Aripiprazole (Abilify) is an antipsychotic medication used to treat various mental health conditions, including schizophrenia and bipolar disorder. It is generally safe and effective, although side effects can occur. Always take aripiprazole exactly as prescribed and report any concerning side effects to the prescribing doctor.
- Aripiprazole is an antipsychotic medication used to treat schizophrenia, bipolar disorder, and other conditions.
- Aripiprazole can cause side effects and may be risky for certain individuals, although it is generally a safe and well-tolerated medication.Â
- The prescribing doctor will monitor individuals on aripiprazole to help ensure safe and effective treatment.Â
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What is aripiprazole (Abilify)?
Aripiprazole is an atypical antipsychotic medication used to treat various mental health conditions. Compared to earlier (typical) antipsychotic medications, aripiprazole is less likely to cause side effects due to its mechanism of action. Aripiprazole works on certain neurochemicals in the brain, like serotonin and dopamine, that affect mood, energy levels, and behavior. [1]
Aripiprazole is available as a generic medication and a brand-name medication, such as Abilify. Other names for the drug include Mezofy and Opipza. It can be administered as a tablet, an orally disintegrating tablet, an oral liquid solution, or an oral film. It can also be administered by a licensed professional in an injection into the muscle. [2]
Approved and off-label uses
Aripiprazole is approved by the Food and Drug Administration (FDA) to treat: [3][4]
- Schizophrenia
- Bipolar disorder
- Irritability in children related to autism spectrum disorder (ASD)
- Major depressive disorder (MDD) as an adjunctive treatment
- Tourette syndrome as an adjunctive treatment for children
Sometimes, aripiprazole is used off-label, for uses not FDA-approved, including: [4]
- Obsessive-compulsive disorder (OCD)
- Anxiety disorders
- Attention deficit disorder (ADHD)
- Sleep disorders and chronic fatigue syndrome
- Comorbid substance use disorders and psychotic disorders as an adjunctive treatment
How aripiprazole works in the brain
Aripiprazole is a partial agonist of the D2 dopamine receptor and 5-HT1A serotonin receptor, and is an antagonist at the 5-HT2A serotonin receptor. These mechanisms help regulate dopamine and serotonin activity in the brain. This can lead to improvements in mood stability, cognitive functioning, and a reduction in hallucinations, delusions, irritability, impulsivity, and aggression. [4]
Dosage and administration
Aripiprazole oral formulations are administered once per day in doses that vary depending on the age of the individual and the condition being treated. [3][4]
- Schizophrenia in adults: Initial and recommended dose of 10-15 mg daily, up to a maximum of 30 mg a day.
- Schizophrenia in adolescents: Initial dose of 2 mg, recommended dose of 10 mg, and maximum dose of 30 mg.
- Bipolar in adults: Initial and recommended dose of 15 mg, maximum dose of 30 mg.
- Bipolar as an adjunctive treatment: Initial dose of 10-15 mg, recommended dose of 15 mg, maximum dose of 30 mg.
- Bipolar in pediatric patients, as monotherapy or adjunctive treatment: Initial dose of 2 mg, recommended dose of 10 mg, maximum dose of 30 mg.
- MDD as an adjunctive treatment: Initial dose of 2-5 mg, recommended dose of 5-10 mg, maximum dose of 15 mg.
- ASD in pediatric patients: Initial dose of 2 mg, recommended dose of 5-10 mg, maximum dose of 15 mg.Â
- Tourette’s disorder: Initial dose of 2 mg, recommended dose of 5-10 mg, maximum dose of 10-20 mg (depending on weight).
Injections can be administered to treat schizophrenia or bipolar disorder at doses of 9.75mg, up to a maximum of 30 mg per day, with at least two hours per dose. [3]
For patients requiring long-term treatment, an extended-release once-monthly injection can be administered in a dose of 300 mg or 400 mg. [4]
The prescribing doctor will monitor the individual throughout treatment. They can make dose adjustments as necessary to find an effective therapeutic dose and also address any adverse effects that occur. [2][4]
Side effects and risks
It is common for people using aripiprazole treatment to experience side effects, particularly at the start of treatment or when increasing the dosage. Often, these side effects will be mild and transient. However, if they persist or worsen, they should be reported to a physician.
