Aripiprazole

Aka: Aripiprazole, Abilify

1. Class
   1. Atypical Antipsychotic (Second Generation agent)
2. Indications
   1. Schizophrenia
   2. Bipolar Disorder
   3. Major Depression (adjunct in refractory cases)
3. Advantages
   1. Lower weight gain than other second generation Antipsychotic agents
   2. Lower diabetes risk than other second generation Antipsychotic agents
4. Drug Interactions
   1. Increase Antipsychotic levels (toxicity risk): Monitor for Aripiprazole toxicity
      1. Clarithromycin
      2. Erythromycin
      3. Grapefruit juice
   2. Increase Antipsychotic levels (toxicity risk): Lower Aripiprazole dose to half
      1. Itraconazole
      2. Ketoconazole
      3. Quinidine
   3. Decrease Antipsychotic levels (lower efficacy)
      1. Barbiturates
      2. Carbamazepine
      3. Phenytoin
5. Efficacy: Depression
   1. Depression remits in 25% of patients by 6 weeks (effects may be seen by 1 week)
6. Adverse Effects
   1. Headache
   2. Restlessness or agitation
   3. Insomnia
   4. Anxiety
   5. Extrapyramidal Side Effects in up to 17% of patients
   6. Nausea
   7. Constipation
   8. Fatigue or Sedation
7. Monitoring
   1. See Antipsychotic
8. Dosing: Schizophrenia or Bipolar Disorder
   1. Starting dose: 10-15 mg once daily
   2. Maximum dose: 30 mg/day
9. Dosing: Major Depression (in refractory and atypical cases)
   1. Starting dose: 2-5 mg/day
   2. Maximum dose: 15 mg/day (up to 30 mg/day has been used)