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

> Abilify (aripiprazole) Overview


Abilify Article Index | Brand and Generic Availability

Brand & Generic Names; Drug Class

US brand name: Abilify
Generic name: aripiprazole
Drug Class: Antipsychotics
Learn More about Abilify’s Generic & Worldwide Availability

Abilify’s Approved & Off-Label Uses (Indications)

US FDA Approved Treatment(s)

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

Popular Off-Label Uses

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

Learn More about Abilify’s Approved & Off-label Uses

How Long Until Abilify Starts Working (Onset of Action)

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.

Likelihood of Working

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. This article shows 5mg a day takes 3-5 weeks to start working, and only enough better than placebo to get approved by the FDA. And that’s Seroquel territory of taking forever. Learn how Abilify Compares with Other Drugs

How to Take Abilify

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 by itself (or with another drug) for bipolar disorder or schizophrenia.


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How to Stop Taking Abilify (Discontinue, Withdrawal)

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. Learn More about Taking and Discontinuing Abilify

Abilify’s Pros and Cons

Pros

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.
  • That also means you can’t take another dopamine agonist to deal with AP-induced movement disorders. So if you do get EPS and want to keep taking Abilify, you’ll need to take a potent anticholinergic like Cogentin, and probably wind up getting anticholinergic side effects after all.
  • 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.

Interesting Stuff your Doctor Probably didn’t Tell You about Abilify

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.

Best Known for

The Hiccups of Death. AKA the Abilify Burp.
In-Depth Pros & Cons

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Abilify’s Side Effects (Adverse Reactions)

Typical 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.

Uncommon 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.

Freaky Rare Side Effects

Rabbit syndrome. Bone pain. Waxing-and-waning catatonia.
Learn More about Abilify’s Side Effects.
TMI at times


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What You Really Need to be Careful About

Losing glycemic control and developing diabetes 2 even if you didn’t gain an ounce of weight.

Abilify’s Black Box and Other Warnings, Pregnancy Category, etc.

Pharmacology

aripiprazole’s Half-Life & How Long Until It Clears Your System

Plasma half-life: Half-lives: 75 hours for Abilfy, 94 hours for its active metabolite. Clearance: 20 days!

aripiprazole’s Pharmacokinetics Information Overload

Half-life is the average time it takes for you to process half of the drug’s active ingredient. If a drug has a half-life of around 24 hours and you take a dose of 100mg, you’ll have roughly the equivalent a 50mg dose after one day, a 25mg dose after two days, and so on. The rule of thumb is: multiply the half-life by five and you get how long it is for the dose you took to be cleared from your bloodstream, so there’s nothing swimming around to attach itself to your brain and start doing stuff1. That’s called “plasma clearance.” Complete clearance is a complex equation based on a lot of factors which may or may not: be published in the PI sheet, include personal data like your weight, or even completely figured out by corporate and independent researchers. It usually winds up being 2–5 days after plasma clearance no matter what2, but can take weeks. Sometimes a drug will clear from your brain and other organs before it clears from your blood. If we’ve found the complete clearance, or how to calculate it if it requires things like your weight and what your piss looks like, you’ll find that on aripiprazole’s pharmacokinetics page.

How 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-HT2A receptors.

Like Seroquel, Geodon, and Clozaril (clozapine), Abilify is a partial agonist at serotonin 5-HT1A receptors, but what makes it special (in the US, for now) is also being a partial agonist at the dopamine D2 receptors. Blocking 5-HT2A, and having a positive effect on 5-HT1A and D2 are responsible for fewer movement disorder and prolactin problems, and all those agitating/antsy/activating side effects.

Learn More than You Probably Ever Wanted to Know about How aripiprazole Works
AKA mechanism/method of action, pharmacodynamics

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Ratings, Reviews, Comments, PI Sheet, and More

Abilify Comments

In case you don’t watch enough TV, Bristol-Myers Squibb (BMS) is pushing Abilify as an add-on for your antidepressant (AD). The ads use wearing a bathrobe all day as a metaphor for depression. 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.
Extended Comments
As if I didn’t go on long enough already.

Abilify Ratings & Reviews, and Consumer Comments & Experiences

Rate Abilify

Give your overall impression of Abilify on a scale of 0 to 5. Detailed ratings and reviews are available on the Abilify Ratings & Reviews Page.

