Abilify (Aripiprazole) - Oral

What Is Abilify?

Abilify (aripiprazole) is an orally prescribed prescription medication used to treat a wide range of psychiatric and neurological disorders, including schizophrenia, bipolar disorder, irritability associated with autism, and other conditions in people 6 and older.

Abilify belongs to a group of drugs called atypical antipsychotics and works by affecting the activity of certain brain chemicals, including dopamine and serotonin.

Antipsychotic drugs are a type of psychiatric medication available by prescription to treat psychosis. They are approved to treat specific mental health problems whose symptoms include psychotic experiences. Notably, this includes schizophrenia.

Moreover, this class of drugs works by altering brain chemistry to help reduce psychotic symptoms like hallucinations, delusions, and disordered thinking.

Abilify, the brand-name product containing the key ingredient, aripiprazole, is available as an immediate-release (IR) tablet and as an orally administered liquid solution.

Comparatively, other brand-name drugs contain the key ingredient aripiprazole, such as Abilify MyCite Kit, which is an IR tablet with a sensor to monitor adherence.

Abilify is also available as a generic product under the name aripiprazole, where it is available as an IR tablet, a liquid solution, and an orally disintegrating tablet (ODT). ODT tablets contain a sensor that allows you to track when you’ve taken your dose using an app on your smartphone.

This article will focus on the oral usage of Abilify.

What Is Abilify Used For?

Abilify is approved by the Food and Drug Administration (FDA) to treat the following conditions:

• Schizophrenia in people 13 and older 
• Manic or mixed episodes (having both depressive and manic symptoms) associated with bipolar disorder in adults and children 10 and older 
• Treatment of major depressive disorder (MDD; depression) in combination with other treatments in adults 
• Irritability associated with autism in children 6 to 17 years old 
• Tourette’s syndrome (TS) in children 6 to 18 years old

For context, schizophrenia is a brain disorder that impacts less than 1% of the U.S. population. When schizophrenia is active, symptoms include delusions, hallucinations, random speech, incoherent thinking, and a lack of motivation to participate in daily life. Nonetheless, with treatment, the majority of symptoms associated with schizophrenia can improve, and the likelihood of a recurrence may lessen.

While there is no cure for schizophrenia, contemporary research is discovering more innovative and safer treatments.

In comparison, manic or mixed episodes of depression are a byproduct of bipolar disorder. Bipolar disorder is a brain disorder that causes changes in a person's mood and ability to function in daily life. People with bipolar disorder experience emotional states of being that can last from days up until weeks referred to as mood episodes.

Bipolar disorder includes three general diagnoses: Bipolar I, bipolar II, and cyclothymic disorder.

Moreover, Abilify works to treat the symptoms associated with MDD. MDD can negatively affect how you feel, the way you think, and how you behave. However, it is treatable.

Depression causes feelings of sadness and a loss of interest in activities you once enjoyed. In addition, it can lead to emotional and physical problems that can decrease your ability to function at work and at home.

Depression symptoms include:

• Feeling sad or having a depressed mood
• Loss of interest or pleasure in activities once enjoyed
• Changes in appetite
• Trouble sleeping

Abilify also works to combat the feeling of irritability associated with autism. It should be noted that autism spectrum disorders (ASD) are characterized by a lack of social awareness, communication skills, and an overt interest in repetitive behaviors. Additionally, children with ASD often display high levels of irritability, which Abilify may lessen.

Finally, Abilify is approved for the treatment of TS. TS is a condition that affects the nervous system and causes people to have tics. Tics are sudden twitches or sounds that people make repeatedly. People who have tics cannot stop their bodies from doing these things.

How to Take Abilify

Abilify may be taken with or without food. Follow your healthcare provider's instructions for how much and how often to take.

The following offers guidance on how to take each of the available oral forms of aripiprazole:

IR tablets:

Swallow the tablets whole. It is usually taken once per day. Do not cut, crush, or chew the tablets.

Orally disintegrating tablets (ODT):

Remove tablets from their blister packaging by peeling the foil back. Do not push the tablet through the foil—this can damage the tablet.

Using dry hands, place the tablet on your tongue. The tablet will dissolve quickly and can be swallowed without liquid (but washing it down with some liquid is permitted). Do not split the tablet.

Tablets with a sensor:

The Abilify MyCite branded product uses tablets that contain a sensor. A patch (that does not contain medication) is worn on your skin to detect when you take a dose. The patch sends a signal to an app on your phone to record when you take your medication.

Follow your healthcare provider's instructions for how to take Abilify MyCite, where to put the patch, and how to use the app.

Liquid suspension:

The oral solution can be substituted for tablets on a milligram-per-milligram basis up to the 25-milligram dose level. People receiving 30-milligram tablets should receive 25 milligrams of the solution.

