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Abilify (Aripiprazole)
SIMPLE EXPLANATION
What is it and what does it do?
Abilify (aripiprazole) is a psychotherapeutic agent used to treat psychoses, as well as perceptual and behavioral disorders. These can include schizophrenia, bipolar disorder, Tourette Syndrome, and irritability associated with autism. It may also be used in conjunction with an antidepressant to treat symptoms of depression.
DETAILED EXPLANATION
Action: exact mechanism of action unknown; may be mediated through both dopamine type 2 and
serotonin type 2 antagonism; dopamine system stabilizer.
Availability: prescription only.
Avoid: fast position changes, especially if standing from sitting, due to orthostatic hypotension;
hot tubs, hot showers, and bathtubs due to hypotension; abrupt withdrawal due to
extrapyramidal symptoms; OTC medications for allergies, cold, or cough unless
approved by provider due to drug interactions; hazardous activities due to dizziness and
drowsiness; extreme heat due to sensitivity to heat stroke.
Black Box Warning: children with depression; suicidal ideation; dementia.
Class (Chemical): quinolinone.
Class (Functional): antipsychotic.
Contraindications: seizure disorders; hypersensitivity; breastfeeding.
Dose: Agitation: Adult IM: 9.75mg, max 30mg/day
Bipolar Disorder: Adult PO: 15mg/day, may increase to 30mg/day
Irritation w/ Autism: Child PO: 2mg/day, may increase to 5mg/day, max 10-15mg/day
Major Depressive Disorder: Adult PO: 2-5mg/day as adjunct to other antidepressant
Schizophrenia: Adult PO: 10-15mg/day
Schizophrenia: 13-17yrs PO: 2mg/day
Tourette’s Syndrome: Less Than 50kg PO: 2mg/day, increase to 5mg/day
Tourette’s Syndrome: More Than 50kg PO: 2mg/day, increase to 5mg/day, target
10mg/day after 8 days
Interactions: CYP3A4 inhibitors such as ketoconazole and erythromycin, as well as CYP2D6
inhibitors such as quinidine, fluoxetine, and paroxetine, will increase the effects of
aripiprazole; CNS depressants and alcohol will increase sedation; other
antipsychotics such as lithium will increase extrapyramidal symptoms; famotidine
and valproate will decrease levels of aripiprazole; CYP3A4 inducers such as
carbamazepine will decrease the effects of aripiprazole; aripiprazole will increase
the anti-hypertensive effect of anti-hypertensives; St John’s wort will decrease
effects of aripiprazole.
Labs: may cause a false positive if screening for amphetamine drug use.
Off-Label Use: aripiprazole may be used to treat anxiety disorders such as generalized anxiety
disorder, obsessive-compulsive disorder, and post-traumatic stress disorder.
Precautions: geriatric patients; neutropenia; pregnancy; renal, hepatic, or cardiac disease.
Report to Provider: impaired vision; muscle twitches; tremors.
Route: IM; PO.
Side Effects: drowsiness; insomnia; agitation; anxiety; headache; seizures; neuroleptic
malignant syndrome; light-headedness; akathisia; tremor; suicidal ideation; tardive dyskinesia; extrapyramidal symptoms; orthostatic hypotension; tachycardia; chest
pain; hypertension; peripheral edema; blurred vision; rhinitis; constipation; nausea;
vomiting; weight gain; rash; dry skin; sweating; hyperglycemia; myalgia; cough;
dyspnea; hypercholesterolemia; agranulocytosis; anemia; leukemia; death among
geriatric patients with dementia and/or hypersensitivity.
Uses: mania associated with schizophrenia and bipolar disorder; mixed episodes of bipolar
disorder; major depressive disorder; irritability associated with autism.
Reference: Mosby's Nursing Drug Reference