Pharm
Aripiprazole
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Aripiprazole
, Abilify
See Also
Antipsychotic Medication
Psychosis
Class
Atypical Antipsychotic
(Second
Gene
ration 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)
Barbiturate
s
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 Effect
s in up to 17% of patients
Nausea
Constipation
Fatigue
or sedation
Impulse control behaviors (rare)
Behaviors seen with other
Dopamine Agonist
s (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)
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