What is the recommended dosage for Abilify (aripiprazole)?

Recommended Dosage for Abilify (Aripiprazole)

The recommended starting and target dose for Abilify (aripiprazole) is 10 or 15 mg/day administered once daily without regard to meals for most adult indications. 1

Adult Dosing Guidelines

Schizophrenia

• Initial dose: 10-15 mg once daily 1
• Effective dose range: 10-30 mg/day, though doses higher than 10-15 mg/day have not shown additional benefit 1, 2
• Maintenance: Continue at effective dose; periodic reassessment recommended 1
• Optimal dose appears to be 10 mg/day based on clinical response data, with doses above 20 mg/day providing no additional benefit 2

Dosage Adjustments

• Allow at least 2 weeks between dose adjustments to achieve steady-state 1, 3
• Full therapeutic effect may take 1-4 weeks to manifest 3
• Dose adjustments required for patients who are:
  • CYP2D6 poor metabolizers 1
  • Taking concomitant CYP3A4 inhibitors or CYP2D6 inhibitors 1
  • Taking strong CYP3A4 inducers 1

Special Populations

Adolescents with Schizophrenia (13-17 years)

• Starting dose: 2 mg/day 1
• Titration: Increase to 5 mg after 2 days, then to target dose of 10 mg after 2 additional days 1
• Target dose: 10 mg/day 1
• Maximum dose: Doses higher than 10 mg/day (up to 30 mg/day) showed no additional benefit 1

Administration Considerations

• Can be administered without regard to meals 1
• When switching from other antipsychotics:
  • Immediate discontinuation may be appropriate for some patients 1
  • Gradual discontinuation may be better for others 1
  • Minimize period of overlapping antipsychotic administration 1

Safety and Monitoring

• Aripiprazole has a favorable side effect profile compared to many antipsychotics 4
• Lower propensity for:
  • Extrapyramidal symptoms 4
  • Clinically significant weight gain 4
  • Hyperprolactinemia 4
  • QT interval prolongation 4
• Common side effects include insomnia, anxiety, headache, and agitation 4

Long-Acting Injectable Formulations

• For patients requiring long-term therapy, long-acting injectable formulations are available:
  • Aripiprazole lauroxil: 1064 mg every 2 months 5
  • Aripiprazole monohydrate: 960 mg every 2 months 5

Clinical Pearls

• The threshold for clinical effect appears to be between 5-10 mg/day 2
• Highest response rate has been observed at 10 mg/day in clinical studies 2
• Steady-state concentrations are achieved within 14 days of dosing 1, 3
• The mean elimination half-life is approximately 75 hours 4, 3

Remember that while the FDA-approved dose range is 10-30 mg/day, clinical evidence suggests that the optimal dose is 10 mg/day for most patients, with limited additional benefit observed above 20 mg/day 2.