Can Abilify Make You Tired?
Yes, Abilify (aripiprazole) can cause fatigue and tiredness, though this side effect occurs at rates only modestly higher than placebo.
Evidence from FDA-Approved Labeling
According to the FDA drug label, fatigue is a documented adverse reaction of aripiprazole 1:
- In adults: Fatigue occurred in 6% of aripiprazole-treated patients compared to 4% receiving placebo 1
- In pediatric patients (6-18 years): Fatigue was more common, occurring in 10% of aripiprazole-treated patients versus only 2% receiving placebo 1
Related Sedating Effects
Beyond fatigue specifically, aripiprazole causes several related symptoms that contribute to tiredness 1:
- Somnolence (sleepiness): 5% in adults (vs 3% placebo) and 16% in pediatric patients (vs 4% placebo) 1
- Sedation: 7% in adults (vs 4% placebo) and 9% in pediatric patients (vs 2% placebo) 1
- Lethargy: 3% in pediatric patients (vs 0% placebo) 1
The FDA label notes a dose-response relationship for somnolence, with the 30 mg dose showing the highest incidence (12.6%) compared to lower doses 1.
Clinical Context
Important caveat: While aripiprazole can cause fatigue, it is generally considered to have a favorable tolerability profile compared to other antipsychotics 2, 3. The drug was specifically designed with lower affinity for histamine H1 receptors, which typically mediate sedation with other antipsychotics 4.
Interestingly, one case report suggests aripiprazole may actually improve daytime sleepiness in delayed sleep phase syndrome, potentially through its effects on histamine release and sleep-wake cycle regulation 5. This highlights that individual responses can vary.
Practical Management
If fatigue occurs on aripiprazole 1:
- Timing adjustment: Consider taking the medication at bedtime rather than during the day to minimize daytime sedation
- Hydration: Ensure adequate fluid intake, as the FDA label recommends drinking plenty of water while on this medication 1
- Monitor for other causes: Evaluate whether fatigue might be related to the underlying psychiatric condition rather than the medication itself
- Dose consideration: Higher doses (particularly 30 mg) show increased somnolence rates 1
The most common side effects overall include nausea, dizziness, vomiting, anxiety, constipation, insomnia, headache, restlessness, and akathisia—with fatigue being less prominent than these 1.