From the FDA Drug Label
Aripiprazole tablets have been systematically evaluated and shown to be effective in a dose range of 10 to 30 mg/day, when administered as the tablet formulation; however, doses higher than 10 or 15 mg/day were not more effective than 10 or 15 mg/day. The maximum recommended dose of aripiprazole (Abilify) per day is 30 mg/day 1.
From the Research
The maximum recommended dose of aripiprazole (Abilify) for adults is typically 30 mg per day. For schizophrenia, the recommended target dose is 10-15 mg daily, but some patients may require up to the 30 mg maximum 2. For bipolar disorder maintenance or major depressive disorder (as adjunctive therapy), the maximum is also 30 mg daily 3. In children and adolescents, maximum doses are lower and vary by age and condition - generally 10-15 mg daily for adolescents with schizophrenia or bipolar disorder, although a study has shown that doses up to 30 mg/day can be tolerated in this population 4. Patients with severe hepatic or renal impairment, those who are CYP2D6 poor metabolizers, or those taking CYP3A4 inhibitors (like ketoconazole) or CYP2D6 inhibitors (like fluoxetine) may require lower maximum doses. Aripiprazole works as a partial agonist at dopamine D2 and serotonin 5-HT1A receptors and as an antagonist at 5-HT2A receptors, which contributes to its efficacy while potentially causing fewer side effects than full dopamine antagonists 5, 6. Some key points to consider when prescribing aripiprazole include:
- Starting doses: 10-15 mg/day for adults, with adjustments as needed and tolerated
- Dose escalation: should not be made before 2 weeks of continuous therapy to allow for steady state to be achieved 5
- Monitoring: for adverse effects, such as akathisia, gastrointestinal complaints, and weight gain, although aripiprazole has been shown to have a low propensity for weight gain and a favorable metabolic profile 2