Abilify and Agoraphobia?

Hmm…seems what I’ve been suspicious of for some time just may have some validity after all.

Everyone who has Bipolar Disorder knows that in the majority of sufferers, it usually presents with a comorbid affliction.  That is, another disorder that coexists simultaneously with BP.  Anxiety disorders are most common, and to get even more granular, there are several disorders that fall under the general class of anxiety disorders.  I’ve had panic disorder beautifully mixed in with my BP for my entire life.  I was still in my teens when  I received my first prescription for Xanax.

Agoraphobia is the abnormal fear of being helpless in an embarrassing or unescapable situation that is characterized especially by the avoidance of open or public places (thanks, Miriam-Webster).

Now Panic Order Mixed with Agoraphobia is a special flavor all to itself:

Panic disorder with agoraphobia is an anxiety disorder in which there are repeated attacks of intense fear and anxiety, and a fear of being in places where escape might be difficult, or where help might not be available.

Agoraphobia usually involves fear of crowds, bridges, or of being outside alone.

To some degree, I’ve had agoraphobia my entire life.  Especially the fear of bridges.  But, I noticed that my agoraphobia has gotten a lot worse since starting my latest drug cocktail about five months ago.  Could one of the drugs be worsening my agoraphobia?

Enter the only drug I am taking that has any correlation with agoraphobia:  Abilify.

The studies I was able to uncover weren’t large or prestigious or well-funded.  Which means the drug company didn’t sponsor them.  What I did find were a few reports to the US FDA that claimed Abilify did result in agoraphobia for several patients who were using the drug to treat schitzoaffective disorder, and a sampling of 18.5K individuals, where .07% reported having experienced agoraphobia while on Abilify. While this percentage is statistically insignificant, the demographics of those reporting the adverse effect were very close to home.

  • 50% of those who reported developing / worsening of agoraphobia on Abilify did so in the first six months of treatment.
  • Females accounted for more than half of those reporting the side effect.
  • By far, the age of the highest percentage of those reporting agoraphobia were 40-49.
  • Of those who were surveyed, the second most common reason for taking Abilify was Bipolar Disorder (Pain was #1)
  • Among the top co-used drugs was Wellbutrin at #4 (Seroquel was #1)

This may be as far from a scientific sampling as you can get, but is there anyone else out there who has experienced either first time or worsening of agoraphobia since starting Abilify?  I’d love to hear from you.

Oddly enough, over the past couple of years (during a couple of which I was taking Abilify), I lost any traces of agoraphobia. I didn’t have it as far as the more catch-all definition, but I had a decided and severe manifestation of one of the sub-categories you mention: gephyrophobia – that is, the fear of crossing bridges.

This was a near paralyzing anxiety at times, and then when I had my girls it was given some reinforcement and legitimacy. It’s one thing to worry about a bridge failing and having to get yourself out of the car, it’s quite another when you have two small children strapped into car seats that are tricky and time consuming to undo under the best circumstances.

In any case, as I said, this fear I had practically all of my life is gone now. I’m not trying to play devil’s advocate or anything, reading your post just made me think about it.

Hi, Ruby! It’s encouraging to know that your agoraphobia has beat a retreat in recent years. I keep hoping mine will at least subside. Funny you should mention having kids in a car seat making it even more fun going over bridges. I actually had a tool in my car (I carry to this day) that has a seat belt cutter incorporated. That thing was never more than 6 inches from my hand when my son was strapped in back and we were going over a bridge. Wow, I hadn’t thought about that in years. It’s good to know there are others out there who have had the same anxieties!

I didn’t know those existed, and that is brilliant! I’m going to have to find one of those. My girls are quite grown enough that they don’t use car seats and can buckle and un-buckle themselves, but it never hurts, does it?

Thanks! I need to find a new doc here, and I’m going to discuss the agoraphobia/Abilify issue when I do. This agoraphobia is really starting to affect my family life. It’s pretty frustrating. 🙁

Wait, they changed the criteria for agoraphobia? By that definition, I would qualify!

I know it’s claustraphobia. I fear crowds, but mostly tight spaces. Or would they consider that agoraphobia now?

And I’ve never taken Abilify before. I wouldn’t be able to tell you.

Hmmm…I don’t think they changed the criteria. My shrink describes it as a severe narrowing of your radius of comfort…like not being able to leave the house because you’re terrified something will happen. The part about ‘no easy escape’ is pretty weird, too. I’m ashamed to admit I’ve bolted from a theatre a few times and gone home because I couldn’t take it. Totally frustrating. Do you do that as well?

I know you’re addressing Lulu, but I have to say the “no easy escape” just hit a button in my brain. I was talking with my mother the other day about how during rush hour, I never take the highway. My rationale is pretty much exactly that – you’re trapped, you have no options for escape until you hit the next exit (which, when traffic is at a standstill, feels extremely uncomfortable). Whereas on the main roads, there is always an intersection or side street coming up, a different route to take, an “escape.”

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