Abilify (aripiprazole) Overview

side effects, dosage, reviews, how to take & discontinue, uses, pros & cons, and more

Abilify Index | Brand and Generic Availability ›
Crazy Meds Comprehensive Abilify pages

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Abilify (aripiprazole) highlights: side effects, dosage, reviews, how to take & discontinue, uses, etc. The “More…” links are to pages with greater detail. The Comprehensive Abilify pages have all information from all the “More about…” pages, but with less explanatory material.

§1.  Brand & Generic Names; Drug Class

US brand name:	Abilify
Generic name:	aripiprazole
What is Abilify (aripiprazole)?
Abilify (aripiprazole) is in the Antipsychotics class of drugs.

More Abilify generic equivalents, worldwide & generic availability, etc.

§2.  What is Abilify (aripiprazole) Used For?

§2.1  US FDA Approved Treatment(s)

Schizophrenia in adults & adolescents; Bipolar 1 in adults & children over 10; as an add-on to antidepressants for MDD in adults;

§2.2  Popular Off-Label Uses

Schizoaffective disorder, bipolar depression, monotherapy for depression-spectrum disorder, delusional disorders without psychoses, OCD, Parkinson’s.

More Abilify approved & off-label uses

§3.  When Will Abilify (aripiprazole) Start Working?

Faster than Seroquel, but slower than most other AAPs. I.e. 3–7 days, with 3 days more likely (but not always) when adding Abilify to an AD (or anything else) and 7 days more likely when using Abilify by itself.

§4.  Will Abilify Really Work for What You Have?

Given its activating nature, Abilify is probably more likely to work as an add-on to treat depression or bipolar disorder depression than as monotherapy for bipolar disorder. I don’t yet have enough data for schizophrenia, other than 5mg a day takes 3-5 weeks to start working, and only enough better than placebo to get approved by the FDA.

More about how long until, and how well will Abilify work; and how Abilify compares with other drugs

§5.  How to Take Abilify (aripiprazole)

As with many APs, BMS recommends you just start at the target dosage. That’s 10–15mg a day for Schizophrenia, 15mg a day for bipolar (as monotherapy), and 10–15mg a day for bipolar (when taken with Depakote or lithium). The maximum dosage is 30mg a day, and you should wait at least two weeks before increasing the dosage.
The only application where you start at a low dosage a move up is when you add it to an antidepressant (AD) for depression. That’s when they recommend you start at 2–5mg a day, work up to 5–10mg a day, and the maximum dosage is 15mg a day, and you should wait at least a week before increasing the dosage.
Our suggestion to discuss with your doctor: if you’re not crazy enough to be hospitalized, follow the instructions for using Abilify with an antidepressant even if you’re taking it for bipolar disorder or schizophrenia.

§6.  How to Stop Taking Abilify (aripiprazole)

With its long-ass half-lives, Abilify is a lot easier to discontinue than most meds, and severe rebound symptoms are less likely as well. Reduce your dosage by 5mg a day every 5–7 days. Every 3 days if you really need to withdraw faster than that.

More about taking and withdrawing Abilify

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§7.  Abilify (aripiprazole) Pros and Cons

§7.1  Pros

As it sort of acts as a Parkinson’s/RLS med, so you’re somewhat less likely to get a couple of the more annoying AP side effects - most movement disorders and those involving prolactin.
The anticholinergic side effects are also less likely than other APs.
The long half-lives of of Abilify and its active metabolite mean you don’t have to worry about a dosing schedule, and you can even take a tablet every other day.

§7.2  Cons

Since it kind of acts like a Parkinson’s/RLS med, you can get the oddball side effects of a Parkinson’s/RLS med, like pathological gambling. It also means you can’t take another dopamine agonist to deal with movement disorders and need to take a potent anticholinergic like Cogentin.
Abilify’s long-ass half-lives mean if you two don’t get along you can be stuck with the side effects for at least one, and possibly two weeks after you stop taking it.

§7.3  Interesting Stuff your Doctor Probably didn’t Tell You about Abilify (aripiprazole)

Abilify is the first third-generation antipsychotic (TGA) to hit the US market. TGAs are defined as being partial agonists at dopamine D₂ receptors, and that’s what makes them act sort of like Parkinson’s/RLS meds. So, unlike Zyprexa, Abilify doesn’t just mask movement disorders by being a potent anticholinergic, it tries to prevent them from happening in the first place.

