Abilify Drug Class
Abilify (aripiprazole) is an atypical antipsychotic medication, also known as a second-generation or third-generation antipsychotic, characterized by its unique mechanism as a partial dopamine D2 receptor agonist combined with serotonin receptor activity. 1, 2
Pharmacological Classification
- Aripiprazole belongs to the quinolinone derivative class of atypical antipsychotics 1, 2
- It is distinguished as a "third-generation" antipsychotic due to its unique receptor binding pattern that differs from typical dopamine antagonists and second-generation serotonin-dopamine antagonists 3
- The drug functions as a partial agonist at dopamine D2 and D3 receptors, and serotonin 5-HT1A receptors, while acting as an antagonist at serotonin 5-HT2A and 5-HT2B receptors 1, 2
Mechanism of Action
- Aripiprazole's efficacy in treating positive and negative symptoms of schizophrenia, along with its lower propensity for extrapyramidal symptoms, is attributed to its partial agonist activity at dopamine D2 receptors 2
- The drug exhibits typical antagonism at D2 receptors in the mesolimbic pathway while having unique partial agonist activity at D2 receptors in the mesocortical pathway 4
- Among atypical antipsychotics, aripiprazole displays the lowest affinity for alpha-1 adrenergic, histamine H1, and muscarinic M1 receptors, which contributes to its favorable side effect profile 4
Clinical Context
- Aripiprazole represents the first functionally selective atypical antipsychotic drug 1
- The American Academy of Child and Adolescent Psychiatry recognizes aripiprazole as a first-line option for acute mania in bipolar disorder, alongside lithium and valproate 5
- The drug is associated with lower sedation compared to other antipsychotics due to its low histamine H1 affinity 3
- Aripiprazole has a favorable metabolic profile with low propensity for weight gain, hyperprolactinemia, or QT interval prolongation 2, 4