Aripiprazole/Abilify

Aripiprazole is an atypical antipsychotic that primarily works by modulating dopamine and serotonin levels in the brain. Unlike traditional antipsychotics that block dopamine, aripiprazole is a partial agonist, meaning it increases or decreases dopamine activity depending on the situation. This unique mechanism can help manage symptoms of schizophrenia, bipolar disorder, and depression while reducing the risk of side effects commonly seen with other antipsychotics.

Aripiprazole is FDA-approved to treat:

• Schizophrenia (adults and adolescents)
• Bipolar I disorder (manic and mixed episodes)
• Major depressive disorder (as an adjunct to antidepressants)
• Autism-related irritability (for children and adolescents)
• Tourette syndrome (for tics in children and adolescents)

• Hallucinations and delusions (schizophrenia)
• Mood swings, manic episodes, and irritability (bipolar disorder)
• Depressive symptoms when combined with an antidepressant (major depressive disorder)
• Aggression, self-injury, and emotional outbursts (autism spectrum disorder)
• Uncontrollable movements or vocal tics (Tourette syndrome)

Aripiprazole is often prescribed for individuals who experience side effects from traditional antipsychotics or need a medication that balances dopamine levels rather than completely blocking them. However, its effectiveness varies, and it may take several weeks to determine if it works for an individual.

Treatment duration depends on the condition being treated:

• Schizophrenia and bipolar disorder – often long-term to manage symptoms and prevent relapse.
• Major depressive disorder – typically used as an adjunct treatment for a few months to years, depending on response.
• Autism-related irritability and Tourette syndrome – varies based on symptom severity and age.

Studies show that aripiprazole is highly effective in reducing psychotic symptoms in schizophrenia and stabilizing mood in bipolar disorder. When used as an adjunct for depression, it can significantly improve treatment-resistant cases.

Aripiprazole does not change personality but helps manage symptoms that may affect behavior. Some people report feeling more stable and in control of their emotions. If personality changes occur, they should be discussed with a doctor.

Common side effects include:

• Weight gain
• Insomnia or drowsiness
• Nausea
• Dizziness
• Restlessness (akathisia)

Rare but serious side effects:

• Increased risk of suicidal thoughts (especially in young adults with depression)
• Uncontrollable movements (tardive dyskinesia)
• Increased blood sugar and diabetes risk
• Neuroleptic malignant syndrome (a rare but life-threatening condition)

Stopping aripiprazole suddenly may cause withdrawal symptoms such as anxiety, insomnia, nausea, dizziness, and a return of the original condition. Tapering off under medical supervision is recommended.

Aripiprazole is classified as Pregnancy Category C, meaning potential risks should be weighed against benefits. Some studies suggest an increased risk of extrapyramidal symptoms or withdrawal in newborns if taken late in pregnancy. It also passes into breast milk and may not be recommended while breastfeeding.

Aripiprazole is not considered addictive, but sudden discontinuation can lead to withdrawal effects. It should always be taken as prescribed.

The FDA has approved aripiprazole for schizophrenia, bipolar disorder, adjunctive treatment for major depression, autism-related irritability, and Tourette syndrome. It carries a black box warning for increased suicidal thoughts in young adults and increased mortality risk in elderly patients with dementia-related psychosis.