Aripiprazole (Abilify): Uses, Forms, and Safety

What is aripiprazole?

Aripiprazole is an active ingredient used in the treatment of several mental health conditions. The source content identifies its use in schizophrenia, bipolar disorder, autism, and depression.

In the United States, brand names listed in the source include Abilify, Abilify Maintena, Aristada, and Abilify MyCite.

How aripiprazole works

Aripiprazole is described as an antipsychotic. Its mechanism of action includes partial dopamine D2 receptor agonism and activity at serotonin 5-HT1A and 5-HT2A receptors.

Therapeutic uses listed in the source

The source content describes the following uses and formulations:

• Oral use: schizophrenia in adults and adolescents over 15 years.
• Oral use: moderate or severe manic episodes in bipolar I disorder in adults and adolescents over 13 years, and relapse prevention.
• Intramuscular normal release: rapid control of agitation and behavioural alterations in schizophrenia when oral treatment is not adequate.
• Intramuscular prolonged release: maintenance treatment in schizophrenia in adults stabilized with oral aripiprazole.

Dosage information from the source

The following information is included in the original content. Exact dosing should always be confirmed in the official product information for the specific medicine and formulation.

The source also notes that if adverse reactions occur with the 400 mg prolonged-release dose, a reduction to 300 mg once monthly may be considered. It also mentions dose adjustments in slow CYP2D6 metabolizers and with potent CYP3A4 inhibitors.

How it is administered

Oral forms

Oral-dispersible tablets or oral solution may be used when swallowing tablets is difficult. The buccodispersible tablet is placed on the tongue and disperses with saliva. It can be taken with or without liquid, and the source notes that it can also be dissolved in water and the resulting suspension drunk.

Intramuscular forms

For normal-release intramuscular use, the source recommends injection into the deltoid or gluteus maximus muscle, avoiding adipose areas to improve absorption and reduce variability.

For prolonged-release intramuscular use, the suspension should be injected immediately after reconstitution. The source also states that it may be kept in the vial below 25 ºC for up to 4 hours before injection, and that it should be injected slowly into the buttocks or deltoids in a single administration.

Contraindications

The source lists hypersensitivity to aripiprazole as a contraindication.

Warnings and precautions

The original content includes several precautions that may be relevant depending on the patient and formulation:

• Severe liver failure.
• Use in people under 15 years for schizophrenia and under 13 years for manic episodes.
• Elderly patients.
• Known cardiovascular disease, cerebrovascular disease, or conditions that may predispose to hypotension.
• Family history of prolonged QT interval.
• Epilepsy or history of seizures.
• Diabetes mellitus or risk factors for diabetes mellitus, with regular monitoring mentioned in the source.
• Weight gain, especially in adolescents.
• Dysphagia and aspiration risk.
• Pathological gambling.
• Risk of suicidal tendencies.

The source also notes that aripiprazole is not indicated in elderly people with dementia-related psychosis.

For intramuscular normal-release use, the source warns about use with parenteral benzodiazepines because of the risk of excessive sedation and cardiorespiratory depression, and it notes that efficacy and safety were not evaluated in alcohol or drug intoxication.

Pharmacovigilance data in the source also mention a risk of falls due to drowsiness, postural hypotension, and motor or sensory instability.

Liver impairment

The source advises caution in severe hepatic insufficiency and notes that dose adjustment may be needed.

Interactions listed in the source

Aripiprazole may interact with other medicines and substances. The source highlights the following:

• May increase aripiprazole levels: quinidine, fluoxetine, paroxetine, ketoconazole, itraconazole, and HIV protease inhibitors.
• May decrease aripiprazole levels: carbamazepine, rifampicin, rifabutin, phenytoin, phenobarbital, primidone, efavirenz, nevirapine, and St. John’s wort.
• May increase the effect of: certain antihypertensive agents.
• Use caution with: alcohol, other central nervous system-active substances, medicines that prolong the QT interval, and electrolyte disorders.
• With SSRIs/SNRIs: the source notes a risk of serotonin syndrome.

Pregnancy and breastfeeding

The source states that, because of insufficient human safety information and findings in animal reproduction studies, aripiprazole should not be used in pregnancy unless the expected benefit clearly justifies the potential risk to the fetus.

It also states that aripiprazole is excreted in human breast milk and that patients should be warned not to breastfeed while taking it.

Driving and operating machinery

Aripiprazole can cause drowsiness, dizziness, visual changes, and reduced reaction ability. The source advises caution when driving or using dangerous machinery, especially until individual sensitivity is known.

Adverse reactions and side effects listed in the source

The original content includes the following adverse reactions:

• Diabetes mellitus
• Insomnia, agitation, anxiety
• Headache, akathisia, drowsiness/sedation, tremor, extrapyramidal disorder, dizziness
• Blurred vision
• Nausea, vomiting, dyspepsia, constipation, salivary hypersecretion
• Fatigue
• Tachycardia
• Orthostatic hypotension
• Aggression
• Hiccup
• Oculogenic crisis

What to check with a doctor or pharmacist

If you are reviewing aripiprazole for yourself or someone else, it is useful to confirm the following in the official leaflet or with a healthcare professional:

• Which formulation is being used: oral, oral-dispersible, solution, or intramuscular.
• The exact indication for that product.
• Whether any dose adjustments are needed for liver problems or interacting medicines.
• How the injection schedule works, if a long-acting form is prescribed.
• Which side effects should prompt medical review.

Safety reminder

Do not use this page to self-manage treatment decisions. If aripiprazole has been prescribed, follow the official instructions for that specific product and speak with a doctor or pharmacist if anything in the leaflet is unclear.

FAQ

Sources and references

The content was prepared from the source material provided and aligned with official medicine information resources. For product-specific details, always check the relevant FDA medication guide or prescribing information.