What is the recommended use and dosage of Abilify (aripiprazole)?

From the Guidelines

Abilify (aripiprazole) should be prescribed at a starting dose of 5 mg p.o. or i.m. (immediate-release) stat, with a recommended dosing frequency of q24h if scheduled dosing is required, and dose reductions should be considered in older patients and in poor metabolisers of cytochrome P450 2D6. The use of Abilify is recommended for various conditions, including schizophrenia, bipolar disorder, major depressive disorder, and irritability associated with autism.

• For adults with schizophrenia, the recommended starting dose is typically higher than the suggested starting dose in the provided evidence, usually around 10-15 mg once daily, with a target dose of 15 mg daily and a maximum of 30 mg daily.
• For bipolar mania, adults usually start with 15 mg once daily, with a maximum of 30 mg daily.
• When used as an adjunct for depression, adults typically start at 2-5 mg daily, potentially increasing to 15 mg daily.
• For irritability in autism, children (6-17 years) usually begin with 2 mg daily, gradually increasing to 5-15 mg daily based on response. Abilify should be taken at the same time each day with or without food. Dosage adjustments may be needed for patients with liver problems, those taking certain medications that affect drug metabolism, or elderly patients, as noted in the study by 1. Abilify works by modulating dopamine and serotonin receptors in the brain, acting as a partial agonist at some receptors and an antagonist at others, which helps stabilize these neurotransmitter systems. Common side effects include weight gain, restlessness, and dizziness, and it may take several weeks to see full therapeutic benefits.
• A recent study by 1 found that antipsychotic augmentation was superior to monotherapy regarding total symptom reduction, although this was only apparent in open-label low-quality trials, and no significant differences were observed in high-quality trials.
• The study by 1 also noted that aripiprazole augmentation was associated with reduced prolactin levels and body weight, and fewer adverse effects, highlighting the potential benefits of using Abilify in certain patient populations.

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.
2. 7 Dosage Adjustments for Cytochrome P450 Considerations Dosage adjustments are recommended in patients who are known CYP2D6 poor metabolizers and in patients taking concomitant CYP3A4 inhibitors or CYP2D6 inhibitors or strong CYP3A4 inducers

The recommended use and dosage of Abilify (aripiprazole) is as follows:

• Schizophrenia in Adults: The recommended starting and target dose is 10 or 15 mg/day, administered once a day.
• Schizophrenia in Adolescents: The recommended target dose is 10 mg/day.
• Dosage Adjustments: May be necessary for patients who are known CYP2D6 poor metabolizers or taking concomitant CYP3A4 inhibitors or CYP2D6 inhibitors or strong CYP3A4 inducers, as outlined in Table 2 2.

From the Research

Recommended Use and Dosage of Abilify (Aripiprazole)

• Abilify (aripiprazole) is an atypical antipsychotic drug used in the treatment of schizophrenia and bipolar I disorder 3, 4, 5, 6.
• The recommended dosage of aripiprazole for the treatment of schizophrenia is between 10 and 30 mg/day, with a starting dose of 10 or 15 mg once daily 4, 5, 7.
• For the treatment of manic or mixed episodes in bipolar I disorder, the recommended dosage is 15-30 mg/day 4.
• In adolescents (aged ≥13 years) with bipolar I disorder, the recommended dosage is 10 mg once daily for 12 weeks 6.
• The dosage may need to be adjusted based on individual patient response and tolerability, and dosage titration is not necessary 5.

Efficacy and Safety

• Aripiprazole has been shown to be effective in reducing symptoms of schizophrenia and bipolar I disorder, with a rapid onset of action within one week 3, 4.
• The drug has a favorable safety profile, with a low propensity for weight gain, hyperprolactinemia, and extrapyramidal symptoms (EPS) 4, 5, 6.
• Common adverse events include insomnia, anxiety, headache, and akathisia, but the incidence of EPS is generally low 4, 5, 6.

Special Considerations

• In children and adolescents, the dosage may need to be adjusted based on weight, and the safety and efficacy of aripiprazole in this population are still being studied 3, 6.
• Aripiprazole is metabolized by the cytochrome P450 enzyme system, and dosage adjustments may be necessary when coadministered with other drugs that affect this system 5.