Recommended Dosages for Abilify (Aripiprazole) and Effexor (Venlafaxine)
For Abilify (aripiprazole), the recommended starting dose is 10-15 mg once daily, with a maximum dose of 30 mg daily; for Effexor (venlafaxine), the recommended starting dose is 75 mg daily in 2-3 divided doses, with a maximum dose of 375 mg daily.
Abilify (Aripiprazole) Dosing
Initial Dosing
- Starting dose: 10-15 mg once daily 1
- Can be taken without regard to meals
- For patients who are CYP2D6 poor metabolizers: Start with half the usual dose (5-7.5 mg)
Dose Titration
- Dosage increases should generally not be made before 2 weeks (time needed to achieve steady-state) 1
- Effective dose range: 10-30 mg daily, though doses higher than 10-15 mg/day have not shown greater efficacy 1, 2
Special Considerations
- For patients taking CYP3A4 inhibitors (e.g., ketoconazole) or CYP2D6 inhibitors (e.g., fluoxetine): Reduce dose by 50% 1
- For patients taking both strong CYP2D6 and CYP3A4 inhibitors: Reduce to 25% of usual dose 1
- For patients taking strong CYP3A4 inducers (e.g., carbamazepine): Double usual dose over 1-2 weeks 1
Effexor (Venlafaxine) Dosing
Initial Dosing
- Starting dose: 75 mg/day, administered in 2-3 divided doses, taken with food 3
- For severe depression, higher starting doses may be considered
Dose Titration
- May increase to 150 mg/day if needed
- Further increases up to 225 mg/day may be made if clinically indicated
- When increasing dose, use increments of up to 75 mg/day at intervals of no less than 4 days 3
- Maximum recommended dose: 375 mg/day (generally in three divided doses) 3, 4
Special Considerations
- Hepatic impairment: Reduce total daily dose by 50% 3
- Renal impairment:
- Mild to moderate (GFR 10-70 mL/min): Reduce dose by 25%
- Hemodialysis patients: Reduce dose by 50%
- Elderly patients: No specific dose adjustment required based on age alone, but use caution when increasing dose 3
Important Monitoring Considerations
For Aripiprazole
- Monitor for extrapyramidal symptoms, particularly at doses above 10 mg 5
- Watch for akathisia, which may occur early in treatment 6
- Consider starting at lower doses (2.5 mg) if concerned about akathisia 6
For Venlafaxine
- Monitor blood pressure regularly as venlafaxine can cause mild increases in blood pressure, particularly at higher doses 4
- Watch for common side effects: fatigue, concentration difficulties, sleepiness, memory issues 4
- When discontinuing, taper gradually over 10-14 days to limit withdrawal symptoms 3
Combination Therapy Considerations
When using both medications together:
- Start at the lower end of the dosing range for each medication
- Monitor closely for drug interactions, particularly serotonin syndrome
- Adjust doses based on clinical response and tolerability
- Be aware that both medications may affect blood pressure
Remember that these dosing recommendations are general guidelines, and clinical response and tolerability should guide individual treatment decisions.