What is the starting dose of Abilify (aripiprazole) for adults?

Aripiprazole Starting Dose for Adults

The recommended starting dose of Abilify (aripiprazole) for adults is 10 or 15 mg once daily, administered without regard to meals, with no titration required. 1

Standard Dosing for Schizophrenia

• The FDA-approved starting and target dose is 10 or 15 mg/day given once daily. 1
• Aripiprazole has been systematically evaluated and shown to be effective in a dose range of 10 to 30 mg/day. 1
• Doses higher than 10 or 15 mg/day were not more effective than the lower doses. 1
• No initial titration is necessary—the drug can be started at the target dose immediately. 1, 2

Time to Therapeutic Effect

• Steady-state plasma concentrations are achieved by 14 days of dosing. 3
• Dosage increases should generally not be made before 2 weeks, the time needed to achieve steady-state. 1, 3
• At least 1 to 2 weeks, and sometimes up to 4 weeks, may pass before aripiprazole reaches its full therapeutic effect. 3
• The drug demonstrates efficacy as early as the first or second week of treatment. 2

Dose-Response Considerations

• Literature review reveals an effective dose range between 10 and 25 mg/day for schizophrenia treatment. 4
• Doses less than 10 mg/day did not show significant efficacy on core symptoms of schizophrenia (though lower doses of 1-15 mg showed efficacy specifically for agitation). 4
• No additional therapeutic benefit was observed at doses above 15 mg/day in controlled trials. 1

Special Population Adjustments

• For older or frail patients, lower starting doses should be used (e.g., 2.5-5 mg for olanzapine equivalent dosing considerations). 5
• Patients with hepatic impairment require dose reduction. 5

Critical Drug Interaction Adjustments

• CYP2D6 poor metabolizers should reduce the dose by 50%. 5
• When aripiprazole is combined with strong CYP3A4 inhibitors or CYP2D6 inhibitors, dosage adjustments are mandatory. 5, 1
• When coadministered with strong CYP3A4 inducers, the aripiprazole dose may need to be doubled. 1

Common Pitfalls to Avoid

• Do not increase the dose before 2 weeks of continuous therapy—steady-state has not been achieved and the full therapeutic effect cannot be assessed. 1, 3
• Do not assume higher doses (20-30 mg) will provide better efficacy—controlled trials showed no additional benefit. 1, 2
• Monitor for akathisia, the most common movement-related side effect, particularly in the first weeks of treatment. 5