Aripiprazole (Abilify) | NAMI: National Alliance on Mental Illness


  • abilify®
    • tablets: 2 mg, 5 mg, 10 mg, 15 mg, 20 mg, 30 mg
    • oral disintegration: 10 mg, 15 mg
    • solution: 1mg/ml
    • abilify mycite®
      • digestible sensor tablet: 2 mg, 5 mg, 10 mg, 15 mg, 20 mg, 30 mg
      • abilify maintena®
        • extended-release suspension for injection: 300 mg, 400 mg
        • abilify aristada® (aripiprazole lauroxil)
          • extended-release injectable suspension: 441 mg, 662 mg, 882 mg, 1064 mg
          • aristada initio® (aripiprazole lauroxil)
            • extended-release injectable suspension: 675 mg
            • generic name: aripiprazole (ay ri pip ray zole), aripiprazole lauroxil (law rox il)

              • aripiprazole
                • oral tablet: 2 mg, 5 mg, 10 mg, 15 mg, 20 mg, 30 mg
                • orally disintegrating tablet: 10 mg, 15 mg
                • oral solution: 1mg/ml
                • all fda black box warnings are listed at the end of this fact sheet. review it before taking this medicine.

                  what is aripiprazole and what does it treat?

                  Aripiprazole is a medicine that works in the brain to treat schizophrenia. It is also known as a second-generation antipsychotic (SGA) or atypical antipsychotic. Aripiprazole rebalances dopamine and serotonin to improve thinking, mood, and behavior.

                  Symptoms of schizophrenia include:

                  • hallucinations: imaginary voices or images that seem real
                  • delusions: beliefs that are not true (eg, other people are reading your thoughts)
                  • disorganized thinking or trouble organizing your thoughts and making sense of them
                  • little desire to be around other people
                  • trouble speaking clearly
                  • lack of motivation
                  • Aripiprazole may relieve some or all of these symptoms.

                    Aripiprazole is also FDA-approved for the following indications:

                    • acute treatment of manic or mixed episodes of bipolar disorder (when used alone or with lithium or valproate)
                    • maintenance (long-term) treatment of bipolar disorder
                    • adjuvant treatment of major depressive disorder. this means that aripiprazole is used in addition to an antidepressant to help treat depression.
                    • irritability associated with autistic disorders
                    • tourette syndrome
                    • This medication sheet will focus primarily on schizophrenia. Find more information on bipolar disorder, depression, and autism spectrum disorders here.

                      Aripiprazole may also be useful when prescribed “off-label” for borderline personality disorder or drug-induced hyperprolactinemia (elevated prolactin levels caused by other antipsychotics). “off-label” means that it has not been approved by the food and drug administration for this condition. your mental health provider must justify your thinking in recommending “off-label” treatment. they should be clear about the limits of research around that drug and whether there are other options.

                      what is the most important information i should know about aripiprazole?

                      Schizophrenia requires long-term treatment. do not stop taking aripiprazole, even when you feel better. With your input, your healthcare provider will assess how long you’ll need to take the medication.

                      Missing doses of aripiprazole may increase the risk of a relapse of symptoms. do not stop taking aripiprazole or change your dose without first talking to your healthcare provider. For aripiprazole to work properly, it must be taken every day as directed by your healthcare provider.

                      Are there specific concerns about aripiprazole and pregnancy?

                      If you plan to become pregnant, tell your health care provider to better manage your medications. People living with schizophrenia who want to become pregnant face important decisions. this is a complex decision since untreated schizophrenia has risks for the fetus as well as for the mother. It is important to discuss the risks and benefits of treatment with your doctor and caregivers.

                      Use of antipsychotics during the third trimester of pregnancy carries a risk of abnormal muscle movements (extrapyramidal symptoms [eps]) and/or withdrawal symptoms in postpartum newborns. symptoms in the newborn may include agitation, feeding disorder, hypertonia, hypotonia, respiratory distress, drowsiness, and tremor; these effects may be self-limiting or require hospitalization.

                      In general, infants exposed to GAS through breast milk should be monitored weekly for the first month of exposure for symptoms such as changes in appetite, insomnia, irritability, or lethargy.

                      Caution is advised while breastfeeding as aripiprazole passes into breast milk.

                      what should I discuss with my healthcare provider before taking aripiprazole?