Storage

Store Abilify at room temperature in the container they came in, away from excess heat and moisture. Keep out of reach of children and pets.

Be sure to keep Abilify ODT in its original blister packaging and use the tablets as soon as you remove them from their packaging.

Keep the liquid suspension stored at room temperature. However, do not store it in a bathroom. Open bottles of liquid solution can be stored for up to six months but not beyond the expiration date.

Off-Label Uses

Healthcare providers may prescribe drugs to treat conditions other than the ones approved by the FDA, a practice called “off-label” use.

Abilify may be prescribed to treat several off-label conditions, including:

• Agitation, aggression, or psychosis associated with dementia 
• Agitation or aggression associated with various mental health disorders
• Delusional disorder (having firmly held beliefs that aren’t true or based on reality, despite evidence showing otherwise)
• Obsessive-compulsive disorder (OCD) when other treatments have failed 
• Delusional infestation (falsely believing you are infected with bugs)

What Are the Side Effects of Abilify?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Be sure to let your healthcare provider know if you experience any side effects that bother you or don’t go away. 

Common side effects in adults include:

• Anxiety 
• Blurred vision 
• Constipation 
• Dizziness 
• Headache
• Nausea and vomiting
• Insomnia (trouble sleeping)

Abilify may affect children differently.

The most common side effects observed in children include:

• Changes in appetite 
• Fatigue 
• Headache 
• Increased saliva or drooling 
• Muscle stiffness 
• Nausea and vomiting 
• Stuffy nose
• Tiredness 
• Uncontrolled movements (e.g., tremors)
• Weight gain

Severe Side Effects

The FDA has issued a boxed warning for Abilify. Boxed warnings are the agency’s strongest warnings for serious and potentially life-threatening risks.

The boxed warning:

Older people with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Abilify is not approved for the treatment of people with dementia-related psychosis.

Abilify also presents a chance for an increased risk of suicidal thinking and behavior in children, adolescents, and young adults taking antidepressants. Monitor for worsening and emergence of suicidal thoughts and behaviors.

Call your healthcare provider immediately if you have serious side effects. Call 911 if your side effects feel life-threatening or if you think you’re having a medical emergency.

Serious side effects can include the following:

• Strokes in older adults, which have sometimes resulted in death 
• Suicidal thoughts or behaviors in children and young adults, especially during the first few months of treatment or when the dose is changed
• Neuroleptic malignant syndrome (NMS), is a serious and potentially life-threatening condition. Symptoms include a high fever, stiff muscles, confusion, sweating, and changes in pulse, heartbeat, or blood pressure. 
• Uncontrolled body movements, such as tardive dyskinesia, involve the face, tongue, or other body parts. These effects may be permanent and can even occur after you stop taking Abilify.
• Hyperglycemia (high blood sugar) and diabetes: Very high blood sugar can lead to coma and death. Symptoms of high blood sugar include confusion, feeling very thirsty or hungry, feeling weak or tired, fruity-smelling breath, nausea, or urinating more often than normal.
• Increased blood fat levels (cholesterol and triglycerides) 
• Unusual urges or intense urges you can’t control involve gambling, sex, binge eating, or shopping. 
• Low blood pressure that occurs when you stand from a sitting or lying position (orthostatic hypotension): You may feel lightheaded or dizzy. 
• Falls, which can result in broken bones or other injuries
• Low white blood cell (WBC) count
• Seizures 
• Trouble controlling your body temperature, particularly when it is hot, or you are exercising. Be sure to drink plenty of water and avoid overheating
• Difficulty swallowing, which can cause food or liquid to get into your lungs
  

Long-Term Side Effects

Abilify may cause a potentially irreversible condition called tardive dyskinesia, which involves uncontrollable movements of the face, tongue, or other body parts.

Some people develop tardive dyskinesia after stopping Abilify.

The risk of tardive dyskinesia increases the longer you take Abilify, but it can happen at any time. Your healthcare provider will regularly assess your need for Abilify and ensure you are on the lowest effective dose.

Dosage: How Much Abilify Should I Take?

Modifications

Users should be aware of the following before beginning Abilify:

Allergic reactions: Avoid using Abilify if you are allergic to aripiprazole or any of the active ingredients in the medication. Your healthcare provider may be able to recommend alternative treatment options.

Pregnancy: Abilify may cause withdrawal symptoms, such as agitation, hypertonia, hypotonia, tremors, respiratory distress, and feeding disorders in neonates following a parent who used Abilify while pregnant. Therefore, if you become pregnant while taking Abilify, alert your healthcare provider immediately. They may subsequently advise you to register with the National Pregnancy Registry for Atypical Antipsychotics.

Breastfeeding: There are reports of poor weight gain in breastfed infants exposed to aripiprazole and reports of inadequate milk supply in lactating people taking aripiprazole.

