II. Class
- Atypical Antipsychotic (Second Generation agent)
III. Indications
- Schizophrenia
- Bipolar Disorder
- Major Depression (adjunct in refractory cases)
IV. Advantages
- Lower weight gain than other second generation Antipsychotic agents
- Lower diabetes risk than other second generation Antipsychotic agents
V. Precautions
- Despite generic in 2015, price still approaches $800 per month
- Primary role remains as an Antipsychotic for Schizophrenia and Bipolar Disorder
- Only consider adjunctively in severe Major Depression refractory to other measures
VI. Drug Interactions
- Increase Antipsychotic levels (toxicity risk): Monitor for Aripiprazole toxicity
- Increase Antipsychotic levels (toxicity risk): Lower Aripiprazole dose to half
- Decrease Antipsychotic levels (lower efficacy)
- Barbiturates
- Carbamazepine
- Phenytoin
VII. Efficacy: Depression
- Depression remits in 25% of patients by 6 weeks (effects may be seen by 1 week)
VIII. Adverse Effects
- Headache
- Restlessness or agitation
- Insomnia
- Anxiety
- Extrapyramidal Side Effects in up to 17% of patients
- Nausea
- Constipation
- Fatigue or sedation
- Impulse control behaviors (rare)
- Behaviors seen with other Dopamine Agonists (e.g. Compulsive Gambling, hypersexuality, shopping, eating)
- Moore (2014) JAMA Intern Med 174(12):1930-3 [PubMed]
IX. Monitoring
- See Antipsychotic
X. Dosing: Schizophrenia or Bipolar Disorder
- Starting dose: 10-15 mg once daily
- Maximum dose: 30 mg/day
XI. Dosing: Major Depression (in refractory and atypical cases)
- Starting dose: 2-5 mg/day
- Maximum dose: 15 mg/day (up to 30 mg/day has been used)
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| aripiprazole (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| ARIPIPRAZOLE 1 MG/ML SOLUTION | Generic | $3.52 per ml |
| ARIPIPRAZOLE 10 MG TABLET | Generic | $1.02 each |
| ARIPIPRAZOLE 15 MG TABLET | Generic | $1.13 each |
| ARIPIPRAZOLE 2 MG TABLET | Generic | $1.08 each |
| ARIPIPRAZOLE 20 MG TABLET | Generic | $1.58 each |
| ARIPIPRAZOLE 30 MG TABLET | Generic | $1.58 each |
| ARIPIPRAZOLE 5 MG TABLET | Generic | $1.02 each |
| abilify (on 11/23/2016 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| ABILIFY 10 MG TABLET | Generic | $1.02 each |
| ABILIFY 15 MG TABLET | Generic | $1.13 each |
| ABILIFY 2 MG TABLET | Generic | $1.08 each |
| ABILIFY 20 MG TABLET | Generic | $1.58 each |
| ABILIFY 30 MG TABLET | Generic | $1.58 each |
| ABILIFY 5 MG TABLET | Generic | $1.02 each |
| ABILIFY MAINTENA ER 300 MG SYR | $1,348.03 each | |
| ABILIFY MAINTENA ER 300 MG VL | $1,353.33 each | |
| ABILIFY MAINTENA ER 400 MG SYR | $1,806.74 each | |
| ABILIFY MAINTENA ER 400 MG VL | $1,799.41 each | |
Ontology: aripiprazole (C0299792)
| Definition (NCI) | A quinoline derivate and atypical anti-psychotic agent. Aripiprazole has partial agonistic activity at dopamine D2 receptors and serotonin 5-HT1A receptors, as well as potent antagonistic activity on serotonin 5-HT2A receptors. This drug stabilizes dopamine and serotonin activity in the limbic and cortical system. Aripiprazole is used in managing symptoms of schizophrenia and of acute manic and mixed episodes associated with bipolar I disorders. |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C094645 |
| SnomedCT | 406785006, 406784005 |
| LNC | LP34967-7, MTHU017703 |
| English | 7-(4-(4-(2,3-dichlorophenyl)-1-piperazinyl)butyloxy)-3,4-dihydro-2(1H)-quinolinone, 2(1H)-Quinolinone, 7-(4-(4-(2,3-Dichlorophenyl)-1-piperazinyl)butoxy)-3,4-dihydro-, aripiprazole, aripiprazole (medication), ARIPIPRAZOLE, aripiprazole [Chemical/Ingredient], ARIPiprazole, Aripiprazole (product), Aripiprazole (substance), Aripiprazole |
| Spanish | aripiprazol (producto), aripiprazol (sustancia), aripiprazol |
Ontology: Abilify (C1170019)
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C094645 |
| English | Abilify, abilify, Bristol-Myers Squibb brand of aripiprazole, Otsuka brand of aripiprazole |
