Aripiprazole

Aripiprazole brand names

• Abilify
• Abilify MyCite
• Abilify Discmelt

What is aripiprazole prescribed for?

Aripiprazole is an atypical or second-generation antipsychotic medication. The US Food & Drug Administration (FDA) has approved aripiprazole for use in the treatment of ^[1]:

• Schizophrenia (aged 13 and above)
• Bipolar disorder: manic or mixed episodes (aged 10 and above)
• Major depressive disorder (MDD): as an adjunctive treatment alongside an antidepressant (adults only)
• Autism spectrum disorder (ASD): to treat behaviors such as irritability and aggression (aged 6 and above)
• Tourette’s disorder (aged 6 and above)

Sometimes, aripiprazole is prescribed for uses that are not FDA-approved if it is deemed necessary or appropriate by a medication professional. Off-label uses of aripiprazole can include ^{[2][3][4][5][6]}:

• Borderline personality disorder (BPD)
• Psychotic disorders
• Anxiety disorders
• Post-traumatic stress disorder (PTSD)
• Eating disorders
• Sleep disorders
• Dementia-related symptoms, such as psychosis, aggression, or agitation

How does aripiprazole work?

Aripiprazole is an atypical antipsychotic medication. It works by regulating the levels of dopamine and serotonin. Dopamine and serotonin are neurotransmitters that impact several functions, including mood, cognition, behavior, sleep, pleasure, and appetite ^[2].

Psychotic symptoms, such as hallucinations and delusions, are believed to be caused by increased dopamine levels in the brain. Aripiprazole can help to reduce these symptoms by regulating dopamine levels ^[3][7].

Similarly, it is believed that by impacting serotonin and dopamine, aripiprazole can help to improve the symptoms of several other conditions, including depression, mania, and aggression. As such, it can be an effective treatment option for various conditions.

How is aripiprazole usually taken?

Aripiprazole is available in various forms, including ^[1][2]:

• Oral tablet: 2mg, 5mg, 10mg, 15mg, 20mg, 30mg
• Orally disintegrating tablet: 10mg, 15mg
• Oral liquid: 1mg/mL
• Injections (to be administered by a healthcare professional)

Typically, doses are taken once per day, although this may vary depending on the form of medication and prescribed use. Initially, individuals will be commenced on a low daily dose that can be gradually increased to find the most effective therapeutic dose.

Dosage may vary depending on the individual’s age, weight, condition, and symptoms.

Typically, aripiprazole will be prescribed in the following doses ^[1]:

• For schizophrenia and bipolar disorder in adults: starting dose of 10-15mg per day, which can be increased to a maximum of 30mg per day.
• For schizophrenia in adolescents: starting dose of 2mg per day, which can be increased to a maximum of 30mg per day.
• For bipolar disorder in children: starting dose of 2mg per day, which can be increased to a maximum of 30mg per day.
• For adjunctive treatment of major depressive disorder in adults: starting dose of 2-5mg per day, which can be increased to a maximum of 15mg per day.
• For ASD symptoms in children: starting dose of 2mg per day, which can be increased to a maximum of 15mg per day.
• For Tourette’s disorder: starting dose of 2mg per day, which can be increased to a maximum of 10-20mg per day depending on weight.

Abilify MyCite is a new medication that contains a sensor. The individual wears a patch on their skin that receives information from the sensor in the pill and records it via an app. This can help the individual and medical professionals track when medication has been taken and the ingestion of the tablet. It is intended to help with medication compliance and improve treatment outcomes ^[8][9].

Aripiprazole should be taken exactly as prescribed, without missing a dose or taking more than is prescribed. If you forget to take your medication, skip the missed dose and take the next one at the specified time.

Taking too much or missing doses can cause adverse effects and reduce the impact of the medication. If you’re struggling with taking you medication, consider exploring ways to improve medication consistency and compliance with your healthcare provider.

How long does aripiprazole stay in your system?

Aripiprazole can take several weeks or even months to take full effect, although changes in your mental state may be noticeable sooner. It is essential to continue taking your medication consistently and as prescribed to ensure that it has the intended effect ^[10].

When coming off aripiprazole, following the last dose, the effects of the medication will reduce within a few days, and it may take several weeks for the medication to leave the body entirely ^[3].

Abruptly stopping aripiprazole can cause adverse effects and withdrawal symptoms. If it is deemed safe and necessary to stop this treatment, your doctor will gradually reduce your dosage to prevent these effects.

Some people may need to take aripiprazole long-term or as a life-long treatment, to effectively manage their condition ^[1][2].

Aripiprazole side effects

When beginning a new medicinal treatment, it is common for side effects to occur as the body adjusts to the medication. These side effects often alleviate within a few weeks. If they are persistent or cause concern, report them to your doctor, who may reduce or change your medication if required.

