//fpnotebook.com/
Aripiprazole
Aka: Aripiprazole, Abilify
- Class
- Atypical Antipsychotic (Second Generation agent)
- Indications
- Schizophrenia
- Bipolar Disorder
- Major Depression (adjunct in refractory cases)
- Advantages
- Lower weight gain than other second generation Antipsychotic agents
- Lower diabetes risk than other second generation Antipsychotic agents
- 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
-
Drug Interactions
- Increase Antipsychotic levels (toxicity risk): Monitor for Aripiprazole toxicity
- Clarithromycin
- Erythromycin
- Grapefruit juice
- Increase Antipsychotic levels (toxicity risk): Lower Aripiprazole dose to half
- Itraconazole
- Ketoconazole
- Quinidine
- Decrease Antipsychotic levels (lower efficacy)
- Barbiturates
- Carbamazepine
- Phenytoin
- Efficacy: Depression
- Depression remits in 25% of patients by 6 weeks (effects may be seen by 1 week)
- 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]
- Monitoring
- See Antipsychotic
- Dosing: Schizophrenia or Bipolar Disorder
- Starting dose: 10-15 mg once daily
- Maximum dose: 30 mg/day
- 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)