Aripiprazole : Uses, Side Effects, Precautions and Dosage
Aripiprazole
What is Aripiprazole?
Aripiprazole is a third-generation antipsychotic medication. The drug's pharmacological profile sets it apart from other antipsychotics and delivers 'adaptive' pharmacological activity. Patients can take this medication in several forms: tablets, orally disintegrating tablets, oral solution, and intramuscular injections.
How Does Aripiprazole Work?
The medication acts as a partial agonist at dopamine D2 and serotonin 5HT-1a receptors while blocking 5HT-2a receptors. This mechanism helps stabilise dopamine and serotonin in the brain's nucleus accumbens, ventral tegmental area, and frontal cortex. The drug shows functionally selective effects on intracellular signalling pathways beyond simple partial agonism.
Uses of Aripiprazole
Aripiprazole helps treat:
Schizophrenia in adults and children (13+ years)
Bipolar I disorder (manic and mixed episodes)
Major depressive disorder (as adjunct therapy)
Irritability associated with autism spectrum disorders
Tourette's disorder in patients 6-18 years.
How & When to Take Aripiprazole
Patients should take aripiprazole once daily with or without food. The drug reaches steady-state serum concentration after about 14 days. Doctors might need up to two weeks to get a full picture of how well you tolerate the medication.
Side Effects of Aripiprazole
The drug causes fewer extrapyramidal symptoms and metabolic problems compared to other antipsychotics. Patients often experience:
Nausea
Restlessness
Dizziness
Akathisia.
Some patients might develop uncontrollable urges to gamble, shop, or take part in other impulsive behaviours, though this is rare.
Dosage for Aripiprazole
Adult schizophrenia patients - starting dose 10-15mg daily
Doctors can adjust up to 30mg when needed.
Adult patients with bipolar disorder - 15mg daily.
Children between 13-17 years need a step-by-step approach. They start at 2mg daily for two days, move to 5mg for two days, and then reach 10mg daily.
Can I Take Aripiprazole Daily?
Aripiprazole works best with daily consumption. Blood levels stay consistent when you take it at the same time each day. The medication reaches its steady-state concentration after about 14 days. You might need two weeks to get a full picture of how well it works.
Precautions
You should wait to understand the medication's effects before driving or operating machinery.
You should avoid alcohol consumption during aripiprazole treatment.
If you have diabetes or are at risk for diabetes keep an eye on your glucose levels, as aripiprazole increases sugar levels.
Avoid excessive heat and stay well hydrated as aripiprazole affects the body's ability to regulate temperature.
Watch for unusual symptoms like seizures, breathing problems, rapid heartbeat, high fever, excessive sweating, or severe muscle stiffness.
What If You Missed a Dose?
You can take the missed dose within a few hours of remembering. Skip the dose and stick to your regular schedule if more time has passed. Taking two doses at once is not safe.
What If You Overdose?
Overdose can cause drowsiness, vomiting, confusion, tremors, seizures, or shallow breathing. Call emergency services if you suspect an overdose.
Caution With Other Drugs: Interactions
Aripiprazole can interact with many drugs. Key interactions include:
Antidepressants like fluoxetine or paroxetine.
Azole antifungals like ketoconazole
Fluoxetine
HIV medications like efavirenz & ritonavir.
Phenytoin
Quinidine
Rifampicin
Thioridazine.
Aripiprazole vs Risperidone
Doctors must think over treatment options for mental health conditions and weigh the benefits of aripiprazole against risperidone. These medicines treat similar conditions but differ in several key ways.
Research indicates that aripiprazole and risperidone work equally well to treat schizophrenia symptoms. Patients report better satisfaction with aripiprazole, which also causes fewer side effects. The medication proved more effective than risperidone to treat acute mania.
Their side effect profiles show distinct differences:
Weight gain: Less common with aripiprazole compared to risperidone.
Movement disorders: Risperidone leads to more extrapyramidal symptoms that need anti-parkinsonian medication.
Hormonal effects: Aripiprazole reduces prolactin levels while risperidone increases them.
Both medications demonstrate similar efficacy and safety to treat autism-related irritability in children.
FAQs
What is aripiprazole used for?
Aripiprazole helps treat several mental health conditions:
Schizophrenia in adults and adolescents (13+ years)
Bipolar I disorder (manic and mixed episodes)
Major depressive disorder
Irritability linked with autism spectrum disorders
Tourette syndrome.
How does aripiprazole work in mental health conditions?
Aripiprazole works differently from traditional antipsychotics. The medication acts as a partial agonist at dopamine D2 and serotonin 5HT-1a receptors, and an antagonist at 5HT-2a receptors. This unique mechanism creates a balance of brain chemicals instead of blocking them completely. The result is a "Goldilocks effect" that maintains optimal dopamine activity.
What are the common side effects of aripiprazole?
Common side effects are:
Can aripiprazole cause weight gain?
Weight gain can occur with aripiprazole, but it's nowhere near as significant as with other antipsychotics. Research shows about 7% of body weight increase affects some patients.
How long does aripiprazole take to show effects?
Patients often notice benefits within 1-2 weeks. The full effects usually take 2-3 months to develop. Schizophrenia patients may see continued improvements over 8-12 weeks.
Is aripiprazole used for depression and bipolar disorder?
Yes aripiprazole treats both conditions. This medication works as an add-on therapy with antidepressants when standard depression treatments fail. The drug effectively manages manic and mixed episodes in bipolar disorder. Doctors also use it as maintenance therapy to prevent symptoms from returning. Patients usually start with 2-5mg daily for depression.
Can aripiprazole cause sleep problems or restlessness?
Sleep issues affect many patients who take this medication. Many adults experience insomnia. Restlessness (akathisia) occurs frequently alongside sleep troubles. Patients feel an uncomfortable inner restlessness that creates a constant need to move. These effects often decrease as time passes.
Is aripiprazole safe for long-term use?
Research indicates that patients tolerate aripiprazole well during extended treatment. A study revealed no unexpected safety concerns. Weight gain progressed over time, and some patients gained ≥7% body weight during this period. Patients who take lower maintenance doses (2-5mg) may experience fewer side effects than those on higher doses (>5-10mg).
What happens if aripiprazole is stopped suddenly?
Patients who stop taking the medication abruptly might experience withdrawal symptoms. These include:
Anxiety
Headaches
Nausea
Insomnia
Dizziness
Lightheadedness
Muscle twitches.
Doctors recommend that patients gradually reduce their dose rather than stopping immediately.
When should I contact a doctor while taking aripiprazole?
Call your doctor immediately if you experience:
Suicidal thoughts
Seizures or trouble breathing
Extreme thirst, frequent urination, or hunger
Unusual urges to gamble, shop, or engage in sexual activities
Severe muscle stiffness or high fever.
