Aripiprazole is an antipsychotic medication used to treat mental health conditions, including schizophrenia. Oral formulations can remain in the body for two or three weeks, while the long-acting injection may take several months to be eliminated from the system. It can be helpful to understand the effect duration and elimination time of aripiprazole to help inform treatments, potential false positive results in drug testing, and check treatment adherence.
- Aripiprazole (Abilify) is available in oral formulations and extended-release injections, which differ in their duration and elimination time.
- Oral aripiprazole can take two or three weeks to leave the system, and the injection can take many months.
- Some people who are prescribed aripiprazole need to continue taking it for the rest of their lives. But anyone prescribed this medication should be aware of what may happen if they stop taking it.
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How long does aripiprazole (Abilify) stay in your system?
The effects of aripiprazole (Abilify) can last three to four days, although it may take up to two to three weeks for the medication to fully leave the system after the last dose. The effects of long-acting injections last many weeks and can take between five and eight months to leave the system. [1][2]
Aripiprazole is an antipsychotic medication, prescribed to treat various mental health conditions, including schizophrenia and bipolar disorder. Many people who receive aripiprazole treatment will continue taking it for many years or the rest of their lives. [3]
Pharmacokinetics: Half-life and active metabolites
Aripiprazole has a half-life of around 75 hours. This refers to the length of time it takes for half of the medication to leave the system. Typically, it takes five half-lives for a substance to be eliminated, meaning that aripiprazole can take around two weeks before it is completely eliminated. [1][4]
Aripiprazole is metabolized by the liver and excreted mostly in urine and feces. During metabolization, aripiprazole produces an active metabolite, dehydroaripiprazole. Dehydroaripiprazole has a half-life of 94 hours, meaning that it remains in the body for longer than aripiprazole. [4]
Oral vs. Injectable aripiprazole
Aripiprazole can be administered orally, including as a tablet or liquid solution. It can also be administered as an extended-release injection, with which the duration of effects and elimination differ.
Extended-release injectable formulations can include four, six, and eight-week dosing schedules. For example, a 300 mg monthly dose has a half-life of almost 30 days, while a 400 mg monthly dose has a half-life of 46.5 days. As such, this form of aripiprazole remains in the body for significantly longer than oral formulations and can depend on the dosage and duration of treatment. [1]
How long does Abilify take to work?
After administering oral aripiprazole, the effects typically take around three to five hours to emerge. Noticeable symptom changes can occur within two weeks, and it can take two or three months before significant symptom improvement is observed. As such, it is important to take the medication every day, exactly as prescribed. [4][5]
Long-acting injection formulations can take several doses before reaching peak plasma levels. As such, it can take several weeks or months to notice improvements. [2]
Detecting Abilify in drug tests
Standard drug tests do not test for antipsychotic medications such as Abilify. It may be necessary to test individuals for aripiprazole, which requires the use of a specific antipsychotic screening. This might be used during treatment to ensure adherence. [6]
Aripiprazole can be detected in urine, blood, and saliva.
- In urine, aripiprazole can be detected for up to 7 days. [7]
- Aripiprazole can be detected for a similar duration in both blood and saliva. As aripiprazole has a half-life of 75 hours, it can be detected with these methods for around two weeks. Its active metabolite, dehydroaripiprazole, has a half-life of 94 hours, which means it can be detected for almost three weeks. [4]
- Aripiprazole can also be detected in hair, if this is required, such as during an autopsy. [8]
Common false positives and precautions
There are some reports that indicate that people taking aripiprazole may test positive for amphetamines on standard drug tests, although this is not common. In most cases, this false positive result has occurred in children who have accidentally ingested the medication. However, it may also occur within adults taking aripiprazole as a medicinal treatment. [9]
It can be helpful to be aware of this when commencing aripiprazole treatment, as it may impact employment or cause other legal consequences.
Genetic and metabolic factors affecting drug clearance
Various factors can impact the duration of aripiprazole effects and elimination, including: [1][3][4][10]
- Aripiprazole format administered
- Duration of aripiprazole use, as long-term use can lead to accumulation of the medication in the system
- Amount of aripiprazole administered per dosage, particularly with injectable formulations
- Weight and age
- Physical health conditions, including impairments in liver or kidney functioning
- Poor CYP2D6 metabolization. Some people have a genetic deficiency causing them to be less able to metabolize certain substances. This can increase the half-life of aripiprazole to 146 hours and should be managed by administering half the usual dose to ensure safe use.
What happens when you stop taking Abilify
After stopping Abilify, it can take several weeks or months for the medication to fully leave the system, depending on the type of aripiprazole used.
If someone stops taking Abilify with no alternative medication to replace it, the effects of the medication will stop within several weeks or months. This means that the symptoms requiring treatment are likely to re-emerge. [10]
Sometimes, people using aripiprazole experience serious side effects, such as neuroleptic malignant syndrome (NMS). In these instances, aripiprazole should be stopped immediately to reduce or prevent severe harm. Medicinal treatments may need to be reintroduced to manage psychological symptoms, which should be carefully considered and monitored on an individual basis. [10]
Safe discontinuation and monitoring
Before commencing injectable aripiprazole, it is advised to use oral formulations to ascertain tolerability. It is recommended to continue the oral medication for two weeks after the first long-acting injection. After two weeks, the oral medication can be stopped, which helps to ensure the medication remains at a stable level. [2]
People switching to alternative antipsychotic medications may manage an immediate change in treatment, although some might require gradual dose reductions before titrating the new medication. This period will require careful monitoring for adverse effects and re-emerging symptoms. [10]
People stopping aripiprazole with no alternative treatment will require gradual dose reductions to reduce the severity of withdrawal symptoms. This may be over a period of weeks or months and should take place only with the guidance of a physician, who will provide close monitoring. [3]
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