From the FDA Drug Label
Aripiprazole may cause orthostatic hypotension, perhaps due to its α1-adrenergic receptor antagonism. The incidence of orthostatic hypotension-associated events from short-term, placebo-controlled trials of adult patients on oral aripiprazole (n=2467) included (aripiprazole incidence, placebo incidence) orthostatic hypotension (1%, 0.3%), postural dizziness (0.5%, 0. 3%), and syncope (0.5%, 0.4%); of pediatric patients 6 to 18 years of age (n=732) on oral aripiprazole included orthostatic hypotension (0.5%, 0%), postural dizziness (0.4%, 0%), and syncope (0.2%, 0%) Orthostatic hypotension (decreased blood pressure): Lightheadedness or fainting may happen when rising too quickly from a sitting or lying position.
Aripiprazole can cause hypotension, specifically orthostatic hypotension, due to its α1-adrenergic receptor antagonism. The incidence of orthostatic hypotension-associated events in adult and pediatric patients is reported in the drug label 1 and 1. Patients with known cardiovascular disease, cerebrovascular disease, or conditions that predispose them to hypotension should use aripiprazole with caution.
- Key points:
From the Research
Aripiprazole can cause hypotension, particularly orthostatic hypotension, as a side effect, and this risk is not directly addressed in the provided studies. The studies provided, 2, 3, and 4, focus on the use of compression stockings for orthostatic hypotension, rather than the effects of aripiprazole on blood pressure. However, based on general medical knowledge, aripiprazole, like other antipsychotics, can block alpha-1 adrenergic receptors in blood vessels, leading to a drop in blood pressure.
Key Points to Consider
- Orthostatic hypotension typically manifests as dizziness, lightheadedness, or fainting when changing positions.
- The risk is higher in elderly patients, those with dehydration, heart disease, or patients taking other medications that lower blood pressure.
- To minimize this risk, patients should rise slowly from sitting or lying positions, stay well-hydrated, and avoid alcohol.
- Healthcare providers often start with lower doses and gradually increase them to reduce the likelihood of hypotension.
- If severe hypotension occurs, dose reduction or medication change may be necessary.
Management and Prevention
- Patients should report persistent dizziness or fainting episodes to their healthcare provider promptly.
- Regular monitoring of blood pressure and adjustment of medication as needed can help prevent hypotension.
- Lifestyle modifications, such as staying hydrated and avoiding sudden changes in position, can also help minimize the risk of orthostatic hypotension.