Aripiprazole (Abilify) is an antipsychotic medication and can be an effective treatment for a range of conditions. Among other potential side effects, aripiprazole may cause some weight gain. However, it is less likely to cause weight gain than many other antipsychotics. Various strategies can be utilized to manage weight during treatment.
- Aripiprazole is an antipsychotic medication used to treat schizophrenia, bipolar disorder, autism, and various other mental health conditions.
- Aripiprazole is less likely than many other antipsychotics to cause weight gain, although some may be more at risk of this than others, and it can depend on individual factors.
- Weight changes during aripiprazole treatment can be managed with changes in diet, exercise, and lifestyle.
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Does aripiprazole (Abilify) cause weight gain?
Aripiprazole may cause some weight gain. Typically, it is during the first year of aripiprazole treatment that the most rapid weight gain occurs. After this, gradual weight increases may continue throughout treatment. [1]
Compared to other antipsychotics, aripiprazole carries a fairly low risk of weight gain. [1][2]
Aripiprazole is an atypical antipsychotic medication, used to treat a range of conditions, including schizophrenia, bipolar disorder, and autism spectrum disorder (ASD). Most antipsychotic medications cause some weight gain, although this can vary depending on the medication, individual factors, and lifestyle. [1]
How much weight do people gain on Abilify?
Weight gain on Abilify may be up to 7% of baseline weight. However, studies also indicate that some people may lose up to 7% of their weight. People with schizophrenia taking aripiprazole experience a mean weight increase of 3kg in one year. [1][2][3]
These figures can depend on whether the individual has previously taken an antipsychotic medication, as well as other individual factors.
Mechanisms behind aripiprazole-related weight changes
Aripiprazole may lead to weight changes due to its effects on: [1][3][5]
- Neurotransmitters: Aripiprazole impacts several neurotransmitters, including dopamine, norepinephrine, and serotonin, which are involved in the regulation of appetite and energy.
- Histamines: Antipsychotic medications like aripiprazole affect histamine levels in the body, which can trigger a sequence of responses that can lead to an increase in appetite.
- Hormones: Aripiprazole impacts hormones, including leptin and ghrelin, which are involved in the brain signaling associated with feelings of hunger, satiety, and appetite. This can influence how the body recognizes available energy reserves, potentially leading to a need to consume more to increase perceived depletion in reserves.
- Glucose metabolism: Antipsychotics can impair glucose metabolism, contributing to increases in weight and the development of metabolic syndrome. Studies have found that obesity is high among those with schizophrenia, and around a third have metabolic syndrome. Aripiprazole may be less likely than other antipsychotics to impact metabolic functioning.
Risk factors that increase the likelihood of weight gain
Weight gain while taking aripiprazole can depend on several factors, including: [1][2][3][4][5]
- Age: Children and adolescents are most likely to experience significant weight gain.
- Severity of illness: People with severe mental health issues are more likely to experience impairments in general well-being and self-care, which can contribute to habits that cause weight gain.
- Low baseline BMI: Studies have shown that weight gain is more common among people who started the medication underweight or at a normal BMI, and that aripiprazole is less likely to cause weight gain in overweight individuals.
- Lifestyle: People with an unhealthy diet, sedentary lifestyle, and little exercise are more likely to gain weight than those who eat healthily and exercise.
- Genetic factors: Some people may be more susceptible to weight gain because of genetic influences, including metabolic factors.
- Physician instructions: Before and during treatment, doctors can provide advice to help individuals prevent and manage weight changes. If this guidance is not provided, it may increase the risk of weight gain.
- Physical health: Physical factors can influence weight gain risk, including metabolic or hormonal conditions, mobility issues, and cardiovascular health.
- Previous antipsychotic medications: Studies find that people who have not taken an antipsychotic medication previously are more likely to experience significant weight gain than those who have.
- Long-term use: Studies suggest that long-term users of antipsychotics are more likely to experience weight gain than those who only take the medication for a short time.
- Metabolic problems: Previous research has shown that individuals with bipolar disorder and schizophrenia are more likely to struggle with metabolic issues, which may predispose them to medication side effects like weight gain.
Aripiprazole vs other antipsychotic medications
Weight gain is a common side effect of all atypical antipsychotic medications, although each medication differs in how much weight gain it is likely to cause. Most studies and reports indicate that aripiprazole causes less weight gain than other antipsychotics. [2]
- The antipsychotic medications causing the most weight gain are olanzapine and clozapine, although these are also considered two of the most effective antipsychotic medications. [1]
- Antipsychotic medications causing the least amount of weight gain include haloperidol, lurasidone, and ziprasidone. [1][2]
- Quetiapine and risperidone cause a moderate amount of weight gain. [1]
- Aripiprazole and amisulpride are found to cause low to moderate weight gain. [1][2]
Avoiding weight gain while on Abilify
Before commencing aripiprazole treatment, the prescribing doctor can also advise the individual on the weight gain risks associated with the medication and strategies to prevent or reduce potential weight gain. This can include implementing diet and nutrition counseling, exercise programs, and cognitive-behavioral strategies to help manage attitudes and behaviors around eating. [1][2]
Throughout treatment, the individual’s weight should be closely monitored, alongside other necessary monitoring and reviews. Sometimes, an additional medication can be prescribed alongside an antipsychotic to help prevent weight gain, such as metformin. However, this may not be necessary with aripiprazole, as it is not as likely to cause weight gain as other antipsychotics. Each additional medication will also influence the risk of other side effects. [1]
When weight gain occurs: What to do about it
Weight gain can have a negative impact on the individual, potentially leading to reduced self-esteem, low mood, poor medication compliance, reduced life quality, and cardiovascular issues. Potential risks must be weighed against benefits to ensure effective management of symptoms without severely impacting other aspects of well-being.
If it is necessary and appropriate, the prescribing doctor can switch the individual from aripiprazole to a different medication with less weight gain potential. However, this could increase the risk of illness relapse and a worsening of symptoms. [1]
It may be necessary to implement interventions to assist with weight loss, rather than altering medications. This can include advice around changes in diet, exercise, and lifestyle, and cognitive-behavioral interventions. [1][2]
People prescribed aripiprazole should not change their dosage or medication without consulting a medical professional, as this can lead to dangerous effects and a worsening of symptoms.
Conclusion
Aripiprazole can be an effective antipsychotic medication for a range of conditions, including bipolar disorder and schizophrenia. Compared to other antipsychotics, it is relatively unlikely to lead to significant weight increase, although, in some cases, weight gain may occur.
People can seek advice about preventing or reducing weight gain while taking aripiprazole and may wish to implement lifestyle changes to help manage their weight and physical health. Any changes in medication or treatment should be discussed with a doctor or prescriber.
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