aripiprazole ABILIFY

Class: Second Generation Antipsychotic/​arylpiperazine Quinolinone Derivative
FDA Indications: Schizophrenia, Tourette's Disorder, Acute Treatment Of Manic And Mixed Episodes Associated With Bipolar I, Adjunctive Treatment Of Major Depressive Disorder, Irritability Associated With Autistic Disorder
Off-Label Use: Anxiety, Alzheimers Disease Related Psychosis, Eating Disorders, Borderline Personality Disorder
Prescribing
Forms: 2, 5, 10, 15, 20, 30mg tablet; 10, 15mg ODT; 1 mg/mL po soln; 9.75 mg/1.3 mL IM
Dose Range: 2-30 mg/day
Starting: Start most patients at 10 mg QD to prevent agitation/akathisia, gradually increase to target dose of 15-30 mg QD.
Stopping: Taper 6-8 weeks, rapid d/c can lead to rebound psychosis
Monitoring:

NAMI drug fact sheet

Precautions
Serious Side Effects: , , ,
Possible Risk of TdP, Drugs to Avoid in Congenital Long QT
Side Effects: headache, sedation/somnolence, dizziness, nausea, insomnia, akathisia, anxiety, agitation, orthostatic hypotension, EPS, activation, dyspepsia
Pharmacodynamics
1° MOA: Partial dopamine agonist
Target: Partial agonist at D2 & 5HT1A, antagonism at 5HT2A
Pharmacokinetics
t½: 75° TMAX: 3-5°
Substrate of: 2D6, 3A4
Inhibits: 2D6, 3A4; Induces:
Active Metabolites: Dehydroaripiprazole (t½ ~90°)
DDIs
Misc
  • - probably most "activating" in its class
  • - minimal EPS compared to other antipsychotics
  • - lacks appreciable affinity at cholinergic muscarinic receptors
  • - minimal weight gain
  • - no prolactin elevation
  • - no significant ECG Δ's; the only SGA known to actually ↓ QTc (~ -1 to -4ms)
  • - no reported sexual side effects
Special Populations

Category CGDM may be a problem with all SGAs; may cause extrapyramidal and/or withdrawal symptoms in neonates with third trimester exposure

RID 0.9%


All atypicals may increase mortality in elderly patients by 1.7 times greater than placebo.

No dosage adjustment necessary.


No dosage adjustment necessary.

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Last updated January 20 2018 15:32:06. Disclaimer: This website does not provide medical advice, nor is it a substitute for clinical judgment.