                      • symptoms of your condition that bother you the most
                      • if you have thoughts of suicide or harming yourself
                      • medications you have taken in the past for your condition, whether they were effective or caused adverse effects
                      • if you have ever had muscle stiffness, tremors, tardive dyskinesia, neuroleptic malignant syndrome, or weight gain caused by medication
                      • If you experience side effects from your medications, talk to your provider. some side effects may pass over time, but others may require medication changes
                      • any medical or psychiatric problems you have, such as heart rhythm problems, long QT syndrome, heart attacks, diabetes, high cholesterol, or seizures
                      • if you have a family history of diabetes or heart disease
                      • all other medications you are currently taking (including over-the-counter products, herbal and nutritional supplements) and any drug allergies you have
                      • Other non-drug treatment you are receiving, such as talk therapy or substance abuse treatment. your provider can explain how these different drug treatments work
                      • if you are pregnant, plan to become pregnant, or are breastfeeding
                      • if you smoke, drink alcohol, or use illegal drugs
                      • how should i take aripiprazole?

                        Aripiprazole tablets and suspension are usually taken once daily with or without food. Patients are usually started on a low dose of medication and the dose is increased slowly over several weeks.

                        The oral dose of aripiprazole is usually between 2 mg and 30 mg once daily. the dose of aripiprazole maintena extended-release injection ranges from 300 mg to 400 mg given once a month; the dose of aripiprazole lauroxil extended-release injection ranges from 441 mg to 1064 mg; depending on the dose, it is given once a month, every 6 weeks, or every 2 months. aripiprazole maintenance requires a two-week oral medication overlap; Aripiprazole lauroxil requires a three-week oral overlap. Aripiprazole lauroxil initio is usually given after an oral dose of aripiprazole together with an injection of aripiprazole lauroxil; this allows for a one-day start and no further oral overlay is required. only your healthcare provider can determine the correct formulation and dosage for you.

                        Use a calendar, pill box, alarm clock, or cell phone alert to remind yourself to take your medicine. You can also ask a family member or friend to remind you or to check in with you to make sure you’re taking your medication.

                        what happens if i miss a dose of aripiprazole?

                        If you miss a dose of aripiprazole, take it as soon as you remember, unless it is closer to the time for your next dose. do not double your next dose or take more than prescribed. if you miss an injection, call your doctor or pharmacist right away. discuss this with your health care provider.

                        what should i avoid while taking aripiprazole?

                        Avoid drinking alcohol or using illegal drugs while taking aripiprazole. they can decrease the benefits (eg, worsen your confusion) and increase the adverse effects (eg, sedation) of the drug.

                        what happens if I overdose on aripiprazole?

                        If an overdose occurs, call your doctor or 911. You may need urgent medical attention. You can also contact the poison control center at 1-800-222-1222. There is no specific treatment to reverse the effects of aripiprazole.

                        what are the possible side effects of aripiprazole?

                        common side effects

                        headache, extrapyramidal symptoms, drowsiness, restlessness, fatigue, sedation, agitation, insomnia, anxiety, weight gain, cholesterol abnormalities, glucose increased, nausea, vomiting, constipation, application site rash ( mycite), tremor

                        rare/serious side effects

                        rash, dry mouth, muscle aches, seizures, agitation

                        Aripiprazole may increase blood levels of a hormone called prolactin. side effects of increased prolactin levels include loss of menstruation in women, production of breast milk, and loss of sexual desire in men or the possibility of experiencing erection problems. Long-term (months to years) elevated prolactin can lead to osteoporosis or an increased risk of bone fractures.

                        Some people may develop muscle-related side effects while taking aripiprazole. the technical terms for these are “extrapyramidal symptoms” (eps) and “tardive dyskinesia” (td). EPS symptoms include restlessness, tremor, and stiffness. symptoms of td include slow or jerky movements that one cannot control, often starting in the mouth with tongue rolling or chewing movements.

                        temperature regulation: impaired regulation of core body temperature may occur; caution with strenuous exercise, heat exposure, and dehydration.

                        Second-generation antipsychotics (SGAS) increase the risk of weight gain, high blood sugar, and high cholesterol. this is also known as metabolic syndrome. Your healthcare provider may order a blood sample to check your cholesterol, blood sugar, and hemoglobin A1C (a measure of blood sugar over time) while you are taking this medication.

                        Information on healthy eating and extra exercise to lower your chances of developing metabolic syndrome can be found at the following sites:

                        • SGAS have been linked to an increased risk of death, stroke, and transient ischemic attacks (TIAs) in older people with behavioral problems due to dementia.

                          All antipsychotics have been associated with the risk of sudden cardiac death due to arrhythmia (irregular heartbeat). To minimize this risk, antipsychotic medications should be used at the smallest effective dose when the benefits outweigh the risks. Your doctor may order an EKG to check for an irregular heartbeat.

                          Neuroleptic malignant syndrome is a rare and life-threatening adverse effect of antipsychotics that occurs in <1% of patients. symptoms include confusion, fever, extreme muscle stiffness, and sweating. If you experience any of these symptoms, contact your healthcare provider right away.

