Aripiprazole

What is aripiprazole?

Aripiprazole – often known under the brand name Abilify – is a second-generation (atypical) antipsychotic medication. It works by helping to balance certain chemicals in the brain, including dopamine and serotonin, which affect mood, behaviour, and thinking[1]. 

What is aripiprazole used for?

Aripiprazole is prescribed to manage several mental health conditions, including schizophrenia and manic episodes in bipolar I disorder. It helps reduce symptoms such as mood swings, hallucinations, disorganised thinking, and delusions[1]. 

How does aripiprazole work?

Aripiprazole acts on brain chemicals in several ways, including[1]: 

• Partially activating dopamine D2 receptors & serotonin 5-HT1A receptors 

• Blocking serotonin 5-HT2A receptors 

This combination is thought to help stabilise mood, reduce psychotic symptoms and improve emotional regulation through dopamine regulation. 

Who can take aripiprazole?

Aripiprazole is generally suitable for adults and adolescents with schizophrenia or manic episodes in bipolar I disorder. It is usually not suitable for those who are pregnant or breastfeeding as it may affect the infant, so discuss with your doctor first[1]. 

Please also tell your doctor or pharmacist about any conditions you may have before you start treatment, and always follow the instructions in the Patient Information Leaflet[2]. 

What is the typical dosage of aripiprazole?

The typical aripiprazole dose will depend on your age, condition and prescribed formulation. Your prescriber may also change dose based on your response to treatment. The most common starting dose for tablets is 10-15mg, taken once per day. Lower or higher doses may be advised based on your unique circumstances. Always follow your doctor’s instructions and do not change your dose without medical advice[1]. 

How do you take aripiprazole?

Aripiprazole comes in several forms including oral tablets, orodispersible tablets, oral solution, or as a long-acting injection. A typical dosage for oral preparations is once daily, with or without food, taken at the same time each day for best results[1]. 

If you are using a long-acting injection, it is usually given by deep intramuscular injection every 4 to 6 weeks by a healthcare professional. If you are prescribed Abilify Maintena® you will receive your depot injection every 2 months[1]. 

Can you stop taking aripiprazole suddenly?

If you are taking aripiprazole, do not stop suddenly, even if you feel better. Stopping too quickly can cause withdrawal symptoms and a return of psychosis or mood instability. Your doctor will closely monitor and guide you on how to gradually reduce your dose. There is a high risk of relapse if medication stopped after 1-2 years, your doctor should monitor for signs and symptoms of relapse for 2 years after stopping medication[1]. 

What should you do if you take too much aripiprazole?

If you take too much aripiprazole, you may experience symptoms of overdose, such as drowsiness, feeling lethargic, blood pressure changes, diarrhoea, nausea, vomiting, tremors, aggression, agitation, seizures, or irregular heartbeat. It’s important to seek emergency medical help immediately if you think you have taken too much[1]. 

Which medicines should you avoid while taking aripiprazole?

Aripiprazole can interact with several medications. As such, you should always tell your doctor or pharmacist about everything you’re taking, including supplements and herbal remedies[1]. 

In particular, aripiprazole is usually not taken with[1]: 

• Other medications that prolong the QT interval (e.g. amiodarone, citalopram) 

• Some diuretics (e.g. bumetanide, bendroflumethiazide) may cause hypokalaemia, hyponatraemia, or hypotension 

• Steroid medication (e.g. prednisolone) may cause hypokalaemia 

• Other antipsychotics as these can increase side effects, especially with clozapine which can lead to toxicity 

• Certain antidepressants, e.g. fluoxetine, paroxetine which may affect aripiprazole levels 

• Antifungals, e.g. ketoconazole which may increase aripiprazole levels 

• Anticonvulsants, e.g. carbamazepine which may lower aripiprazole levels 

• Alcohol which can increase drowsiness and other Central Nervous System depressant effects such as unconsciousness, breathing difficulty and fatigue.  

Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2]. 

What are the side effects of aripiprazole?

The common side effects of aripiprazole include nausea, vomiting, gastrointestinal discomfort, muscle stiffness, headaches, anxiety, restlessness, insomnia, dizziness, light-headedness, and weight increase or decrease (less common than with other antipsychotics)[1]. 

Other, more serious, side effects of aripiprazole which require urgent medical care include[1]: 

• Suicidal thoughts or behaviours 

• Seizures 

• Uncontrollable movements (tardive dyskinesia) 

• High blood sugar or diabetes symptoms (e.g. excessive thirst or urination) 

• Neuroleptic malignant syndrome – a rare, serious reaction with high fever, muscle stiffness, and confusion 

If any side effects are worrying, severe, or persistent, contact your doctor.

If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice.

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2]. 

Frequently asked questions about aripiprazole

Is aripiprazole addictive? 

No, aripiprazole is not considered addictive. However, you should not stop taking it suddenly as this could cause withdrawal syndrome or risk of relapse[1]. 

How long does aripiprazole take to work? 

When you start taking aripiprazole, you may notice some improvement within a few days. In other cases, the full effects can take a few weeks[1]. 

Can I drink alcohol while taking aripiprazole? 

When taking aripiprazole, it’s best to limit or avoid alcohol, as it may worsen central nervous system side effects such as drowsiness, dizziness, unconsciousness and poor coordination[1]. 

Will aripiprazole affect my weight? 

Some people gain weight when taking aripiprazole. However, it’s been shown to have less of an effect on weight change compared to other antipsychotics[1]. 

Can I drive or use machinery while taking aripiprazole? 

Aripiprazole can cause drowsiness or dizziness. For that reason, you should not drive, use heavy machinery, or drink alcohol should you feel sleepy. If in any doubt, please talk to your doctor[1]. 

How should I take orodispersible aripiprazole? 

With dry hands, peel back the foil from the blister containing the dispersible tablet, do not push the tablet through the foil. Place the tablet onto your tongue and allow to dissolve, alternatively disperse the tablet in water and drink the resulting suspension[1]. 

Will I need regular check-ups while taking aripiprazole? 

Yes, you’ll usually need frequent blood tests while taking aripiprazole. This will monitor for prolactin levels – especially at the start of treatment, at 6 months and then yearly[1].  

What should I do if I notice an increase in urge to gamble or other impulse? 

Talk to your doctor about your dose if you notice an increase in urge to gamble or other impulse control symptoms such as excessive eating, spending or hypersexuality when taking aripiprazole[1].  

For the official NHS guide to aripiprazole, visit their website.