Aripiprazole (Abilify®, Abilify Maintena® and generic forms) belong to a group of medications called “atypical antipsychotics” or “third- generation antipsychotics.”

What is this medication used for?

Aripiprazole was first developed to treat psychotic illnesses such as schizophrenia. However, research shows aripiprazole can also help treat bipolar disorder, irritability of autism and tic disorders.

Aripiprazole is approved by Health Canada for treatment of schizophrenia in ages 15 and older, and treatment of bipolar disorder in ages 13 and older.

When potential benefits outweigh risks, aripiprazole may be prescribed “off-label.” Learn more about off-label medication use.

Tell your doctor or pharmacist if you:

• Have allergies or bad reactions to a medication
• Take (or plan to take) other prescription or non- prescription medications, including natural medicines Some medications interact with aripiprazole. Your doctor may adjust medication doses or monitor for side effects
• Have a history (or family history) of seizures, diabetes or lactose intolerance
• Have a history (or family history) of heart disease, arrhythmia or “familial long QT syndrome”
• Miss a period, are pregnant, breast-feeding or planning a pregnancy
• Use alcohol or drugs. Taking aripiprazole together with certain substances may cause a bad reaction. Learn more at www.DrugCocktails.ca

When will the medication start to work?

Some improvements may be seen within 1 to 2 weeks. However, it can take up to 6 weeks to see the full benefits of the medication. You (or your family members) may notice clearer thoughts, stable mood, and less agitation or intense fears. If you experience seeing, hearing or feeling things that are not there, this may also decrease or stop entirely.

It is important that you continue taking aripiprazole regularly even if you are feeling well, as it can prevent symptoms from returning. Talk with your doctor if you feel aripiprazole treatment has not been helpful. Your doctor may recommend switching you to a different medication.

This medication is not addictive. Do not stop taking it before talking to your doctor.

Possible common or serious side effects:

• Dizziness, drowsiness or headache
• Feelings of agitation or trouble sleeping
• Blurred vision
• Changes in appetite or weight gain
• Nausea, vomiting, constipation
• Increased blood glucose or cholesterol levels
• Fast or irregular heartbeat

Contact your doctor immediately if you experience:

• Feelings of restlessness
• Unexplained rash, seizure, fever or excessive sweating
• Fainting, feeling lightheaded or difficulty with balance
• Frequent urination accompanied by excessive thirst
• Shaking, muscle spasm/stiffness, pain or weakness
• Unusual movements of fingers, toes, neck, lips or tongue
• Increased sexual urges, excessive gambling or struggles with impulse control
• Thoughts of hurting yourself, suicide, increased hostility or worsening symptoms

How do I take this medication?

Aripiprazole tablets are usually taken once daily in the morning, with or without food. Usually, you will start with a low dose and slowly increase this dose over several days to weeks, based on how you tolerate it. Aripiprazole tablets should be swallowed whole with fluid. Do not crush, chew or divide aripiprazole tablets.

Aripiprazole is also available as a long acting injection (Abilify Maintena). A doctor or nurse will administer this into a large muscle once monthly. You may be asked to continue taking aripiprazole by mouth for about 2 weeks after the first injection until the injection starts to take effect.

What precautions should my doctor and I be aware of when taking this medication?

• When you take this medication, your body may have difficulty maintaining a normal body temperature. Drink enough fluids to avoid becoming dehydrated. Avoid doing a lot of physical activity on hot days.
• While taking this medication, if you feel dizzy, drowsy or slowed down, do not drive a car or operate heavy machinery. Alcohol could make this worse. Try to avoid alcohol while taking aripiprazole.
• Aripiprazole can cause a rare side effect called “tardive dyskinesia.” Symptoms include involuntary movements of the lips, tongue, toes, hands or neck. Stopping or switching this medication at first signs will decrease the chances this side effect will continue. These movements may become permanent without a medication change.
• Aripiprazole can cause a rare side effect called “neuroleptic malignant syndrome.” Symptoms include severe muscle stiffness, high fever, sweating, increased or irregular heartbeat and increased blood pressure.

What special instructions should I follow while using this medication?

• Keep all appointments with your doctor and the lab. Your doctor may order lab tests to check how you are responding and monitor for side effects.
• Try to keep a healthy, well-balanced diet and exercise regularly. Some people may gain weight as a result of increased appetite.
• Do not allow anyone else to use your medication.

What should I do if I forget to take a dose of this medication?

If you forget to take a dose of aripiprazole, take the missed dose as soon as you remember within 4 hours. If it is more than 4 hours after your scheduled dose, skip the missed dose and continue regularly with your next scheduled dose.

DO NOT double your next dose to try to ‘catch up’. If you are receiving aripiprazole long-acting injections and you miss your dose, make an appointment with your doctor for injection administration.

How does this medication work?

Like other antipsychotics, aripiprazole affects actions of the brain chemicals dopamine and serotonin. The exact way that aripiprazole improve symptoms of schizophrenia, bipolar disorder and other conditions is not known.

How do I store this medication?

Keep this medication in the original container, stored at room temperature away from moisture and heat and protected from light. Keep this medication out of reach and sight of children.

How well does the medication work in children and adolescents?

Evidence supports the use of aripiprazole in children and adolescents. Aripiprazole has shown to be better than placebo (an inactive pill) for treatment of schizophrenia in ages 13 and older, prevention and management of mania in ages 10 and older, and treatment of irritability associated with autism and Tourette syndrome in children and adolescents. Limited evidence suggests that aripiprazole may be better than placebo for treatment of resistant depression or bipolar depression, in combination with an SSRI antidepressant. Aripiprazole is sometimes prescribed for children and adolescents when other treatments have not been effective or well-tolerated.

How long should I take the medication for?

This depends on the symptoms you have, how frequently they occur, and how long you have had them. Most people will need to take aripiprazole for several months. This allows time for symptoms to stabilize and for function to improve. Your doctor will discuss the benefits and risks of taking aripiprazole with you. At this time, you can also discuss how long you might need to take this medication.

If you have schizophrenia and you tolerate aripiprazole well, you may be asked to take aripiprazole on an ongoing basis. Continuing treatment will significantly decrease the chance that your symptoms will return.

Do not increase, decrease, or stop taking this medication without discussing it with your doctor. If you stop taking aripiprazole suddenly, it is possible that your symptoms may return or you may have a bad reaction.

TIP: Use the Kelty Mental Health Antipsychotic Monitoring Form for Children and Adolescents to help measure your progress on this medication. 

Also see the Kelty Mental Health document Atypical Antipsychotics & Metabolic Monitoring.