Common side effects of aripiprazole can include ^[2][9]:

• Stomach upset, including nausea, vomiting, diarrhea, and constipation
• Stomach pain
• Headaches
• Change in appetite and weight
• Dizziness
• Drowsiness
• Fatigue
• Insomnia
• Agitation
• Anxiety
• Blurred vision
• Increased saliva

In some cases, serious side effects of aripiprazole may occur. If you experience any of the following symptoms, contact your doctor immediately ^[9][10]:

• Pain or stiffness in the muscles
• Shaking
• Jerky or uncontrolled movements
• Swelling in the face or mouth
• Breathing difficulties
• Pain or tightness in the chest or throat
• Sweating
• Fever
• Rapid or irregular heartbeat
• Fainting or falling
• Excessive thirst and urination
• High body temperature
• Seizures
• Loss of consciousness

Aripiprazole precautions

Dementia

Aripiprazole is not approved for use in dementia psychosis as it causes a significantly increased risk of stroke and death in elderly patients. If it is used off-label for this purpose, it may be required to use a reduced dose and ensure careful monitoring of physical health changes ^[1][3].

Suicidal ideation

Individuals being treated for symptoms of depression may be at an increased risk of experiencing suicidal thoughts when commencing a new treatment. As aripiprazole is used alongside an antidepressant medication when treating major depressive disorder, it can be associated with this risk ^[1][9].

If you notice emerging or worsening thoughts of self-harm or suicide, inform your doctor or mental health professional immediately.

Health history

Inform your doctor of your mental and physical health history, as certain medical conditions could impact the safe use of aripiprazole, and it may not be suitable.

People with a history of heart, liver, or kidney problems, strokes, seizures, diabetes, or allergic reactions to medications may not be able to take aripiprazole safely or may require a reduced dose and careful monitoring ^[1][10].

Weight gain

Aripiprazole has been associated with an increase in appetite and weight. This may cause a significant risk of obesity, diabetes, high cholesterol, and other health issues. Your doctor may wish to conduct regular physical health checks to monitor your blood sugar and cholesterol levels ^[2].

Your doctor can advise you on maintaining a healthy weight throughout your treatment to help prevent weight gain and physical health problems.

Neuroleptic malignant syndrome

Antipsychotic medications, including aripiprazole, can cause neuroleptic malignant syndrome (NMS). NMS occurs rarely but can be potentially fatal, so it must be treated immediately if symptoms occur, including fever, confusion, irregular or rapid heartbeat, and extreme muscle stiffness and rigidity ^[1][2].

Tardive dyskinesia

Tardive dyskinesia can occur with the use of antipsychotic medications such as aripiprazole. It can cause uncontrollable and involuntary movements that may be irreversible. The onset of tardive dyskinesia symptoms may require stopping the medication, although it might be necessary to continue treatment or reduce the dose ^[1].

Body temperature

Aripiprazole can impact how the body regulates temperature. Caution is advised when spending time in the sun or exercising, as your body temperature may take longer to return to normal ^[9].

Pregnancy and breastfeeding

Taking aripiprazole while pregnant or breastfeeding may cause a risk of side effects or withdrawal symptoms in infants. Inform your doctor if you are pregnant, planning to become pregnant, or breastfeeding, as they can discuss the potential benefits and risks of this medication so that you can make an informed decision about your treatment ^[2][10].

Drowsiness

Aripiprazole can cause drowsiness and sedation, so you should not drive until you know how the medication affects you.

Additionally, it can increase the risk of falling or fainting when rising from a seated or lying position, so it is advised to move slowly and cautiously when standing up ^[9].

Impulsive behaviors

In some cases, individuals taking aripiprazole have begun engaging in reckless or impulsive behaviors, such as excessive gambling, spending, sexual behaviors, or eating. You may wish to inform your family of this risk so they can help you to monitor these behaviors and report unusual activity to your doctor ^[2].

Aripiprazole interactions

Aripiprazole can interact with several medications and substances, which can cause adverse effects or reduce the effectiveness of your medication.

This includes antihistamines, antibiotics, antivirals, antifungals, anticonvulsants, medications for heart conditions, Parkinson’s medications, medications for urinary or kidney disorders, sedatives, tranquilizers, antianxiety medications, antidepressants, and St John’s wort ^[10].

Inform your doctor of all medications you take before starting a new prescription.

It is advised to avoid alcohol use while taking aripiprazole as this can cause increased sedation and side effects ^[9].

Aripiprazole storage

Always keep medications in a locked or safe place, out of reach of children.

Store aripiprazole in its original packaging, in an airtight container or blister pack, and at room temperature with no humidity.

When medication needs to be disposed of, such as when it is out of date or no longer required, take it to a pharmacy or medical professional to be disposed of safely. Discarding medications in the toilet or bin can cause unnecessary risks.

What to do if you overdose on aripiprazole

If you overdose on aripiprazole, call Poison Control at 1-800-222-1222 or a medical professional. In case of emergency, call 911. Symptoms of an aripiprazole overdose can include excessive weakness and fatigue, nausea and vomiting, confusion, uncontrollable movements, irregular heartbeat, seizure, and loss of consciousness ^[9].

Aripiprazole alternatives

Aripiprazole is used to treat many conditions, for which several alternative medications are available, including antidepressants, anticonvulsants, and anti-anxiety medications.

Alternative treatments for schizophrenia include typical and atypical antipsychotics. Atypical antipsychotics are more commonly prescribed as they usually cause fewer side effects ^[7].

Discuss with your doctor if you wish to change your medication or learn more about available alternatives. They can advise which treatments would be appropriate for you, as this will depend on your mental and physical health history, response to previous medications, condition, and symptom severity.