What You Need to Know About Abilify
Mental health conditions such as schizophrenia, bipolar disorder, and treatment-resistant depression can keep you from enjoying life the way you want. The best way to manage your condition is a combined approach, including therapy and medication overseen by a healthcare provider. Aripiprazole, or Abilify, is a medication option you can discuss with your healthcare professional.
At Levelheaded Mind, we believe that patient education is the best route to successful mental health care. That’s why we’ve created medication guides that give you the essential information you need to know about mental illness treatment options.
In this guide to Abilify, we’ll tell you what aripiprazole is, how it works, and give you details on side effects and drug interactions so you can collaborate with your doctor to determine if it’s the proper treatment for you.
What is Abilify?
Aripiprazole revolutionized the treatment of schizophrenia and other disorders because of how it affects dopamine and serotonin. Abilify is an atypical antipsychotic that increases dopamine in areas of the brain where it’s too low and lowers the amount of dopamine if it’s too high. It has similar effects on serotonin.
Abilify was approved by the Food and Drug Administration (FDA) in 2002 to treat flat affect, lack of motivation, lack of energy, hallucinations, and symptoms such as hearing voices or seeing things.
What is it used for?
Aripiprazole is used for both FDA-approved and off-label treatment.
FDA-approved uses
schizophrenia in adults and adolescents (13 and older);
bipolar I disorder (manic and mixed episodes) in adults and pediatric patients (10 and older).
major depressive disorder and treatment-resistant depression in adults when used in conjunction with other medications.
irritability associated with autistic disorders in pediatric patients (6–17 years)
vocal and motor tics associated with Tourette's syndrome in pediatric patients (6–18 years)
Off label uses
Bipolar depression
Other psychotic disorders, such as major depressive disorder with psychotic features - depression so severe you hear voices saying negative things about you or telling you to do something. Some people with this type of depression see shadows, deceased loved ones, etc.
Behavioral disturbances in children/adolescents
Problems with impulse control
How is Abilify administered?
Abilify comes in immediate and long-acting forms. The immediate form is available as an injection and used for acute agitation.
Long-acting aripiprazole comes as an injection, tablet, or oral solution and is used to manage mental health conditions. Healthcare providers often start patients on a low dose and slowly increase it as needed.
How long does aripiprazole take to work?
The immediate-action injectable form of Abilify works right away. With the other types, including the long-acting injection, it can take a while to see results. Patients treated with Abilify will see relief from manic and psychotic symptoms within the first week or two. Depressive symptoms like low mood and motivation take 2-4 weeks to improve.
You may have to wait 4-6 weeks to experience the full effects of aripiprazole. If you don’t see improvement, talk with your doctor about switching medications or increasing your dose. Once your symptoms improve, most people use Abilify for at least one year to achieve maximum benefit.
Conditions such as schizophrenia and bipolar disorder will require long-term or life-long treatment to avoid the return of symptoms. If symptoms of these disorders return because of stopping the medication, it can be challenging to get them under control again.
Is aripiprazole addictive?
None of the antipsychotic drugs are addicting. Addicting medications cause cravings and an intense urge to use more to get the same effect. Addiction causes you to be unable to manage your work or home life. Addicting substances cause problems in relationships and can make you give up important social, occupational, or recreational activities.
However, Abilify does affect the chemicals in your brain and body. Because of this, if you and your healthcare provider decide to stop or change your medication, you should taper off slowly to avoid abstinence syndrome or withdrawal. Withdrawal symptoms of aripiprazole are nausea, excessive sweating, rapid heart rate, lightheadedness, headaches, body shakes, flu-like symptoms, and anxiety. You may experience some of these symptoms from a missed dose, but they will subside after you take your next dose.
What are the side effects and drug Interactions?
One of the most bothersome side effects of Abilify is akathisia, which is a severe form of restlessness that causes you to feel restless throughout your body. People with akathisia may pace back and forth all day. If you experience this side effect, your healthcare provider may change your medication or add medication to counteract the restlessness.
Other common symptoms include insomnia, the inability to fall asleep or stay asleep, sedation, or drowsiness. If you experience insomnia, your doctor may recommend taking the medication early in the day or lowering your dose. If sedation is bothersome, you may take the medicine at night.
Some less common side effects of Abilify include orthostatic hypotension, constipation, headaches, and weight gain. Orthostatic hypotension is when your blood pressure drops on standing and can cause lightheadedness. This symptom usually goes away as your body gets accustomed to the medication.
People who experience weight gain with Abilify typically gain about 5 pounds but find their weight stabilizes afterward. The slight weight increase is due to how dopamine levels cause your body to crave carbohydrates. A healthy diet and adequate exercise can offset this symptom.
There are side effects of most antipsychotic medications that Abilify does not cause. Hyperprolactinemia, or increased prolactin levels that cause lactation and low sex drive, don’t typically occur with Abilify. It also carries a low risk of extrapyramidal symptoms (EPS), which are uncontrolled movements of the mouth, face, and hands, similar to Parkinson’s disease.
Serious side effects
Abilify does carry a few rare and dangerous side effects you should be aware of so you can contact your doctor if you experience the following symptoms.
Abilify carries a black box warning of an increased risk of death and stroke in elderly patients with dementia-related psychosis. It should be used with caution in these patients.
Though rare, some patients experience seizures with aripiprazole.
Neuroleptic malignant syndrome (NMS) is another rare but serious side effect of Abilify. This syndrome is life-threatening if not treated. Symptoms include a fever above 102, irregular or fast heart rate, fast breathing, muscle stiffness, altered mental status, and autonomic nervous system dysfunction that can lead to death.
Recently, aripiprazole was linked to compulsive behaviors such as gambling and binge eating in a small group of patients. This is an unusual side effect of antipsychotics. If you have new or worsening compulsive behaviors, tell your doctor right away.
Drug Interactions:
Though Abilify is often used in combination with antidepressants for treatment-resistant depression, there are a few that should be used with caution if you’re also taking aripiprazole.
Some antidepressants, such as fluoxetine (Prozac), bupropion (Wellbutrin), and Paroxetine (Paxil), can increase the levels of Abilify in your blood. This can increase the likelihood of side effects. If your doctor decides to use these medications in combination with Abilify, they will likely give you a low dose.
Other medications like carbamazepine can lower the efficacy of aripiprazole, so you must share your complete list of medications, including supplements and over-the-counter ones, with your doctor.
Get More Mental Health Education
Educated patients can make clear, informed decisions about their mental health care. That’s why Levelheaded Mind is committed to providing all the information you need about medications and other treatments for mental illness.
For more information about mental illness and advice from our psychiatric nurse practitioner, Jezel Rosa, visit our YouTube channel. If you are facing mental health issues and have a few questions, don't hesitate to schedule an initial mental health coaching session so we can help you move forward on your mental health care journey.
Disclaimer: All of the information on this channel is for educational purposes and not intended to be specific/personal medical advice or substitute for diagnosis and treatment of any conditions discussed herein. Furthermore, watching these videos or getting answers to comments/questions does not establish a provider-patient relationship. Please consult with your healthcare provider for proper diagnosis and treatment.
References:
Casey, A. B., & Canal, C. E. (2017). Classics in Chemical Neuroscience: Aripiprazole. ACS chemical neuroscience, 8(6), 1135–1146. https://doi.org/10.1021/acschemneuro.7b00087
Gettu N, Saadabadi A. Aripiprazole. [Updated 2021 Sep 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547739/
Stahl, S. M., Grady, M. M., & Muntner, N. (2021). Stahl's essential psychopharmacology: Prescriber's Guide. Cambridge University Press.
