Aripiprazole

Aripiprazole is a medication that is used to treat several mental health conditions, including schizophrenia, bipolar disorder, and major depressive disorder. It is also sometimes used to treat irritability associated with autism spectrum disorder.

Aripiprazole belongs to a class of medications known as atypical antipsychotics, which work by regulating the activity of neurotransmitters in the brain, such as dopamine and serotonin. Aripiprazole is unique among atypical antipsychotics in that it functions as both a partial agonist and antagonist of dopamine receptors, which can help to stabilize the activity of dopamine in the brain.

Aripiprazole is usually taken orally, either in tablet or liquid form, and is typically taken once a day with or without food. The dosage may be adjusted over time based on the individual’s response to the medication and any potential side effects. Common side effects of aripiprazole may include drowsiness, dizziness, weight gain, and nausea.

It is important to note that aripiprazole should only be taken under the guidance of a healthcare provider, as it can have potential risks and side effects. Aripiprazole may also interact with other medications or supplements, so it is important to inform the healthcare provider of any other medications being taken. Additionally, aripiprazole may not be effective for everyone and may require adjustment of the dosage or a switch to a different medication.

Active Ingredient
  • Aripiprazole
Brand Names
  • Abilify
  • Abilify Discmelt
  • Abilify Maintena
  • Abilify Asimtufii
  • Aristada
  • Aristada Initio
Forms & Strengths
  • Oral tablets: 2 mg, 5 mg, 10 mg, 15 mg, 20 mg, 30 mg
  • Orally disintegrating tablets (ODT): 10 mg, 15 mg
  • Oral solution: 1 mg/mL
  • Short-acting IM injection (agitation): 9.75 mg/1.3 mL
  • Long-acting injectables (LAI):
  • • Abilify Maintena: 300 mg, 400 mg once monthly
  • • Abilify Asimtufii: 960 mg every 2 months
  • • Aristada (aripiprazole lauroxil): 441 mg, 662 mg, 882 mg monthly / 1064 mg every 8 weeks
  • • Aristada Initio: 675 mg single-dose initiation
Onset / Half-life
  • Onset of action: several days; steady-state after ~14 days (oral)
  • Peak plasma concentration (Tmax): 3–5 hours
  • Elimination half-life: 75 hours (aripiprazole), 94 hours (dehydro-aripiprazole); up to 146 hours in poor metabolizers

Warnings

  • Increased mortality risk in elderly patients with dementia-related psychosis
  • Suicidality warning for young adults (antidepressant adjunct use)
  • Neuroleptic Malignant Syndrome (NMS) and tardive dyskinesia risk
  • Metabolic changes: hyperglycemia, dyslipidemia, weight gain
  • Impulse-control disorders (e.g., gambling, compulsive behavior)
  • Orthostatic hypotension and sedation – caution with driving or alcohol
  • Avoid abrupt discontinuation; monitor for withdrawal or relapse

Monitoring

  • Monitor weight, BMI, fasting glucose, and lipid profile
  • Assess for EPS, akathisia, and tardive dyskinesia (AIMS test)
  • Monitor orthostatic blood pressure and signs of sedation
  • Check CBC in patients with prior leukopenia
  • Evaluate suicidality during antidepressant adjunct therapy
  • Assess for impulse-control changes or compulsive behaviors

Indications

  • Approved: Schizophrenia (adults & adolescents)
  • Approved: Bipolar I disorder – manic or mixed episodes, maintenance treatment
  • Approved: Adjunctive therapy for major depressive disorder (MDD)
  • Approved: Irritability associated with autism spectrum disorder
  • Approved: Tourette’s disorder (pediatric)
  • Off-label: Behavioral disturbances in dementia (short-term)
  • Off-label: Borderline personality disorder (experimental/adjunct)

Guides & Questions

References