Switching Abilify to Evening Dosing for Daytime Sleepiness
Yes, you can switch Abilify (aripiprazole) to evening or bedtime dosing if it is causing daytime sleepiness, as the FDA label explicitly states it can be taken with or without food at any time of day, and drowsiness is a recognized side effect that may be better tolerated at night. 1
Rationale for Evening Dosing
Aripiprazole causes drowsiness as a common side effect, particularly in children and adults, and the FDA specifically warns that patients should not drive or operate heavy machinery until they know how the medication affects them 1
The medication can be taken at any time without regard to meals, giving you flexibility to adjust timing based on side effect profile 1
Switching sedating medications to evening administration is a standard strategy to minimize daytime functional impairment while maintaining therapeutic benefit 2, 3
Important Considerations
Timing Strategy
Make the switch gradually if possible - take the dose progressively later over several days to allow your body to adjust to the new schedule 3
Take at a consistent time each evening to maintain steady medication levels and optimize therapeutic effects 1
If you miss a dose, take it as soon as you remember unless it's almost time for the next dose - never double up 1
Potential Paradoxical Effects
Be aware that aripiprazole can cause both drowsiness AND insomnia as side effects, so evening dosing may worsen sleep in some patients 1, 4
One small study suggested aripiprazole taken during the day actually helped treat delayed sleep phase syndrome, possibly because the daytime insomnia it caused counteracted excessive daytime sleepiness 4
Monitor your response carefully - if evening dosing worsens nighttime sleep or causes next-morning grogginess, you may need to return to morning dosing or discuss alternative strategies with your prescriber 2
Safety Precautions
Aripiprazole can cause orthostatic hypotension (dizziness when standing), which combined with drowsiness increases fall risk, particularly concerning at night when getting up to use the bathroom 1
Avoid alcohol and other CNS depressants, as these can enhance sedation and impairment 2
Stay well-hydrated and avoid overheating, as aripiprazole affects body temperature regulation 1
When to Contact Your Prescriber
Do not make this change without informing your healthcare provider, especially if you have bipolar disorder or schizophrenia where maintaining stable medication levels is critical 1
Contact your provider if daytime sleepiness persists despite evening dosing, as dose adjustment or medication change may be needed 5
Report any new or worsening symptoms including insomnia, unusual urges (gambling, compulsive eating), movement disorders, or mood changes 1