§7.4  What Abilify (aripiprazole) Is Best Known for

The Hiccups of Death. AKA the Abilify Burp.
More pros, cons, and interesting stuff about Abilify

§8.  Abilify (aripiprazole) Side Effects

§8.1  Typical Abilify Side Effects

Headache. Agitation, akathisia (the inability to sit still), anxiety, insomnia, restlessness; unlike almost all other APs, Abilify is more likely to make you hyper instead of turning you into a zombie.
The Abilify Burp - a type of mild-to-moderate gastric reflux. You’ll know it when you taste it. Abilify has so many GI-related side effects that you might as well be taking valproic acid or felbamate.
These side effects are in the “Usually temporary, but they’ll flare up, especially when you change your dosage” category.

§8.2  Uncommon Abilify Side Effects

Blurred vision, mania (regardless of your being bipolar or not), teeth grinding & jaw clenching (but rarely progressing to TMJ like Lexapro), muscle aches, orthostatic hypotension (getting dizzy, feeling faint and nearly-to-actually passing out when you stand up).
Weight gain is a lot less likely than most APs, but Abilify can still hose your blood sugar, though.

§8.3  Freaky Rare Abilify Side Effects

Rabbit syndrome. Bone pain. Waxing-and-waning catatonia.
More Abilify side effects

§9.  What You Really Need to be Careful About with Abilify (aripiprazole)

Losing glycemic control and developing diabetes 2 even if you didn’t gain an ounce of weight.
More Abilify black box and other warnings, pregnancy category, etc.

§10.  Abilify (aripiprazole) Half-Life & How Long Until Abilify Clears Your System

Half-lives: 75 hours for Abilfy, 94 hours for its active metabolite. Clearance: 20 days!
Drugs.com’s drug-drug and drug-food interaction checker
More Abilify pharmacokinetics & noted drug-drug & drug-food interactions
Clearance given here is “plasma clearance,” or how long it takes to be out of your blood so there’s nothing swimming around to attach itself to your brain and start doing stuff. Complete clearance is a complex equation based on a lot of factors which may or may not be published in the PI sheet or even figured out by independent researchers. If we’ve found it and calculated it you’ll find that on the pharmacokinetics page.

§11.  How Abilify (aripiprazole) Works

the current best guess at any rate
Abilify is a moderate antagonist at the dopamine D₃ receptor and a potent antagonist at the serotonin 5-HT_2A receptors.
Like Seroquel, Geodon, and Clozaril (clozapine), Abilify is a partial agonist at serotonin 5-HT_1A receptors, but what makes it special (in the US, for now) is also being a partial agonist at the dopamine D₂ receptors. Blocking 5-HT_2A, and having a positive effect on 5-HT_1A and D₂ are responsible for fewer movement disorder and prolactin problems, and all those agitating/antsy/activating side effects.
More about how Abilify works. AKA Abilify mechanism/method of action, or pharmacodynamics.

§12.  Comments, Abilify PI Sheet, and More

In case you don’t watch enough TV, Bristol-Myers Squibb (BMS) is pushing Abilify as an add-on for your antidepressant (AD). Depression is a far more socially acceptable form of brain cooties than bipolar disorder and schizophrenia, so it’s no surprise that you’ll see way more ads about ADs than mood stabilizers. And recent approvals are always heavily advertized.
More comments As if I didn’t go on long enough here.
Abilify’s Full US Prescribing Information / PI Sheet
Consumer/patient comments about, reviews of, and experiences with Abilify
If you have any questions about Abilify (aripiprazole), please see the Crazy Meds’ Abilify (aripiprazole) discussion board
Allegedly Useful Links. Mostly official sites we could find for this med, PI sheets from countries other than the US, and reviews from consumer review sites.

Abilify Index | Brand and Generic Availability ›
Crazy Meds Comprehensive Abilify pages

Date created Tuesday, 29 November 2011 at 11:57:45 Page Author: Jerod Poore Last edited by: Jerod Poore on March 09, 2013, at 04:58 PM

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Abilify (aripiprazole) Overview by Jerod Poore is copyright 2011 Jerod Poore

Abilify is a trademark of someone else. Look on the the PI sheet or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing.

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¹ While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

² Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?
[begin rant] I rent a dedicated server for Crazy Meds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had the forerunner to QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]

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