The development and health benefits of breastfeeding should be considered along with the parent's clinical need for Abilify and any potential negative effects on the breastfed infant from Abilify or the underlying condition.

Children: Abilify is not approved to treat people below the age of 6. Therefore, consult with a healthcare provider to find alternative treatment options for your child or dependent.

Older adults: Placebo-controlled studies of oral Abilify in schizophrenia, bipolar mania, or major depressive disorder did not include enough numbers of people 65 and over to determine whether they respond differently from younger people. Consult with a healthcare provider if you fear your age may impact your ability to tolerate Abilify.

Hepatic and renal impairment: No dosage adjustment for Abilify is required on the basis of a person's hepatic function or renal function.

Missed Dose

If you forget to take your dose of Abilify, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double up or take extra Abilify.

Overdose: What Happens If I Take Too Much Abilify?

The most common reactions of an Abilify overdose include vomiting, drowsiness, and tremors. Additionally, feelings of aggression, confusion, coma, seizures, and heartbeat or blood pressure changes can also occur.

If you or someone else has taken more Abilify than prescribed, call your healthcare provider or the Poison Control Center right away. If your symptoms feel life-threatening, call 911.

Precautions

What Are Reasons I Shouldn't Take Abilify?

Do not take Abilify if you are allergic to aripiprazole or any other ingredient in Abilify.

Discuss with a healthcare provider if any of the following apply before starting Abilify:

• Abilify should be used with caution in people with hematological diseases (disorders of the blood). Hematologic effects including leukopenia, neutropenia, and agranulocytosis have been associated with antipsychotic use.
• People with dysphagia (difficulty swallowing) or at risk for aspiration pneumonia should be closely monitored while receiving Abilify.
• Antipsychotics can cause motor and sensory issues, which may lead to falls with the potential for fractures and other injuries. A fall risk assessment should be completed when initiating an antipsychotic in people with diseases (e.g., neurological disease), conditions, or similar medication use that could worsen motor and sensory instability.

What Other Medications May Interact With Abilify?

Many medications may interact with Abilify. Be sure to inform your healthcare provider about all the medicines you take—including over-the-counter (OTC), nonprescription products, and supplements. 

Watch out for these common drug interactions:

• Benzodiazepines, such as Ativan (lorazepam), Xanax (alprazolam), varying opioid pain medications, sedatives, and sleeping pills can increase the sedative and blood pressure-lowering effects of Abilify. 
• Blood pressure medications, such as Zestril (lisinopril), may cause dangerously low blood pressure when taken with blood pressure drugs. Your healthcare provider will monitor your blood pressure and adjust the dose of your medicines if needed. 

Some drugs may increase levels of Abilify, Your healthcare provider may lower your dose if you take any of the following:

• Select human immunodeficiency virus (HIV) medications
• Biaxin XL (clarithromycin) 
• Ketoconazole 
• Paxil (paroxetine)
• Prozac (fluoxetine)
• Sporanox (itraconazole)
• Wellbutrin (bupropion)

Some drugs may lower levels of Abilify. Your healthcare provider may increase your dose of Abilify if you take:

• Dilantin (phenytoin)
• Mysoline (primidone) 
• Donnatal (belladonna/phenobarbital) 
• Rifampin 
• Tegretol (carbamazepine)

Many other medications may interact with Abilify.

Always keep an up-to-date list of all the medicines you take, and share this information with your healthcare provider any time there are changes.

What Medications Are Similar?

Abilify belongs to a group of medications called atypical antipsychotics.

Other atypical antipsychotics include:

• Invega (paliperidone)
• Latuda (lurasidone)
• Rexulti (brexpiprazole)
• Risperdal (risperidone) 
• Seroquel (quetiapine)

Most atypical antipsychotics are considered equally effective for the treatment of schizophrenia. Choosing between the different drugs usually depends on side effects. For example, someone with diabetes would want to select an antipsychotic that is less likely to cause high blood sugar.

Except for restlessness, Abilify causes fewer side effects than most other atypical antipsychotics. Abilify also comes in several formulations, including an orally disintegrating tablet and oral solution, which can be helpful for people unable to swallow pills.

This is a list of atypical antipsychotics, similar to Abilify. It is not a list of drugs to be taken with Abilify. In fact, you should not take these drugs together.

Ask your healthcare provider if you have any questions about your medications. 

How Can I Stay Healthy While Taking Abilify?

Having a mental health condition like schizophrenia or bipolar disorder can affect your day-to-day functioning and put a strain on your relationships.

Fortunately, effective treatments, including Abilify, can help minimize your symptoms and get you back to doing the things you love.

Most people tolerate Abilify without any problems, but serious side effects can occur. Be sure to review all the warnings each time you pick up your prescription and report any reactions to your healthcare provider as soon as they happen.