFY ASIMTUFII and ABILIFY MAINTENA, and
      MEDICATION GUIDE for
      ABILIFY ASIMTUFII and ABILIFY MAINTENA.

      Centers for Disease Control and Prevention (CDC). Learn About Mental Health.

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      National Institute of Mental Health (NIMH). Bipolar Disorder.

      National Institute of Mental Health (NIMH). Schizophrenia.

      American Psychiatric Association (APA). What Is Schizophrenia.

      Treatment Advocacy Center. Schizophrenia – Fact Sheet.

      Blanco C, Compton WM, Saha TD, et al. Epidemiology of DSM-5 bipolar I disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions - III. Journal of Psychiatric Research.

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      Mauldin SG, Morton-Rias D, Barnhill GC, Kozikowski A, Hooker RS. The role of PAs in providing mental health care. JAAPA: Official Journal of the American Academy of Physician Assistants.

      American Psychiatric Association (APA). Warning Signs of Mental Illness.

      Substance Abuse and Mental Health Services Administration (SAMHSA). Bipolar Disorder.

      CNBC. What you need to know about the cost and accessibility of mental health care in America.

      Guo J, Lv X, Liu Y, Kong L, Qu H, Yue W. Influencing factors of medication adherence in schizophrenic patients: a meta-analysis. Schizophrenia.

      Krzystanek M, Krysta K, Skałacka K. Treatment Compliance in the Long-Term Paranoid Schizophrenia Telemedicine Study. Journal of Technology in Behavioral Science.

      Psychiatric Times. Treatment-Resistant Bipolar Disorder.

      Leelahanaj T, Kongsakon R, Choovanichvong S, et al. Time to relapse and remission of bipolar disorder: findings from a 1-year prospective study in Thailand. Neuropsychiatric Disease and Treatment.

      National Alliance of Mental Illness. Long-Acting Injectables (LAIs).

      Guzman F. Long-Acting Injectable Antipsychotics: A Practical Guide for Prescribers. Psychopharmacology Institute; London, UK: 2017.

      June 2024 23US24EXC0040

      From: Women's Health US