From the Guidelines
The recommended starting dose of aripiprazole for children with autism-related irritability is 5 mg per day. For children aged 6-17 years:
- Start with 5 mg daily, as this dose has been shown to be effective in reducing irritability, hyperactivity, stereotypy, social withdrawal, and inappropriate speech in children with autism spectrum disorder (ASD) 1
- Increases can be made in 5 mg increments up to a maximum of 15 mg daily, based on response and tolerability Dosing should be individualized based on response and tolerability. The medication should be taken once daily, with or without food. Aripiprazole works as a partial agonist at dopamine D2 and serotonin 5-HT1A receptors, and as an antagonist at 5-HT2A receptors. This unique mechanism helps to modulate dopamine and serotonin systems, potentially reducing irritability and improving behavior in children with autism. Monitor for side effects such as weight gain, sedation, and extrapyramidal symptoms. Regular follow-ups are necessary to assess efficacy and adjust the dose as needed. Key considerations for dosing include:
- Age: 6-17 years
- Target symptoms: irritability, hyperactivity, stereotypy, social withdrawal, inappropriate speech
- Dose range: 5-15 mg/d
- Study demographics: 218 children 6-17 y old 1
From the Research
Starting Dose for Aripiprazole in Children with Autism Spectrum Disorder (ASD) and Irritability
- The starting dose for aripiprazole (Abilify) in children with ASD and irritability is not explicitly stated in the provided studies, but the dosage range used in the studies was 2-15 mg/day 2, 3, 4, 5, 6.
- In the study by 4, patients were randomly assigned to flexibly dosed aripiprazole with target dosages of 5, 10, or 15 mg/day.
- Another study by 5 used a flexible dose of 2-15 mg/day, and the study by 6 also used a flexible-dose (2-15 mg/day) regimen.
- It is essential to note that the dosage of aripiprazole should be determined by a healthcare professional, taking into account the individual child's needs and response to the medication 3, 4.
Dosage Range and Efficacy
- The dosage range of 2-15 mg/day was effective in reducing irritability in children with ASD, as measured by the Aberrant Behavior Checklist Irritability subscale score and the Clinical Global Impression-Improvement score 2, 4, 5, 6.
- The studies demonstrated that aripiprazole was generally well tolerated in children with ASD, with most adverse events being mild to moderate in severity 2, 3, 4, 5, 6.
Safety and Tolerability
- Aripiprazole was associated with weight gain in both short- and long-term studies, with data from the long-term study indicating that the increase in body weight reached a plateau at 3-6 months 2, 5, 6.
- The most common adverse events reported in the studies included nasopharyngitis, weight increase, and extrapyramidal symptoms 3, 4, 5.