Aripiprazole (Abilify)

In recent years, a new group of antipsychotics have been appearing on the market. They are often referred to as the “third generation neuroleptics”. Aripiprazole, more commonly known by its brand name, Abilify® is one of these newer drugs. It was originally created in Japan. The FDA approved it for use in 2002.

What it’s used to treat

Aripiprazole is primarily used to treat major depressive disorder, manic and mixed episodes associated with bipolar disorder, bipolar maintenance, and schizophrenia. When used for , it is typically prescribed after other antidepressant medications have not been effective, and is used as an additional medication to augment the effect of antidepressants.

Aripiprazole is also used to treat bipolar disorder in children and teens as young as age 10, and for adolescent schizophrenia. It is also used to treat autistic children and teens as young as age 6 who exhibit irritability as part of their disorder.

How it works

Aripiprazole, like other antipsychotic drugs, impacts chemicals in the brain in a way which can reduce or alleviate symptoms. The exact mechanism which makes it effective is not totally understood at this time, but it targets both dopamine and serotonin. These two neurotransmitters are known to play a significant role in the symptoms of both schizophrenia and bipolar disorder.

How it’s administered

Aripiprazole comes in several different tablet strengths, and also comes in tablets which are orally disintegrating (Abilify Discmelt). It also comes in an oral liquid as well as an injection.

Potential side effects

As with all medications, aripiprazole has many potential side effects. Some of the more common ones are:

  • Headaches
  • Problems sleeping
  • Anxious feelings
  • Feelings of restlessness
  • Sedation
  • Drowsiness
  • Agitation
  • Nausea and vomiting
  • Tiredness
  • Constipation 
  • Drop in blood pressure

More serious side effects may include a greater chance of stroke, extreme fever, tremors, confusion, rapid heart rate, increase in blood pressure, and muscle rigidity. Like other antipsychotic medications, aripripazole may cause both tardive dyskinesia (TD) and neuroleptic malignant syndrome (NMS).

TD can become a permanent condition for some individuals. TD symptoms involve involuntary, random and uncontrollable movements, such as lip smacking, odd tongue or jaw movements, blinking, grimacing, and movements involving the limbs, fingers, toes, upper body or hips.

Neuroleptic malignant syndrome is very serious because it can be fatal. Some of the symptoms include muscle stiffness, changes in one’s mental state, fluctuations in blood pressure or heartbeat, sudden renal failure, tremors, difficulty breathing, dehydration, rapid heartbeat, and extremely high temperature.

Precautions

As with other antipsychotics, aripripazole should not be used to treat psychosis associated with dementia, as it may be fatal. If you are considering this medication, be sure to tell your doctor is you have any drug allergies. Also, let your doctor know if you or a family member has a history of diabetes; liver, kidney or heart disease; breast cancer; hypertension; heart or cardiovascular problems of any kind; low white blood cell counts; seizures; difficulties with swallowing; or phenylketonuria. If you are nursing, pregnant, or considering becoming pregnant, be sure to tell your doctor before starting this medication.

written by Dr. Cheryl Lane, PsyD

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