From the Guidelines
Aripiprazole is indicated for the treatment of schizophrenia, bipolar I disorder, major depressive disorder, irritability associated with autism spectrum disorder, and Tourette's disorder, with dosing varying by condition and patient population. The recommended dosing for Aripiprazole, as per the provided evidence 1, starts at 5 mg p.o. or i.m. (immediate-release) stat, with scheduled dosing required at a frequency of q24h. It's crucial to reduce the dose in older patients and in poor metabolisers of cytochrome P450 2D6. Aripiprazole's unique mechanism as a partial agonist at dopamine D2 and serotonin 5-HT1A receptors and as an antagonist at 5-HT2A receptors helps in stabilizing dopamine and serotonin systems.
Key Indications and Dosing:
- Schizophrenia: The evidence does not specify the exact dosing for schizophrenia, but according to general medical knowledge, the typical starting dose for adults is 10-15 mg once daily.
- Bipolar I Disorder: Similarly, the provided evidence does not detail specific dosing for bipolar disorder, but typically, adults start at 15 mg daily.
- Major Depressive Disorder: As an adjunctive treatment, the starting dose is usually 2-5 mg daily.
- Autism Spectrum Disorder: Pediatric dosing begins at 2 mg daily, titrating to 5-15 mg daily based on response.
- Tourette's Disorder: The provided evidence does not specify dosing for Tourette's disorder, but the general starting dose for pediatric patients is typically lower and adjusted based on response and tolerability.
Important Considerations:
- Dose adjustments are necessary for patients with hepatic impairment or those taking CYP2D6 or CYP3A4 inhibitors, as noted in the evidence 1.
- Common side effects include akathisia, weight gain, sedation, and metabolic changes, though these are often less severe than with other antipsychotics.
- Aripiprazole is less likely to cause extrapyramidal side effects (EPSEs) compared to other antipsychotics, making it a preferable option for certain patients 1.
From the FDA Drug Label
- 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 indications for Aripiprazole are:
- Schizophrenia in adults and adolescents The dosing for Aripiprazole is:
- Adults: 10 or 15 mg/day
- Adolescents: 10 mg/day 2
From the Research
Indications for Aripiprazole
- Schizophrenia: Aripiprazole has been approved for the treatment of schizophrenia, with efficacy established in the dose range of 10-30 mg/day 3.
- Bipolar I Disorder: Aripiprazole is also approved for the treatment of manic or mixed states associated with bipolar I disorder, with a recommended dose of 15-30 mg/day 3.
- Major Depressive Disorder: Aripiprazole has been approved as an adjunctive therapy to antidepressants for the treatment of major depressive disorder, with a recommended dose of 5-15 mg/day 4.
- Irritability Associated with Autism: Aripiprazole is indicated for the treatment of irritability associated with autism, although the exact dose range is not specified in the provided studies.
- Other Potential Indications: Aripiprazole has been studied in various other disorders, including resistant depression, anxiety, obsessive-compulsive disorder, borderline personality disorder, Tourette syndrome, addiction, and neurological and psychiatric disorders in the elderly 5.
Dosing for Aripiprazole
- Schizophrenia: 10-30 mg/day 3, 6
- Bipolar I Disorder: 15-30 mg/day 3
- Major Depressive Disorder: 5-15 mg/day 4, 7
- Dosage titration is not necessary, and the drug is effective in the first few weeks of treatment 6.