Tapering Aripiprazole from 10mg per Day
The recommended approach for tapering Aripiprazole is a gradual reduction of approximately 10% of the original dose per week to minimize withdrawal symptoms. 1
Recommended Tapering Schedule
- Start with a reduction from 10mg to 9mg daily for one week, then continue reducing by approximately 1mg per week until complete discontinuation 1
- For patients who have been taking Aripiprazole for longer durations, a slower taper of 10% per month may be better tolerated than more rapid tapers 1
- If withdrawal symptoms become severe during tapering, temporarily return to the previous well-tolerated dose and extend the time between dose reductions 2
Monitoring During Dose Reduction
- Regularly assess for withdrawal symptoms, which may include anxiety, insomnia, irritability, and mood changes during the dose reduction process 1
- If withdrawal symptoms occur, pause the taper and restart when the patient is ready 1
- Patients should be reassessed at least every 3 months during the dose reduction process 1
Special Considerations
- The oral solution formulation may be more appropriate for precise dose reductions, especially in the final stages of tapering 1
- Timing the final discontinuation during periods of lower life stress may improve tolerability 2
- Don't set arbitrary time limits for completing the taper; individualize based on patient response 2
- Be aware that Aripiprazole has a long half-life (approximately 75 hours), which may help reduce withdrawal symptoms compared to medications with shorter half-lives 3
- Full effects of dose changes may take 1-2 weeks, and sometimes up to 4 weeks, due to the long time needed to reach steady state 3
Potential Withdrawal Symptoms to Monitor
- Parkinsonian symptoms (hypertonia, akinesia, shuffling gait) have been reported with Aripiprazole, which may emerge or worsen during tapering 4
- If severe Parkinsonian symptoms develop during tapering, a more gradual reduction may be necessary 4
Practical Implementation
For a 10mg starting dose, a sample tapering schedule might be:
- Weeks 1-2: 9mg daily
- Weeks 3-4: 8mg daily
- Weeks 5-6: 7mg daily
- Weeks 7-8: 6mg daily
- Weeks 9-10: 5mg daily
- Weeks 11-12: 4mg daily
- Weeks 13-14: 3mg daily
- Weeks 15-16: 2mg daily
- Weeks 17-18: 1mg daily
- Week 19: Discontinue 1
For patients experiencing difficulty with withdrawal symptoms, consider an even slower taper, particularly in the final stages of discontinuation 1