Aripiprazole (US brand name Abilify® and generic) is a second-generation (atypical) antipsychotic.
On this page, we present some basic information about this medication. Other articles on this website with more advanced information and tips related to this medication are linked to under Related Pages below.
FDA-approved indications
A. Oral
1. Schizophrenia
2. Acute treatment of manic and mixed episodes associated with bipolar I disorder
3. Adjunctive treatment of major depressive disorder
4. Irritability associated with autistic disorder
5. Treatment of Tourette’s disorder
B. Injectable
Agitation associated with schizophrenia or bipolar mania
Pharmacodynamic effects
Aripiprazole has a high affinity for D2, 5-HT1A, and 5-HT2A receptors and has the following effects on these receptors (DeLeon et al., 2004):
1. Partial agonist at post-synaptic dopamine-2 (D2) receptors. This effect tends to lead to upregulation of the D2 receptors.
2. Partial agonist at pre-synaptic dopamine-2 (D2) autoreceptors. This effect tends to lead to a decrease in the synthesis and release of dopamine.
3. Partial agonist at serotonin-1A (5-HT1A) receptors
4. Antagonist at serotonin-2A (5-HT2A) receptors
Pharmacokinetics
Aripiprazole is metabolized by two cytochrome P450 enzymes—2D6 and 3A4.
Potential side effects
Please see THIS PAGE for a handout listing both the common and less common side effects of this medication along with the percentages of patients who report them.
Dosage
Schizophrenia (adults)
Initial: 10–15 mg/day
Recommended: 10–15 mg/day
Maximum: 30 mg/day
Schizophrenia (adolescents)
Initial: 2 mg/day
Recommended: 10 mg/day
Maximum: 30 mg/day
Bipolar mania (adults: monotherapy)
Initial: 15 mg/day
Recommended: 15 mg/day
Maximum: 30 mg/day
Bipolar mania (adults: adjunct to lithium or valproate)
Initial: 10–15 mg/day
Recommended: 15 mg/day
Maximum: 30 mg/day
Bipolar mania (pediatric patients: monotherapy or as an adjunct to lithium or valproate)
Initial: 2 mg/day
Recommended: 10 mg/day
Maximum: 30 mg/day
Major depressive disorder (adults: adjunct to antidepressants)
Initial: 2–5 mg/day
Recommended: 5–10 mg/day
Maximum: 15 mg/day
Irritability associated with autistic disorder (pediatric patients)
Initial: 2 mg/day
Recommended: 5–10 mg/day
Maximum: 15 mg/day
Tourette’s disorder (patients <50 kg)
Initial: 2 mg/day
Recommended: 5 mg/day
Maximum: 10 mg/day
Tourette’s disorder (patients >50 kg)
Initial: 2 mg/day
Recommended: 10 mg/day
Maximum: 20 mg/day
Agitation associated with schizophrenia or bipolar mania (adults)
Initial: 9.75 mg/1.3 mL Injected IM
Maximum: 30 mg/day Injected IM
General Instructions
1. Oral formulations may be administered once daily without regard to meals.
2. IM injection: Wait at least 2 hours between doses. Maximum daily dose 30 mg.
Dose modification
The Prescribing Information for aripiprazole recommends using half of the usual dose of aripiprazole in known CYP2D6 poor metabolizers.
If the person is a CYP2D6 poor metabolizer and is also on a medication that is a strong CYP3A4 inhibitor, the Prescribing information recommends a quarter of the usual dose of aripiprazole. This is because the peak serum concentration and the “area under the curve” for aripiprazole are expected to be tripled when the person is both a CYP2D6 poor metabolizer and on a strong CYP3A4 inhibitor (Prescribing Information).
Dosage forms and strengths
Tablets (Abilify® and generic): 2 mg, 5 mg, 10 mg, 15 mg, 20 mg, and 30 mg
Orally disintegrating tablets (Abilify® and generic): 10 mg and 15 mg
Oral solution (generic): 1 mg/mL
Injection (Abilify®): 9.75 mg/1.3 mL single-dose vial (7.5 mg/mL)
Please refer to Prescribing Information (see link below) for a complete discussion of dosage, administration, warnings and precautions, contraindications, etc.
Related Pages
FDA issues new warning about aripiprazole (impulse control problems)
How exactly to add aripiprazole for hyperprolactinemia with risperidone
What dose of aripiprazole as an adjunct for OCD?
Resolution of hyperglycemia after switching to aripiprazole
Can aripiprazole *worsen* psychosis?
Aripiprazole with sensor (Abilify Mycite®): Basic Information
Aripiprazole (Abilify Maintena®): Basic Information
Aripiprazole lauroxil (Aristada®)
Aripiprazole lauroxil (Aristada Initio™): Basic information
Aripiprazole lauroxil (Aristada®) versus Aripiprazole (Abilify Maintena®)
Second-Generation (“Atypical”) Antipsychotics
Long-acting injectable antipsychotics
Second-Generation Antipsychotics: Dose Equivalents
References
Aripiprazole Prescribing Information
DeLeon A, Patel NC, Crismon ML. Aripiprazole: a comprehensive review of its pharmacology, clinical efficacy, and tolerability. Clin Ther. 2004 May;26(5):649-66. doi: 10.1016/s0149-2918(04)90066-5. PMID: 15220010.
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