ADHD and Tourettes - Abilify and Ritalin together?

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I'm currently on Guanfacine and Ritalin for ADHD. My neurologist wants me to try Abilify for Tourettes. I read up. Ritalin basically increases dopamine, and the Abilify acts as a partial agonist to the D2 receptors. It triggers a dopaminergic response, but weaker that that of dopamine. So depending on how many receptors the Abilify binds to, it could end up causing an overall reduction in dopaminergic response.

In short, the Abilify could theoretically reduce the effectiveness of the Ritalin. I'd rather deal with the Tourettes, if that's the case.

Anyone on both? Anyone know anything about this?

I was on Abilify 15mg for paranoia, and it was the worst medication I have ever been on, period. My parents called it "Debilify" because all I did was sit around and stare when taking it. I couldn't drive myself anywhere. I could barely sleep because it made me feel restless and edgy. All I did was watch TV and eat. I lost my job because I could not concentrate enough to get assignments done. It was super, super gross. Even reducing to half a dose was not enough. I wasn't functional again until I got off it.

Thank you for sharing that. That was a specific concern of mine. I'd rather deal with my symptoms than get zombified. Been there done that. Never again.

Various atypical antipsychotics(Zyprexa, Risperdal, Seroquel) never had any impact on the ADHD meds I was on at one time or another (Methylphenidate, Dexerdine, Vyvanse, Adderall XR). Was never on Abilify though.

I heard of people taking both meds together for depression. I was on Abilify for most of 5 years. I tried other antipsychotics out before & after but went back to Abilify. It did not turn me into a zombie but it made me shaky, caused me to slur when I talked sometimes & had bad dry mouth. I have a tremor disorder that causes me to be shaky & can affect my voice sometimes so maybe Abilify aggravated that & wouldn't cause the 1st two issues for most people. I take a low dose Haldol/Haloperidol nowadays & I haven't really noticed any side-effects except for being more tired but that could be related to the other meds I'm on(I'm on alot). I think Haldol can help with tourettes.

As I understand it , those with Tourette Syndrome are not supposed to be taking stimulants such as Ritalin . http://adhd-treatment-options.blogspot.com/2008/10/do-adhd-stimulant-meds-worsen-tourettes.html?m=1

It's not black and white, as the link you posted noted, and the stimulants don't linger so if it's a problem you can just stop taking them. Some, like Ritalin, are better tolerated than others and the effect can attenuate over time.

If I had to pick between improved function from ADHD meds and reduced ticks, I'd take the improved function. When I'm stressed and the ticks are bad it can be uncomfortable and aggravating, but losing track of what people are saying, no matter how hard I'm trying to pay attention, and having trouble staying on task at work is worse.

I think the conclusion at the bottom, is about right. Most people stay in the ADHD meds even if it makes the tourettes a little worse.
https://www.ncbi.nlm.nih.gov/m/pubmed/9136492/

While Abilify do zombified, Ritalin, contrary to popular perceptions, do not.

Yeah, I've been on Concerta for a few months and I've never felt better, focus-wise. When I initially voiced my concern to my doctor about the Abilify, she told me she had a number of professionals in engineering fields that were on it and it did not negatively affect them but I've read stories of people who did not do well on it. I decided it wouldn't hurt to at least try it so I started a couple of weeks ago at 5mg. It is helping tremendously with my tics with no other impact that I can discern, so, so far so good...

Thanks for sharing your experience. I decided to try it. It is its action on the D2 receptors that help with the tourettes, which is why I'm taking it and that only takes 2 weeks (or less?) to notice. It has helped a lot. It also acts on the 5-HT receptors, but that takes a month for the effect to be fully realized. We'll see what that does...

I'm onboth of the adhd pills but not abilify but my doctor wants to take off them.

I'm glad it's working for you so far & hope it continues without too many side-effects

I have wanted to try Abilify but it's too expensive here in Australia. The reason I want to try it is because it's not as fatigue-inducing as haloperidol. At least I think so.

I have been on dexamphetamine for ADHD since 2004, haloperidol since 2011. I take 5mgs of haloperidol every night. It's for motor tic disorder and it works. No side effects since I take benztropine too.

Haloperidol does take some of the effectiveness of dex away I think. I told my psych that so he put me on risperidone for a while. It made me feel shaky and weak so it was back to the haloperidol.

They have a generic now. It is more expensive at $100 USD for three months vs $60 for my regular meds, but that's not too bad.

I do feel like there has been a bit of a decrease in the efficacy of the Concerta with the introduction of the Abilify. I'm at a pretty moderate dose right now so I might talk my doctor about increasing it. Though it might aggravate my tics. I don't want to get into a see-saw effect. Right now both my ADHD and Tourettes symptoms are improved so even if this is as good as it gets, its still pretty better than nothing. Only one way to find out. I feel like a walking guinea pig sometimes Se la vie.

I've just learnt that Vyvance is on the Pharmaceutical Benefits Scheme for adult ADHDers (before it was just for kids). It's lisdexamphetamine and apparently lasts all day like Ritalin LA does. I would like to try it but don't have an appointment with my psychiatrist until next year.

I hope if you get to try it, it works well for you. I've missed a day here and there on the Concerta and it reminds me of how much it really helps.