Get all critical about Abilify

3 stars Rating 2.9 out of 5 from 216 criticisms.
Vote Distribution: 43 – 14 – 23 – 21 – 57 – 58


Rate this article

If you’re still feeling judgmental as well as just mental3, please boost or destroy my self-confidence by honestly (and anonymously) rating this article on a scale of 0 to 5. The more value-judgments the better, even if you can criticize my work only once.

Get all judgmental about the Abilify (aripiprazole) Overview

4 stars Rates 3.8 out of 5 from 110 value judgments.
Vote Distribution: 5 – 6 – 2 – 7 – 46 – 44


Allegedly Useful Links. Mostly official sites, PI sheet-equivalents4 from countries other than the US, and reviews from other consumer review sites.

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It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on the Faecesbooks.



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Abilify Article Index | Brand and Generic Availability

1 Based on Julien's calculations from A Primer of Drug Action, the half-life multiplied by five is the generally accepted estimate of how long it takes a single dose of any given drug to be eliminated from the blood stream/plasma of someone with a normal metabolism. That's also the rough estimate for steady stage if they can't get, or won't provide a number for that.

2 For crazy meds. I have no idea what the average complete clearance is for other types of medications. For all I know there are drugs that utterly vanish from your system in under five passes, and others that won't let go of your squishy bits for years after you stop taking them.

3 Thank you! I'll be here all weak. Be sure to tip your content provider. And don't try the veal, it's cruelicious!

4 These include: Canada's Product Monographs (PM), New Zealand's Medicine Data Sheets (MDS), the EU's European Public Assessment Reports (EPAR), and the Summary of Product Characteristics (SPC) used in Britain, Ireland, and many other places.


If you have any questions not answered here, please see the Crazymeds Abilify discussion board. We welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why we write these damn things. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds. — Jerod Poore, CME, Publisher Crazymeds (crazymeds.us)


Last modified on Wednesday, 26 March, 2014 at 01:04:00 by SomeMedCriticPage Author Date created Tuesday, 29 November 2011 at 11:57:45
“Abilify (aripiprazole): a Synopsis for the Educated Consumer.” by Jerod Poore is copyright © 2011 Jerod Poore Published online 2011/11/29
Citation options to copy & paste into your article:
Plain text:Poore, Jerod. “Abilify (aripiprazole): a Synopsis for the Educated Consumer.” Crazymeds (crazymeds.us). (2011).
with Microdata: <span itemprop='citation'>Poore, Jerod. "Abilify (aripiprazole)." <em>Crazymeds (crazymeds.us)</em>.(2011).</span>
Linked:<a href="http://scholar.google.com/citations?user=5rkux7sAAAAJ&hl=en&oi=sra">Poore, Jerod</a>. <a href='http://www.crazymeds.us/pmwiki/pmwiki.php/Meds/Abilify'>"Abilify (aripiprazole): a Synopsis for the Educated Consumer."</a>. <a href="http://www.crazymeds.us/pmwiki/pmwiki.php/Main/HomePage"> <em>Crazymeds (crazymeds.us)</em></a>. (2011).
with Microdata:<span itemprop='citation'> <a href="http://scholar.google.com/citations?user=5rkux7sAAAAJ&hl=en&oi=sra">Poore, Jerod</a>. <a href='http://www.crazymeds.us/pmwiki/pmwiki.php/Meds/Abilify'>"Abilify (aripiprazole): a Synopsis for the Educated Consumer."</a>. <a href="http://www.crazymeds.us/pmwiki/pmwiki.php/Main/HomePage"> <em>Crazymeds (crazymeds.us)</em></a>. (2011).</span>

Abilify, and all other drug names on this page and used throughout the site, are a trademark of someone else.

will probably have the name of the manufacturer and trademark owner (they’re not always the same company) at or near the very bottom. 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. It may of changed hands by the time you finished reading this article.




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Almost all of the material on this site is by Jerod Poore and is copyright © 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, and 2014 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.



All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else. Plus we are big pottymouths and talk about S-E-X a lot.
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Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained through our personal experience and the experiences family, friends, what people have reported on various reputable sites all over teh intergoogles, the medications’ product information / summary of product characteristic (PI/SPC) sheets, and from sources that are referenced throughout the site. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
Very little information about visitors to this site is collected or saved. From time to time I look at search terms used and which pages they bring up in an effort to make the information I present more relevant. And the country of origin, just because I’m geeky like that. That’s about it. Depending on how you feel about Schrodinger, our privacy policy should either assuage or exacerbate your paranoia.
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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.

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3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas? I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion of anonymity. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.

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