Common side effects of aripiprazole include: [2][3]
- Blurred vision
- Weight gain
- Muscle stiffness or spasms
- Stomach pain
- Gastrointestinal issues such as diarrhea or constipation
- Dizziness
- Restlessness
- Nervousness
- Headaches
- Changes in appetite
- Increased salivation or drooling
- Pain in the arms or legs
- FatigueÂ
- Insomnia
- Flu or cold-like symptoms
- Increased impulsive or compulsive behaviors, such as urges to engage in gambling, binge eating, shopping, or sexual activity
Serious side effects
In some cases, rare or serious side effects can occur, which should be reported to a doctor immediately, such as: [2][3]
- Persistent swelling or pain in the legs
- Rash, hives, or itching
- Swelling in the mouth, face, hands, or feet
- Impaired vision
- Issues with breathing or swallowing
- Tightness or pain in the chest or throat
- Uncontrollable shaking
- Uncontrollable movements, spasms, or tics
- Yellowing of the eyes or skin
- Unsteadiness or issues with coordination
- Fever and sweating
- Confusion, delirium, or psychosis
- Seizures
- Extreme changes in heartbeat
- Suicidal thoughts or behaviors
- Passing out
Who can and can't take aripiprazole
Aripiprazole may not be suitable for some populations or should be used with caution and in lower doses. High-risk groups include: [2][3]
- People with a history of heart conditions, diabetes, low white blood cell count, seizures, or conditions related to impaired swallowingÂ
- People with a history of substance misuse, impulse-control disorders, or obsessive-compulsive disorder (OCD)
- People who are pregnant, trying to become pregnant, or currently breastfeeding
- Older adults, due to an increased risk of side effects and cerebrovascular adverse events
Inform the prescribing doctor of all current and past mental and physical health conditions, to help ensure that treatment is safe and appropriate.Â
Is aripiprazole addictive?
There is no evidence that aripiprazole is an addictive substance or that it is involved in substance use issues. Tolerance and physical dependence may develop with prolonged use, which requires gradual dose reductions upon cessation. [3]
Aripiprazole withdrawal and tapering guidance
Stopping aripiprazole could cause withdrawal symptoms, particularly if the medication is stopped suddenly and after a prolonged treatment. Because of this, it is advised to gradually reduce the dosage under the close supervision of a prescribing doctor. Withdrawal symptoms could include abnormal movements, nausea, lightheadedness, anxiety, and insomnia. [5]
People should not stop taking aripiprazole without professional guidance. The prescribing doctor will advise how to make gradual dose reductions for a safe taper. This can vary depending on the individual and can be slowed or adjusted as necessary if withdrawal symptoms occur.
Aripiprazole overdose and response
Taking more aripiprazole than prescribed may result in an overdose. Typically, an aripiprazole overdose is not fatal, although combining the medication with other substances could increase this risk. Signs of an overdose include: [2][4]
- Dilated pupils
- Increased sensitivity to light
- Extreme drowsiness
- Loss of strength
- Vomiting
- Weakness
- Uncontrollable movements
- Shaking
- Extreme changes in heart rate
- Seizures
- Difficulty breathingÂ
- Respiratory arrest
- Loss of consciousness
If an aripiprazole overdose is suspected, call 911 for urgent medical care and call poison control at 1-800-222-1222. Activated charcoal may be administered to help prevent absorption. Treatment will involve managing the presenting symptoms and professional monitoring until the individual recovers. [4]
Long-term use: What patients should know
Although aripiprazole has a relatively safe side effect profile compared to older antipsychotics, adverse side effects are not uncommon, and some may be serious in nature. During treatment, the prescribing physician will conduct checks before and during treatment, including weight, blood pressure, electrolytes, liver function, and blood glucose levels. [1][4]
This can help to reduce the risk of serious side effects during treatment. If the individual gains more than 5% of their initial weight, alternative treatments may be recommended. [4]
Generally, aripiprazole can be an effective treatment for the long-term management of schizophrenia, Tourette’s, ASD irritability, and bipolar disorder. [1]
Lifestyle considerations and managing side effects
It is recommended to avoid alcohol while on aripiprazole, as it may worsen symptoms or side effects. Similarly, other medications, supplements, or illicit substances could be dangerous when used alongside aripiprazole. [2]
It is not necessary to avoid any specific food or drinks while taking aripiprazole. However, eating a healthy diet, ensuring adequate hydration, exercising, and sleeping well can be beneficial to physical and mental well-being and may reduce the impact of side effects.
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