DS had first been placed on Abilify about three years ago for "symptoms of irritability associated with Autism." It seemed to work well enough, as I recall. I know the worse parts of his irritability subsided to the point that both my wife and I took notice enough to make notations. The doctor we had at the time (who was also the first to officially diagnose an Autism Spectrum disorder) had planned from the outset to add a 'mood stabilizer' and had chosen Fluvoxamine Maleate. I recall him saying that the Aripiprozole could treat DS' agitation but it would not treat (or could worsen) his OCD ª. DS' mum and I had already started becoming suspicious regarding the effects of SSRIs but the doctor felt our son would benefit from it and that it would be safer/less side effects than the other antideps.

To an extent, the doctor was correct. We didn't see any negative side effects for some time with the addition of Luvox to the treatment; however, a great deal of time was taken to get our son to get to therapeutically useful dosages to minimize any unwanted effects, but once he did reach close to maint. dosage, things began slipping. For some reason, I canna recall the specifics of it (I've probably written it in a journal) but whatever they were, they were disturbing enough to pull him off of everything, which we did under the doctor's scheduling. Fortunately, it was Summer and school was out, in case of negative withdrawal effects.

I don't recall our son experiencing side effects from the withdrawal of the meds. I do remember the PsyMD had said that we might need to return him to Abilify if the anger presented itself.

He was correct, the anger/hatefulness did return and DS was placed back on Abilify as the primary agent, along with guanfacine for what's probably a provisional tic disorder (it fluctuates, waxes, wanes, changes form and first manifested long before any psychotropic meds were introduced) and had been on it continuously 2 - 2 1/2 years. He'd had his last dose couple of weeks ago.

Forgive me, I'm sure all of that is relevant to something, but the reasons presently escape me.

In any advent, so he's placed on a 2nd gen AP with unique activating propertiesᵇ for the purpose of controlling agitation "associated with autism" - which it did.

Three years later, he returns with symptoms of agitation at levels equal or higher than when first placed on Abilify. Perseverance of limited interests now at dysfunctional levels. Inability to maintain limits (even those he has placed on himself), hypomaniacal-like (no such word )etc., etc.

Enter Seroquel. 2nd gen AP with sedative properties. He experiences heavy (but not unacceptable) levels of sedation.

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first line treatments of acute mania

. And it delivers. Hyper perseverance/mania does, in fact diminish; however, irritation and anger (he states he'd never experienced the likes of before) skyrocket.



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Abilify seemed to work. Odd enough. The only problem was the agitation it seemed to cause. it was from there that I was placed on quetiapine."

In my son's case, the Abilify did help control "irritability associated with Autism". Rather well. BUT, it did not control mania, if fact, in hindsight, we can see how it acerbated things on that end. But it warn't prescribed for that. The mania/biopolar symptoms ( though present) had not taken front and center yet. (DS has never rec a Bipolar dx, I use the term "bipolar" because its the closest term I can find that describes some of his features)

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(Seroquel)... should ... have a calming effect on agitation or other manic symptoms.

The Seroquel did have a marked effect on his mania symptoms, for which it was prescribed. It warn't Px'd for "irritability associated with Autism", though, which maybe is what has rebounded so badly.

Irritability, anger associated with AS must be quite different from that associated with BP and likewise responds quite differently. If that really is the case, I'm wondering if this has exposed the possibility he has both.

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We took our son to see the PsyMD, yesterday. She officially yanked the Seroquel, a decision which we wholly agree on and put him on Rispiridone - which you'd mentioned.

We did have one experience with it a number of years ago, when he was about 10 or 11. At the time, I really didn't know much at all (even less than I do now) about these medications, the differences between APs, ACs, SSRIs, what was for what or what symptoms to be on the lookout for.

Or to even be on the lookout for anything.

I just recalled my son behaving differently. He used to love to play with his action men, his little toy soldiers and their little vehicles, it brought him such joy. I noticed him not acting right. Couldn't put my finger on it, he just moved funny and he didn't want to play with his favourite things. One day, he was just sitting on the bottom of the staircase landing not doing anything, looking worried.

I asked him what was wrong and he started telling me about how when he moved, all his 'selves' would move before him and after him. He had 'before selves' and 'after selves'. Some would move in advance of him and some after, like images on a camera taken during multiple, high speed exposures and these 'selves' had memories of before life, different periods during his life and his 'after selves' had memories of after he died.

Then he said that it didn't bother him until his 'after-selves' began breaking order, when he was getting ready to get up and go up the flight of stairs, some of his after-selves had left him to go up first and it was worrying him.

He had'nt been on Rispiridone for very long. He'd started mentioning coloured circles around lights and other visual oddities a bit before his experience on the staircase. I didn't know the significance of these effects at the time, but when he started talking about how beings that lived in between light rays were getting ready to come take care of him - I remembered something my grandmother had described she'd experienced when her heart had stopped for a good while in ICU - and no more Rispiridal!


I wondered in the Risperadone wasn't metabolizing into DMT by some strange process.

Have you ever heard of such?

He'd never experienced anything like that before or since.


So, he's on it now...

The doc said that he was a different person now, older, bigger...different metabolism, etc.


Okay, we'll see.






ª Long story, some obsessional personality traits had merged with the AS' tendency towards repetition after a traumatic illness from eating tainted strawberries - was mistaken for OCD for some time.

ᵇ You know, I'm sure I've read that Abilify was mood-lifting, non-sedating and so forth dozens of times, but it warnt till I read your "mood stabilizing effects, but is activating." that its dawned on me why our son went from shunning sports, absolutely hating physical training to become an obsessive weight lifter and gymnast! It was during the period he was taking Abilify!! It was energizing!



* One thing, TTT, if you don't mind - could you describe for me what an acute mainia episode would look like from my end. What it would feel like from the afflicted's point of view?


Take your time, no rush on it. But I think it would be very helpful in our case to get that perspective.