From the Research
Abilify (aripiprazole) can cause liver function test (LFT) derangement, though this is considered an uncommon side effect. Patients taking aripiprazole may experience elevations in liver enzymes such as ALT (alanine aminotransferase) and AST (aspartate aminotransferase), typically occurring within the first few months of treatment. These elevations are usually mild to moderate and often asymptomatic. The mechanism behind aripiprazole's effect on liver function is thought to be related to its metabolism in the liver through the cytochrome P450 system, primarily CYP2D6 and CYP3A4.
Key Points to Consider
- For patients starting Abilify, baseline liver function tests are recommended, with follow-up monitoring particularly in those with pre-existing liver disease, those taking other potentially hepatotoxic medications, or patients showing symptoms of liver dysfunction (such as jaundice, fatigue, abdominal pain, or dark urine) 1.
- If significant LFT elevations occur (typically greater than three times the upper limit of normal), dose reduction or discontinuation may be necessary, with close monitoring until values normalize.
- Most cases of aripiprazole-associated LFT abnormalities resolve with dose adjustment or discontinuation of the medication.
- Aripiprazole is considered a lower-risk agent for causing liver injury compared to other antipsychotics, with no reports of liver failure associated with its use 1.
Monitoring and Management
- Regular monitoring of LFTs is essential for patients taking aripiprazole, especially those with risk factors for liver disease.
- Patients should be counseled to report any symptoms of liver injury, such as jaundice, fatigue, or abdominal pain.
- In cases of significant LFT elevations, a careful risk-benefit analysis should guide the decision to discontinue or adjust the dose of aripiprazole 1.