What is a suitable initial dose of Abilify (aripiprazole) for a 60-year-old patient?

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From the FDA Drug Label

  1. 1 Schizophrenia Adults The recommended starting and target dose for aripiprazole tablets is 10 or 15 mg/day administered on a once-a-day schedule without regard to meals Adolescents The recommended target dose of aripiprazole tablets is 10 mg/day. Aripiprazole was studied in adolescent patients 13 to 17 years of age with schizophrenia at daily doses of 10 mg and 30 mg The starting daily dose of the tablet formulation in these patients was 2 mg, which was titrated to 5 mg after 2 days and to the target dose of 10 mg after 2 additional days.

The suitable initial dose of Abilify (aripiprazole) for a 60-year-old patient is 10 or 15 mg/day. There is no specific recommendation for a 60-year-old patient to start at 5mg daily. The dose may need to be adjusted based on the patient's response and tolerance. 1

From the Research

For a 60-year-old patient, a suitable initial dose of Abilify (aripiprazole) is typically 5 mg once daily, as this dose is often prudent in older adults, with gradual titration based on response and tolerability, as suggested by the most recent study 2. When considering the initiation of Abilify (aripiprazole) in a 60-year-old patient, it's essential to prioritize a conservative approach due to age-related changes in metabolism and drug clearance.

  • The dose can be increased gradually after 1-2 weeks if needed, typically not exceeding 15 mg daily in this age group.
  • Aripiprazole has a long half-life (approximately 75 hours), so steady-state concentrations take about 2 weeks to achieve, as noted in earlier studies 3, 4.
  • Common side effects to monitor include dizziness, somnolence, akathisia, and potential metabolic effects, with a study from 2009 5 highlighting the importance of monitoring for these effects, especially at higher doses.
  • Baseline and follow-up monitoring should include vital signs, weight, blood glucose, and lipid profiles, considering the potential for metabolic changes.
  • Aripiprazole works as a partial dopamine agonist, which provides a more balanced approach to dopamine modulation compared to traditional antipsychotics, potentially resulting in fewer extrapyramidal symptoms in elderly patients, as discussed in a 2005 review 6. Given the information from the most recent study 2 and considering the principles of minimizing morbidity, mortality, and maximizing quality of life, starting with a lower dose and titrating as needed is a prudent approach.

References

Research

Aripiprazole: a review of its pharmacology and clinical use.

International journal of clinical practice, 2003

Research

Aripiprazole.

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2003

Research

Aripiprazole: pharmacology, efficacy, safety and tolerability.

Expert review of neurotherapeutics, 2005

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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