From the Guidelines
Abilify (aripiprazole) should be used at a starting dose of 5 mg p.o. or i.m. (immediate-release) stat, with a recommended dose of 5 mg q24h if scheduled dosing is required, as it is less likely to cause extrapyramidal side effects (EPSEs) compared to other antipsychotics 1.
Key Considerations
- The dosage should be reduced in older patients and in poor metabolizers of cytochrome P450 2D6, and titrated gradually as needed.
- Aripiprazole may cause headache, agitation, anxiety, insomnia, dizziness, and drowsiness, and caution should be exercised when using it in combination with other medications that affect the cytochrome P450 2D6 and 3A4 pathways.
- Antipsychotic polypharmacy, including the use of aripiprazole with other antipsychotics, may be considered in some cases, but should be approached with caution and careful monitoring due to the potential for increased side effects and interactions 1.
Monitoring and Precautions
- Regular monitoring for movement disorders, metabolic changes, and cardiovascular effects is necessary during treatment with aripiprazole.
- Patients should be advised not to stop taking aripiprazole abruptly without medical supervision, and to take the medication at the same time each day, with or without food.
- The use of aripiprazole in combination with other medications, such as benzodiazepines, should be approached with caution due to the potential for increased sedation and respiratory depression.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Overview of Abilify (Aripiprazole)
- Abilify, also known as Aripiprazole, is an atypical antipsychotic medication used to treat schizophrenia and bipolar I disorder 2, 3, 4, 5, 6.
- It has a unique receptor binding profile, exhibiting partial agonist activity at dopamine D2 receptors and serotonin 5-HT1A receptors, as well as antagonist activity at 5-HT2A receptors 3, 4, 6.
Efficacy of Aripiprazole
- Aripiprazole has been shown to be effective in treating acute relapse of schizophrenia and schizoaffective disorder, as well as maintaining response in chronic schizophrenia 2, 3, 4, 5, 6.
- It has also been found to be effective in treating acute bipolar mania 5.
- Aripiprazole has been compared to other antipsychotic agents, including haloperidol and olanzapine, and has been found to have a mixed response in terms of efficacy outcomes 2, 3, 6.
Tolerability and Safety of Aripiprazole
- Aripiprazole is generally well tolerated, with a lower incidence of extrapyramidal symptoms compared to haloperidol and fewer weight-gain issues compared to olanzapine 2, 3, 4, 6.
- It has also been found to have a favorable cardiovascular tolerability profile and a reduced risk of metabolic syndrome compared to placebo or olanzapine 6.
- Commonly reported side effects include worsening extrapyramidal symptoms and motoric activation similar to akathisia 5.