                          All antipsychotics can cause sedation, dizziness, or orthostatic hypotension (a drop in blood pressure when getting up from a sitting or lying position). these side effects can lead to falls that could cause broken bones or other injuries. this risk is higher for people with conditions or other medications that could worsen these effects. if you fall or have any of these symptoms, contact your healthcare provider.

                          The United States Food and Drug Administration (FDA) warns that compulsive or uncontrollable urges to gamble, overeat, shop, and have sexual intercourse have been reported with the use of aripiprazole. these uncontrollable urges were reported to have ceased when the drug was discontinued or the dose was reduced. These impulse control problems are rare, but can cause harm to the patient and others if left undetected.

                          Are there any risks from taking aripiprazole for long periods?

                          tardive dyskinesia (TD) is a side effect that develops with prolonged use of antipsychotics. Medications such as aripiprazole have been shown to have a lower risk of td compared to older antipsychotics such as haldol (haloperidol). If you develop symptoms of TD, such as grimacing, lip sucking and smacking, or other movements you can’t control, contact your health care provider right away. All patients taking first- or second-generation antipsychotics should have an Abnormal Involuntary Movement Scale (Target) completed regularly by their healthcare provider to monitor Td.

                          Second-generation antipsychotics (SGAS) increase the risk of diabetes, weight gain, high cholesterol, and high triglycerides. (See “Serious Side Effects” section for follow-up recommendations.)

                          what other drugs may interact with aripiprazole?

                          The following medications may increase the levels and effects of aripiprazole:

                          • the antibiotic clarithromycin (biaxin®)
                          • antidepressants, such as fluoxetine (prozac®), paroxetine (paxil®), and nefazodone
                          • antifungals, such as fluconazole (diflucan®), ketoconazole (nizoral®), and itraconazole (sporanox®)
                          • the antiarrhymic agent quinidine
                          • HIV medications, such as the protease inhibitors indinavir (crixivan®), ritonavir (norvir®), saquinavir (fortovase®, invirase®), and lopinavir/ritonavir (kaletra®)
                          • The following medications may decrease the levels and effects of aripiprazole:

                            • carbamazepine (tegretol®)
                            • rifampin (rifadin®)
                            • how long does it take for aripiprazole to work?

                              It is very important to tell your doctor how you feel during the first few weeks after you start taking aripiprazole. It will probably take several weeks to see big enough changes in your symptoms to decide if aripiprazole is the right medicine for you.

                              People with schizophrenia generally need lifelong antipsychotic treatment. your doctor can better discuss the length of treatment you need based on your symptoms and condition.

                              • hallucinations, disorganized thinking, and delusions may improve in the first 1 to 2 weeks
                              • sometimes these symptoms do not go away completely
                              • motivation and desire to be around other people may take at least 1-2 weeks to improve
                              • symptoms continue to improve the longer you take aripiprazole
                              • It may take 2 to 3 months before you get the full benefit of aripiprazole
                              • summary of fda black box warnings

                                increased mortality in elderly patients with dementia-related psychosis

                                • Both first-generation (typical) and second-generation (atypical) antipsychotics are associated with an increased risk of mortality in elderly patients when used for dementia-related psychosis.
                                • Although there were multiple causes of death in the studies, most deaths appeared to be due to cardiovascular causes (eg, sudden cardiac death) or infections (eg, pneumonia).
                                • Antipsychotics are not indicated for the treatment of dementia-related psychosis.
                                • suicidal thoughts or actions in children, adolescents and young adults

                                  Depression and other psychiatric disorders are associated with increased risk of suicide.

                                  • Patients treated with antidepressants may experience a worsening of their depression and/or the onset of suicidal ideation and behavior (suicidality) or unusual changes in behavior, whether or not they are taking medication. this risk may persist until significant remission occurs.
                                  • Patients, their families, and caregivers should be vigilant for anxiety, restlessness, irritability, aggressiveness, and insomnia. if these symptoms occur, they should be reported to the patient’s physician or health care professional.
                                  • All patients being treated with this medication for depression should be vigilant and notify their healthcare provider of worsening symptoms, suicidality, and unusual changes in behavior, especially during the first few months of treatment .
                                  • provided by

                                    (July 2022)

                                    ©2022 the college of psychiatric and neurological pharmacists (cpnp) and the national alliance on mental illness (nami). cpnp and nami make this document available under the Creative Commons Attribution-No Derivatives 4.0 International License. last update: January 2016.

                                    This information is provided as a community outreach effort of the College of Neurological and Psychiatric Pharmacists. This information is for educational and informational purposes only and is not medical advice. this information contains a summary of important points and is not an exhaustive review of the drug information. always seek the advice of a physician or other qualified medical professional with any questions you may have about medications or medical conditions. never delay in seeking professional medical advice or disregard the advice of a medical professional as a result of the information provided in this document. The College of Psychiatric and Neurological Pharmacists disclaims any liability alleged as a result of the information provided in this document.

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